Early recovery of quality of vision and optical performance after refractive surgery: Small-incision lenticule extraction versus laser in situ keratomileusis

J Cataract Refract Surg. 2018 Sep;44(9):1073-1079. doi: 10.1016/j.jcrs.2018.06.044. Epub 2018 Aug 2.

Abstract

Purpose: To assess the early time course of the visual function after small-incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK).

Setting: Quinze-Vingts National Ophthalmology Hospital, Paris, France.

Design: Prospective case series.

Methods: Patients scheduled for bilateral small-incision lenticule extraction or LASIK were consecutively enrolled. In addition to standard refraction and visual acuity, contrast sensitivity, aberrometry, and patient-reported quality of vision and overall satisfaction were measured 1 day, 7 days, and 1 month postoperatively.

Results: Each group comprised 23 patients (46 eyes). The postoperative contrast sensitivity was better in the LASIK group at 1 day (P = .014) and 7 days (P = .001) but not at 1 month. No significant differences in visual acuity, efficacy, or safety were found between the 2 groups throughout the follow-up. The objective scatter index assessed by double-pass aberrometry was better after LASIK 1 day postoperatively (P = .036) but was not statistically different thereafter. The patient-reported quality of vision was significantly worse in the small-incision lenticule extraction group than in the LASIK group at 7 days (P = .010). Global satisfaction did not differ between groups throughout the study. Significant correlations were found between contrast sensitivity and aberrometry in both groups at all examinations.

Conclusions: Targeted analysis of early quality of vision through objective and subjective methods suggested that compared with LASIK, a slight delay in corneal optical recovery after small-incision lenticule extraction might lead to reduced contrast sensitivity and specific patient-reported visual disturbance during the first postoperative week with no effect on overall patient satisfaction.

MeSH terms

  • Aberrometry
  • Adult
  • Astigmatism / physiopathology
  • Astigmatism / surgery
  • Cornea / physiology*
  • Corneal Stroma / surgery*
  • Corneal Surgery, Laser / methods*
  • Female
  • Humans
  • Keratomileusis, Laser In Situ / methods*
  • Lasers, Excimer / therapeutic use
  • Male
  • Microsurgery / methods
  • Myopia / physiopathology
  • Myopia / surgery
  • Prospective Studies
  • Quality of Life
  • Recovery of Function / physiology*
  • Refraction, Ocular / physiology*
  • Visual Acuity / physiology*