Long-term (5 years) follow-up of small-incision lenticule extraction in mild-to-moderate myopia

To report long-term efficacy and safety of small-incision lenticule extraction (SMILE) in patients with mild-to-moderate myopia.

Beyoglu Eye Training and Research Hospital, İstanbul, Turkey.

Retrospective case series.

Medical records of patients who had SMILE for surgical correction of myopia or myopic astigmatism were retrospectively reviewed. Patients with a preoperative spherical equivalent (SE) of manifest refraction of 6.00 D or less and a 5-year follow-up period were included in the study. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities and SE were analyzed preoperatively and at 1 year, 3 years, and 5 years postoperatively.

The study comprised 54 eyes (34 patients). The mean SE of the intended correction was -4.11 diopters (D) ± 0.98 (SD) and ranged from -1.38 to -5.88 D. The mean preoperative UDVA and CDVA were 1.08 ± 0.29 logarithm of the minimum angle of resolution (logMAR) and 0.02 ± 0.08 logMAR, respectively. At the 5-year follow-up, the mean difference between the intended and achieved SE was -0.13 ± 0.29 D. The mean postoperative UDVA and CDVA were 0.04 ± 0.09 logMAR and 0.00 ± 0.04 logMAR, respectively. At the 5-year follow-up, the SE was within ±0.50 D of the intended correction in 32 (93%) of the 34 patients and within ±1.00 D of intended correction in all patients. The SE at the 5-year follow-up was within ±0.50 D of the 1-year visit in 33 (98%) of all patients. No patient lost CDVA lines, and no vision-threatening events occurred during the surgery or the postoperative period.

SMILE in mild-to-moderate myopia offers predictable correction of SE refractive error. Refractive results were stable at the long-term follow-up.