Five-year outcomes of small-incision lenticule extraction vs femtosecond laser-assisted laser in situ keratomileusis: a contralateral eye study.

PURPOSE: To compare the long-term refractive and visual outcomes and the corneal higher-order aberrations of contralateral eyes of patients who received small-incision lenticule extraction (SMILE) in one eye and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in the other eye.

SETTING

Refractive Surgery Clinic of the University of Health Sciences Beyoğlu Eye Training and Research Hospital, Istanbul, Turkey.

DESIGN

Retrospective case series.

METHODS

The medical files of patients who received SMILE in one eye and FS-LASIK in the contralateral eye for myopia and myopic astigmatism were reviewed. Postoperative examinations at 1 year, 3 years, and 5 years were evaluated. The main outcome measures were the comparison of the refractive and visual outcomes and the effect on corneal higher-order aberrations between the procedures.

RESULTS

This study included 44 eyes from 22 patients. At the 5-year follow-up, the mean uncorrected distance visual acuity improved to 0.03 ± 0.06 and 0.02 ± 0.05 logarithm of the minimum angle of resolution (range 0.15 to -0.08 and 0.10 to -0.08) for SMILE and FS-LASIK groups, respectively. There was no statistically significant difference between the groups (P = .572). At 5 years, all eyes in both groups were within ±1.00 diopter of attempted spherical equivalent refraction, and no statistically significant difference was found between the intended and achieved correction comparing the groups at any time points. None of the aberrations showed a difference between the groups at any time.

CONCLUSIONS

Both SMILE and FS-LASIK were safe and similar in terms of efficacy and predictability at long-term follow-up for the correction of myopia and myopic astigmatism.