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Klokova OA, Sakhnov SN, Geydenrikh MS, Damashauskas RO. Quality of life after refractive surgery: ReLEx SMILE vs Femto-LASIK. Clin Ophthalmol 2019; 13:561-570. [PMID: 30988598 PMCID: PMC6440445 DOI: 10.2147/opth.s170277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The safety and effectiveness of complex myopic astigmatism correction using ReLEx SMILE or Femto-LASIK techniques have been well established. The purpose of the current study is to compare quality of life (QoL) outcomes following ReLEx SMILE or Femto-LASIK procedures in parallel with functional vision and anatomic outcomes of treated eyes. Patients and methods This prospective, consecutive series included 118 patients, 18–43 years of age, out of which 56 underwent ReLEx SMILE and 62 underwent Femto-LASIK surgery for correction of myopic astigmatism. All patients underwent standard comprehensive ophthalmic examinations, and additionally, completed The Quality of Life Impact of Refractive Correction Questionnaire to determine the impact the vision-correction treatment had on their QoL. Results In both treatment groups, the postoperative refractive outcomes were comparable, with visual acuity improvements for both groups noted the day following surgery. After laser correction of complex myopic astigmatism using Femto-LASIK and ReLEx SMILE methods, the overall QoL indicators are statistically significant (P<0.01) exceeding preoperative values 1 month after the operation and reaching the maximum values by the end of the observation period (P<0.0001). Conclusion The results of the study suggest that patients require some time to adapt to their new visual function and its impact on their daily living, delaying detectable improvements in QoL. Moreover, these results may suggest a higher satisfaction trend and long-term QoL in patients undergoing ReLEx SMILE in comparison to Femto-LASIK. Long-term results from the study demonstrated high patient satisfaction with both methods.
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Han T, Zheng K, Chen Y, Gao Y, He L, Zhou X. Four-year observation of predictability and stability of small incision lenticule extraction. BMC Ophthalmol 2016; 16:149. [PMID: 27577086 PMCID: PMC5006606 DOI: 10.1186/s12886-016-0331-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate long-term refractive outcomes, wavefront aberrations and quality of life after small incision lenticule extraction (SMILE) for moderate to high myopia. METHODS A total of 26 patients (47 eyes) with preoperative mean spherical equivalent (SE) of -6.30 ± 1.47 diopters (D) who underwent SMILE were recruited. The measurements included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, wavefront aberrations, and quality of life. RESULTS At 4 years postoperatively, UDVA was better than or equal to 20/20 in 92 % of eyes. The efficacy index was 1.07 ± 0.16. 89 % of eyes were within ± 0.5 D of the intended refractive target. No eye lost any Snellen lines. The safety index was 1.16 ± 0.14. No significant changes of SE occurred among postoperative follow-ups at months 1, 3, 6 and years 1, 2, 4 (P > 0.05, Scheffe test). Higher-order aberrations, coma, spherical aberration and higher-order astigmatism increased postoperatively, and no significant changes of aberrations were detected among the 1-month, 6-month or 4-year follow-ups postoperatively (37 eyes). Compared to the spectacles group, the surgery group showed a significantly higher total score on quality of life (45.71 ± 2.61 vs 39.96 ± 3.56, P < 0.001). CONCLUSIONS SMILE provides a predictable and stable correction of moderate to high myopia as documented by long-term follow-up.
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Affiliation(s)
- Tian Han
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Ke Zheng
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Yingjun Chen
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China
| | - Yang Gao
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Li He
- Department of Ophthalmology, UruTmqi Eye and ENT Hospital, No.387 Zhongshan Road, Urumqi, Xinjiang, China
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital of Fudan University, No.19 Baoqing Road, Xuhui District, Shanghai, China.
