Vision-related quality of life and visual outcomes after small-incision lenticule extraction and laser in situ keratomileusis

J Cataract Refract Surg. 2015 Oct;41(10):2136-44. doi: 10.1016/j.jcrs.2015.10.049.

Abstract

Purpose: To compare vision-related quality of life (VRQoL) scores and clinical outcomes between small-incision lenticule extraction and laser in situ keratomileusis (LASIK).

Setting: Singapore National Eye Centre, Singapore.

Design: Prospective study.

Methods: Patients had small-incision lenticule extraction using the Visumax 500 kHz femtosecond laser; or LASIK excimer ablation with the Wavelight Allegretto 400 Hz laser. Primary outcomes were 3-month predictability, efficacy, and safety. Secondary outcomes were intraoperative experience, visual symptoms, and VRQoL (validated Quality of Life Impact of Refractive Correction [QIRC] questionnaire) in 25 a subgroup of patients in each group. Following Rasch analysis, "Functional" and "Emotional," QIRC dimensions were analysed separately.

Results: At 3 months, predictability (82.5% versus 85.3%, ±0.5 diopters attempted correction, P =.453), safety index (1.13 ± 0.19 [SD] versus 1.07 ± 0.16, P = .158), and efficacy index (0.91 ± 0.21 versus 0.97 ± 0.19; P = .002) were found when comparing small-incision lenticule extraction (172 eyes) and LASIK (matched 688 eyes). Intraoperative experience between groups was not statistically different; visual fluctuations (P = .020) and episodes of visual blurring (P = .008) were greater after small-incision lenticule extraction than after LASIK at 1 month but not at 3 months. There was no difference in "functional" (66.7 ± 15.7 versus 55.3 ± 22.2, P = .064) and "emotional" (42.7 ± 23.2 versus 37.9 ± 23.8, P = .394) QIRC dimensions between the 2 groups (25 patients in each group) at 3 months.

Conclusion: The study, 3-month predictability, safety, and VRQL scores were not statistically different between small-incision lenticule extraction and LASIK.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Corneal Stroma / surgery*
  • Female
  • Health Status Indicators
  • Humans
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer / therapeutic use*
  • Male
  • Microsurgery / methods
  • Myopia / physiopathology
  • Myopia / psychology
  • Myopia / surgery*
  • Prospective Studies
  • Quality of Life / psychology*
  • Refraction, Ocular / physiology
  • Surgical Flaps
  • Surveys and Questionnaires
  • Visual Acuity / physiology*