Simulated night vision after small-incision lenticule extraction.

PURPOSE: To describe simulated night vision, night-vision symptoms, and refractive outcomes after small-incision lenticule extraction.

SETTING: Tertiary referral eye center, Singapore.

DESIGN: Prospective case series.

METHODS: All patients had small-incision lenticule extraction using the Visumax 500 kHz femtosecond laser system. The main outcome measure was simulated night vision logMAR corrected distance visual acuity (CDVA) using the super vision test-night vision goggle vision chart at 12 months. Secondary outcomes measures included refractive outcomes (ie, efficacy, predictability, and safety) up to 12 months and vision-related symptoms assessed using a validated questionnaire.

RESULTS: The study comprised 50 eyes. Overall simulated night vision was not affected (mean CDVA 0.08 logMAR ± 0.1 [SD], P = .67; mean mesopic CDVA -0.02 ± 0.1 logMAR, P = .58) after small-incision lenticule extraction at the 12-month follow-up. In low myopia, simulated night vision improved from preoperatively (mean 0.099 ± 0.07) to 12 months postoperatively (mean 0.006 ± 0.09) (P = .008). Most patients reported mild or no night-vision symptoms 3 months after surgery (score range 1.6 to 2.2). At 12 months, the overall efficacy index was 0.98 ± 0.20, with 100% of eyes attaining an uncorrected visual acuity of 20/40 or better and 86% attaining 20/20 or better. Ninety-four percent eyes were within ±1.0 diopter of the attempted correction, and the overall safety index was 1.17 ± 0.17.

CONCLUSION: Small-incision lenticule extraction did not affect simulated night vision or contrast sensitivity, with patients reporting no or mild night-vision symptoms.

FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.