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Ang M, Ho H, Fenwick E, Lamoureux E, Htoon HM, Koh J, Tan D, Mehta JS. Vision-related quality of life and visual outcomes after small-incision lenticule extraction and laser in situ keratomileusis. J Cataract Refract Surg 2016; 41:2136-44. [PMID: 26703289 DOI: 10.1016/j.jcrs.2015.10.049] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/20/2015] [Accepted: 02/22/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare vision-related quality of life (VRQoL) scores and clinical outcomes between small-incision lenticule extraction and laser in situ keratomileusis (LASIK). SETTING Singapore National Eye Centre, Singapore. DESIGN Prospective study. METHODS Patients had small-incision lenticule extraction using the Visumax 500 kHz femtosecond laser; or LASIK excimer ablation with the Wavelight Allegretto 400 Hz laser. Primary outcomes were 3-month predictability, efficacy, and safety. Secondary outcomes were intraoperative experience, visual symptoms, and VRQoL (validated Quality of Life Impact of Refractive Correction [QIRC] questionnaire) in 25 a subgroup of patients in each group. Following Rasch analysis, "Functional" and "Emotional," QIRC dimensions were analysed separately. RESULTS At 3 months, predictability (82.5% versus 85.3%, ±0.5 diopters attempted correction, P =.453), safety index (1.13 ± 0.19 [SD] versus 1.07 ± 0.16, P = .158), and efficacy index (0.91 ± 0.21 versus 0.97 ± 0.19; P = .002) were found when comparing small-incision lenticule extraction (172 eyes) and LASIK (matched 688 eyes). Intraoperative experience between groups was not statistically different; visual fluctuations (P = .020) and episodes of visual blurring (P = .008) were greater after small-incision lenticule extraction than after LASIK at 1 month but not at 3 months. There was no difference in "functional" (66.7 ± 15.7 versus 55.3 ± 22.2, P = .064) and "emotional" (42.7 ± 23.2 versus 37.9 ± 23.8, P = .394) QIRC dimensions between the 2 groups (25 patients in each group) at 3 months. CONCLUSION The study, 3-month predictability, safety, and VRQL scores were not statistically different between small-incision lenticule extraction and LASIK. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Marcus Ang
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Henrietta Ho
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Eva Fenwick
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Ecosse Lamoureux
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Hla M Htoon
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Jane Koh
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Donald Tan
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia
| | - Jodhbir S Mehta
- From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
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Ma J, Cao NJ, Xia LK. Efficacy, safety, predictability, aberrations and corneal biomechnical parameters after SMILE and FLEx: Meta-analysis. Int J Ophthalmol 2016; 9:757-62. [PMID: 27275436 DOI: 10.18240/ijo.2016.05.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/30/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To identify possible differences of efficacy, safety, predictability, higher-order aberrations and corneal biomechnical parameters after small-incision lenticule extraction (SMILE) and femtosecond lenticule extraction (FLEx). METHODS A systematic literature retrieval was conducted in Medline, Embase and the Cochrane Library, up to October, 2015. The included studies were subject to a Meta-analysis. Comparison between SMILE and FLEx was measured as pooled odds ratio (OR) or weighted mean differences (WMD). Of 95% confidence intervals (CI) were used to analyze data. RESULTS A total of seven studies were included. Firstly, there were no differences in uncorrected distance visual acuity (UDVA) 20/20 or better (OR, 1.37; 95% CI, 0.69 to 2.69; P=0.37) and logMAR UDVA (WMD, -0.02; 95% CI, -0.05 to 0.01; P=0.17) after SMILE versus FLEx. We found no differences in corrected distance visual acuity (CDVA) unchanged (OR, 0.98; 95% CI, 0.46 to 2.11; P=0.97) and logMAR CDVA (WMD, -0.00; 95% CI, -0.01 to 0.01; P=0.90) either. Secondly, we found no differences in refraction within ±1.00 D (OR, 0.98; 95% CI, 0.13 to 7.28; P=0.99) and ±0.50 D (OR, 1.62; 95% CI, 0.62 to 4.28; P=0.33) of target postoperatively. Thirdly, for higher-order aberrations, we found no differences in the total higher-order aberrations (WMD, -0.04; 95% CI, -0.09 to 0.01; P=0.14), coma (WMD, -0.04; 95% CI, -0.09 to 0.01; P=0.11), spherical (WMD, 0.01; 95% CI, -0.02 to 0.03; P=0.60) and trefoil (WMD, -0.00; 95% CI, -0.04 to 0.03; P=0.76). Furthermore, for corneal biomechanical parameters, we also found no differences (WMD, 0.08; 95% CI, -0.17 to 0.33; P=0.54) after SMILE versus FLEx. CONCLUSION There are no statistically differences in efficacy, safety, predictability, higher-order aberrations and corneal biomechnical parameters postoperative between SMILE and FLEx.
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Affiliation(s)
- Jing Ma
- Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Nan-Jue Cao
- Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Li-Kun Xia
- Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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