Visual recovery after small incision lenticule extraction (SMILE) in relation to pre-operative spherical equivalent
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REFRACTIVE SURGERY
Visual recovery after small incision lenticule extraction (SMILE) in relation to pre-operative spherical equivalent Eugene Tay 1
&
Ram Bajpai 2
Received: 13 August 2020 / Revised: 16 September 2020 / Accepted: 25 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To assess visual recovery after small incision lenticule extraction (SMILE) in relation to pre-operative spherical equivalent. Methods Two hundred fourteen eyes of 107 patients were enrolled. Following surgery, patients were examined pre-operatively, 1 day, 2 weeks, 1 month and 3 months later. High myopia was defined as pre-operative spherical equivalent ≤ − 5 D. A linear mixed-effects model was used. Results Mean ± standard deviation pre-operative spherical equivalent was − 5.30 ± 1.36 D that reduced significantly to 0.04 ± 0.70 D (p < 0.001) at 1 month and − 0.02 ± 0.66 D (p < 0.001) at 3 months. Mean pre-operative LogMAR uncorrected distance visual acuity ± SD was 0.97 ± 0.09 that improved significantly to 0.04 ± 0.06 at 2 weeks (p < 0.001), 0.01 ± 0.04 at 1 month (p < 0.001) and 0.01 ± 0.04 at 3 months (p < 0.001). Eighty-eight eyes (41.2%) had uncorrected distance visual acuities of 0.0 at 1 day, 154 eyes (72.0%) at 2 weeks,194 eyes (90.7%) at 1 month and 199 eyes (93.0%) at 3 months. Significantly more eyes with low myopia (> − 5 D) achieved acuities of 0.0 at 1 day and 2 weeks (p = 0.041 and p < 0.001). Post-operative acuities were not associated with refractive targets, laser cut energy settings or other variables. Two hundred nine eyes (97.7%) were within ± 0.5 D of target and 213 eyes (99.5%) were within ± 1 D. Conclusions SMILE for low myopia had faster visual recovery in the early post-operative period with no significant differences between groups detected by 1 and 3 months. Keywords SMILE . Visual recovery . Spherical equivalent
Key messages Delayed visual recovery may occur after SMILE surgery and adversely affect patient satisfaction. Previous research has identified non-patient factors such as energy settings, laser profiles and surgical techniques as possible causes. A previous study suggested that lower myopic treatments had faster visual recovery but follow up was limited and extended to only 1 month after surgery with small patient numbers. Our larger study of 214 eyes had a longer follow up period of 3 months. We demonstrated that visual recovery after low myopic SMILE treatments of > -5 D was faster with significantly more eyes achieving UDVAs of 0.0 logMAR at 1 day and 2 weeks post-operatively. There were no significant differences in mean UDVA between low and high myopia treatment groups at 1 and 3 months after surgery. Other patient and non-patient variables were not found to be significantly associated with post-operative UDVA.
* Eugene Tay [email protected] 1
Singapore Eye Research Institute, The Academia, 20 College Road, Singapore 169856, Singapore
2
School of Primary, Community and Social Care, Keele University, Keele, Staffordshire ST5 5BG, UK
Grae
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