Surface Ablation Versus CIRCLE for Myopic Enhancement After SMILE: A Matched Comparative Study

Area of Science:

• Ophthalmology
• Refractive Surgery

Background:

• Small incision lenticule extraction (SMILE) is a popular refractive surgery procedure.
• Enhancement procedures may be necessary to correct residual refractive errors after primary SMILE.
• Surface ablation and the VisuMax CIRCLE option are two methods for SMILE enhancement.

Purpose of the Study:

• To compare the outcomes of SMILE enhancement using surface ablation versus the VisuMax CIRCLE option.
• To evaluate refractive and functional results, safety, and efficacy of both enhancement techniques.

Main Methods:

• A retrospective matched analysis compared eyes undergoing surface ablation enhancement with mitomycin C versus CIRCLE enhancement.
• Data from 2,803 SMILE procedures were screened, resulting in 24 eyes (12 per group) for analysis.
• Outcomes were assessed at a 3-month follow-up, including uncorrected and corrected distance visual acuity (UDVA/CDVA) and mean refractive spherical equivalent (MRSE).

Main Results:

• Both surface ablation and CIRCLE enhancement achieved comparable refractive accuracy and efficacy at 3 months.
• UDVA and CDVA showed similar improvements, with no significant difference in safety or efficacy indices.
• Eyes enhanced with CIRCLE demonstrated significantly faster visual recovery at 1 week compared to surface ablation.

Conclusions:

• Surface ablation and CIRCLE enhancement after SMILE yield comparable refractive and functional outcomes at 3 months.
• The CIRCLE option offers a faster visual recovery compared to surface ablation.
• This is the first study directly comparing these two enhancement methods after SMILE.