One-year refractive results, contrast sensitivity, high-order aberrations and complications after myopic small-incision lenticule extraction (ReLEx SMILE)

Graefes Arch Clin Exp Ophthalmol. 2014 May;252(5):837-43. doi: 10.1007/s00417-014-2608-4. Epub 2014 Mar 20.

Abstract

Background: To report one year results of the first cohort of routine refractive lenticule extraction through a small incision (ReLEx SMILE) for correction of myopia and myopic astigmatism.

Methods: Fifty-four eyes of 27 patients with spherical equivalent of -4.68 ± 1.29D who underwent routine ReLEx SMILE by a single surgeon were prospectively followed-up for 1 year. We used the VisuMax femtosecond laser system (Carl Zeiss Meditec AG, Germany) with a 500 kHz repetition rate. Folow-up intervals were at 1 day, 1 week, 1, 3, 6, and 12 months after surgery. We obtained following parameters: uncorrected (UDVA) and distance-corrected visual acuity (CDVA), contrast sensitivity, and wave front measurements. We also recorded all complications.

Results: Because of suction loss in one eye, 12-month results were obtained in 53 eyes as follows. After 1 year, 88% of eyes with plano target had an UDVA of 20/20 or better. Twelve percent of eyes lost 1 line of CDVA, while 31% gained 1 line and 3% gained 2 lines. The mean SE after 1 year was -0.19 ± 0.19. The mean refraction change between month 1 and 12 was 0.08 D. Neither mesopic nor photopic contrast sensitivity showed any significant changes. The high-order aberrations (HOA) increased from 0.17 to 0.27 μm (Malacara notation). No visually threatening complications were observed.

Conclusion: In this first cohort, ReLEx SMILE produced satisfactory refractive outcomes with moderate induction of HOA and unaffected contrast sensitivity after 1 year.

MeSH terms

  • Adult
  • Astigmatism / physiopathology
  • Astigmatism / surgery
  • Contrast Sensitivity / physiology*
  • Corneal Stroma / surgery
  • Corneal Surgery, Laser / methods*
  • Corneal Topography
  • Corneal Wavefront Aberration / physiopathology*
  • Female
  • Humans
  • Lasers, Excimer / therapeutic use*
  • Learning Curve
  • Male
  • Microsurgery / methods
  • Myopia / physiopathology
  • Myopia / surgery*
  • Postoperative Complications*
  • Prospective Studies
  • Surgical Flaps
  • Visual Acuity / physiology*
  • Young Adult