J Refract Surg. 2014 Sep;30(9):590-6. doi: 10.3928/1081597X-20140814-02.
To compare the visual and refractive out-comes of femtosecond laser-assisted LASIK with small-incision lenticule extraction (SMILE) in terms of visual acuity, contrast sensitivity, aberrations, and dry eye.
A single-center prospective randomized study in which patients diagnosed as having myopia presenting for refractive correction were allocated to either a LASIK or SMILE group. The primary outcome measures were refractive efficacy, predictability, and safety, postoperative contrast sensitivity, aberrations, and dry eye status. Patients were followed up at days 1 and 15 and 3 months; postoperative uncorrected visual acuity (UCVA), aberrations, dry eye, and contrast sensitivity were recorded and compared to preoperative data. Two postoperative subjective questionnaires were used to assess pain, pricking sensation, redness, glare, and overall patient satisfaction.
At day 1 postoperatively, 48 (96%) of 50 eyes in the SMILE group achieved a UCVA of 20/20 compared with 46 (92%) of 50 eyes in the LASIK group. At day 15 postoperatively, contrast sensitivity was similar in the two groups (P = .15), but by 3 months, it was better in the SMILE group than the LASIK group at all spatial frequencies (P < .0001). At 3 months postoperatively, 42 (84%) eyes in each group achieved a UCVA of 20/20, with 6 (12%) eyes in the SMILE group and 2 (4%) eyes in the LASIK group achieving 20/15. Higher-order aberrations at 3 months postoperatively were significantly higher in the LASIK group (0.437 + 0.103 pm) than in the SMILE group (0.267 + 0.07 pm; P < .001). Postoperative dry eye and glare were significantly more common following LASIK (P < .001).
Three-month results demonstrate that refractive accuracy, dry eye, contrast, and induced aberrations are better following SMILE rather than LASIK.
比较飞秒激光辅助 LASIK 与小切口微透镜提取 (SMILE) 在视力、对比敏感度、像差和干眼症方面的视觉和屈光结果。
这是一项单中心前瞻性随机研究，将诊断为近视并接受屈光矫正的患者分配到 LASIK 或 SMILE 组。主要观察指标为屈光疗效、可预测性和安全性、术后对比敏感度、像差和干眼症状况。患者在第 1 天、第 15 天和第 3 个月进行随访，记录并比较术后未矫正视力 (UCVA)、像差、干眼症和对比敏感度。使用两个术后主观问卷评估疼痛、刺痛感、发红、眩光和整体患者满意度。
术后第 1 天，SMILE 组 50 只眼中有 48 只 (96%)达到 UCVA 20/20，而 LASIK 组 50 只眼中有 46 只 (92%)。术后第 15 天，两组对比敏感度相似 (P =.15)，但 3 个月时，SMILE 组在所有空间频率均优于 LASIK 组 (P <.0001)。术后 3 个月，每组 42 只 (84%)眼达到 UCVA 20/20，SMILE 组有 6 只 (12%)眼和 LASIK 组有 2 只 (4%)眼达到 20/15。术后 3 个月，LASIK 组高阶像差 (0.437 + 0.103 pm)显著高于 SMILE 组 (0.267 + 0.07 pm；P <.001)。术后干眼症和眩光在 LASIK 后更为常见 (P <.001)。
3 个月的结果表明，SMILE 术后的屈光准确性、干眼症、对比敏感度和诱导像差均优于 LASIK。
