Abstract
Purpose :
Previous studies have shown similar efficacies of laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE), however, prospective, comparative trials evaluating the quality of vision to include: satisfaction with vision, and visual symptoms are limited. This study evaluates and compares quality of vision as determined by the validated PROWL (Patient Reported Outcomes with LASIK) questionnaire in eyes that have undergone LASIK versus SMILE surgery.
Methods :
This is a prospective study with 26 of 50 patients enrolled to date. Eyes of each patient were randomized to receive either Wavefront-guided (WFG) LASIK or SMILE surgery with the contralateral eye receiving the alternate surgery. Primary outcome measures include responses to the PROWL questionnaire focusing on the preferred eye, difficulty with activities of daily living, presence and symptomatic level of glare, halos, and starbursts. Secondary outcome measures include visual acuity and refraction measurements.
Results :
We analyzed 26 eyes treated with WFG LASIK and 26 eyes treated with SMILE. Eyes treated with WFG LASIK were preferred over eyes treated with SMILE at post-operative month one (93%), three (62%), and six (60%) (Figure 1). Both groups showed a reduction in difficulties with activities of daily living by 15.6% (LASIK) and 12.8% (SMILE) at postoperative month twelve. Presence and bothersomeness of glare, halos, and starbursts increased at postoperative month one in both groups and returned to baseline preoperative levels by postoperative month twelve (Figure 2). Manifest spherical equivalent averaged -0.18 diopters in the WFG LASIK group and -0.15 diopters in the SMILE group at postoperative month twelve.
Conclusions :
WFG LASIK and SMILE surgery resulted in excellent predictability in both groups. Overall, eyes treated with WFG LASIK resulted in faster visual recovery. Quality of vision is preferred in eyes with LASIK compared to those with SMILE. Presence and symptomatic level of glares, halos or starbursts may be more severe (p>0.05) in SMILE early on the postoperative course. Study enrollment is ongoing. This study demonstrates that the characterization of quality of vision in LASIK and SMILE remain essential in the counseling of patients undergoing corneal refractive surgery.
This is a 2020 ARVO Annual Meeting abstract.