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Published on: June 27, 2025
Comparison of Refractive Outcomes and Visual Quality Between Topography-Guided LASIK and Small Incision Lenticule
Shanshan Wei1, Yue Wang1, Caiyun Fu1
1Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, People's Republic of China.
Clinical Ophthalmology (Auckland, N.Z.)
|May 11, 2026
Summary
Topography-guided LASIK (TG-LASIK) and SMILE effectively correct myopia and astigmatism. TG-LASIK offers superior refractive precision and contrast sensitivity, especially at higher spatial frequencies, compared to SMILE.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Corneal Surgery
Background:
- Laser vision correction procedures like LASIK and SMILE are widely used for myopia and astigmatism.
- Evaluating the comparative outcomes of different refractive surgery techniques is crucial for patient selection and surgical planning.
Purpose of the Study:
- To compare postoperative refractive outcomes and visual quality between topography-guided laser in situ keratomileusis (TG-LASIK) and small incision lenticule extraction (SMILE).
- To assess visual acuity, refractive error, and objective visual quality metrics over a 6-month follow-up period.
Main Methods:
- A comparative study involving 100 eyes (50 patients) undergoing either TG-LASIK or SMILE.
- Outcomes measured included uncorrected distance visual acuity (UDVA), spherical equivalent (SEQ), cylinder, contrast sensitivity, and objective visual quality parameters (OSI, MTF cutoff, Strehl Ratio).
Main Results:
- Both procedures achieved high rates of uncorrected distance visual acuity (UDVA) of 0.0 logMAR or better at 6 months (98% TG-LASIK vs. 100% SMILE).
- TG-LASIK showed significantly higher refractive precision, with more eyes achieving SEQ within ±0.25 D (58% vs. 36%) and ±0.50 D (88% vs. 64%).
- TG-LASIK demonstrated significantly better contrast sensitivity at higher spatial frequencies (6.0 and 18.0 c/d) at 6 months compared to SMILE.
Conclusions:
- Both TG-LASIK and SMILE are safe and effective for correcting myopia and astigmatism.
- TG-LASIK provides superior refractive accuracy and enhanced contrast sensitivity at higher spatial frequencies compared to SMILE.
