Initial experience with Small Incision Lenticule Extraction (SMILE) to treat myopic refractive error and comparison with LASIK : CPD : SMILE to treat myopic refractive error

Purpose: To present our initial experience with Small Incision Lenticule Extraction (SMILE) and compare it to a matched sample of patients that underwent wavefront-guided femtosecond LASIK. Methods: In this study, we evaluated 121 eyes (61 patients) that underwent SMILE formyopia/myopic astigmatism. The mean pre-operative sphere ranged between -0.75 and -7.50 D (mean -3.21 D) and the pre-operative cylinder ranged between 0.0 and -4.75 D(mean: -0.75 D). Visual and refractive outcomes and patient satisfaction was assessed in this study, and compared to a cohort of LASIK patients (390 eyes of 200 patients). Results: Three months post-operatively, the mean post-operative spherical equivalent reduced to -0.03 ± 0.37 D. Of all SMILE eyes, 93.4% were within 0.50 D of emmetropia and 96.7% were within 1.00 D. The percentage of eyes achieving 20/20 or better uncorrected distance visualacuity 3 months post-operatively was 76.2% for SMILE patients and 94.3% for LASIK patients (p<0.01). There was no statistically significant difference in post-operative satisfaction, severity of starburst, glare, halos, ghosting/double vision or dry eye symptoms between the two groups. Conclusion: SMILE is a promising refractive surgery for the future; however, in our sample of patients, LASIK had better uncorrected visual acuity at early post-operative visits.