Comparison between aberration-free transepithelial photorefractive keratectomy and small incision lenticule extraction f
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ORIGINAL PAPER
Comparison between aberration-free transepithelial photorefractive keratectomy and small incision lenticule extraction for correction of myopia and myopic astigmatism Zhiyuan Zheng . Mingzhi Zhang . Vishal Jhanji . Lixia Sun . Jinyu Li . Riping Zhang
Received: 14 February 2020 / Accepted: 29 August 2020 Springer Nature B.V. 2020
Abstract Purpose To evaluate the clinical outcomes of small incision lenticule extraction (SMILE) and aberrationfree transepithelial photorefractive keratectomy (AF t-PRK) in patients with low to moderate myopic astigmatism, including visual acuity, refractive outcomes, astigmatic vector analysis and corneal aberrometric changes. Method This retrospective comparative case series study involved 110 right eyes of 110 patients who underwent either SMILE (55 eyes) or AF t-PRK (55 eyes). Visual acuity, manifest refractive error and corneal higher-order aberrations (HOAs) were measured and analyzed at baseline, 1 month and 3 months after operation. The safety and efficacy indices, and vector parameters were also compared. Result 1 month postoperatively, the mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) and spherical equivalent refraction (SE) were better after SMILE than AF t-PRK (logMAR UDVA, - 0.03 ± 0.07 and
- 0.006 ± 0.07, P = 0.050; logMAR CDVA, - 0.06 ± 0.07 and - 0.03 ± 0.07, P = 0.043; SE, - 0.04 ± 0.25 and 0.15 ± 0.26, P \ 0.001). However, these parameters were comparable between the groups at 3 months after surgery. Residual astigmatism B 0.25 diopters was observed in 74.5% and 90.9% (P = 0.023) of the eyes at one month and in 87.3% and 85.5% (P = 0.781) of the eyes at 3 months after SMILE and AF t-PRK, respectively. There were no significant differences between the groups in any of the vector parameters at 1 month or 3 months after surgery. Coma and total HOAs after SMILE were significantly higher than AF t-PRK (1 month coma, 0.49 ± 0.23 and 0.29 ± 0.15, P \ 0.001; 1 month total RMS HOAs, 0.65 ± 0.20 and 0.54 ± 0.14, P = 0.001; 3 months coma, 0.50 ± 0.22 and 0.30 ± 0.17, P \ 0.001; 3 months total RMS HOAs, 0.68 ± 0.20 and 0.55 ± 0.17, P \ 0.001). Conclusion In this study, both SMILE and AF t-PRK were effective and comparable for correction of low to moderate myopic astigmatism. AF t-PRK group induced less coma and total HOAs than SMILE.
Z. Zheng M. Zhang V. Jhanji L. Sun J. Li R. Zhang (&) Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, China e-mail: [email protected]
Keywords Small incision lenticule extraction (SMILE) Transepithelial photorefractive keratectomy (t-PRK) Aberration-free profile Wavefront-optimized Astigmatism Corneal higherorder aberrations (HOAs)
V. Jhanji Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Int Ophthalmol
Introduction
Patients and methods
Small incision lenticule extraction (SMILE) has gained popularity i
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