Control-matched comparison of refractive and visual outcomes between small incision lenticule extraction and femtosecond laser-assisted LASIK.

Purpose: This retrospective case-matched study aimed to compare visual and refractive outcomes between small incision lenticule extraction (SMILE) and LASIK.

Patients and methods: Patients who underwent SMILE (34 eyes of 23 patients) or LASIK (34 eyes of 24 patients) were enrolled and matched according to preoperative manifest refractive spherical equivalents. The mean preoperative manifest refractive spherical equivalent was -4.69±0.6 and -4.67±0.64 D in the SMILE and LASIK groups, respectively. The safety, efficacy, and predictability were compared 3 months after surgery. Changes in corneal refractive power from the center to peripheral points and their maintenance ratios were analyzed and compared between the two groups.

Results: In the SMILE and LASIK groups, 82.4% and 85.3% of patients, respectively, achieved 20/13 or better uncorrected distance visual acuity ( p =1.00). There were no eyes that lost two or more lines of corrected distance visual acuity in either group. The maintenance ratios of corneal refractive power changes at the peripheral points in the SMILE group were significantly higher than those in the LASIK group ( p <0.05).

Conclusion: Both groups achieved similar high efficacy and safety. SMILE surgery resulted in higher refractive power correction in the peripheral cornea than LASIK surgery.