Comparative Vector Analysis of Astigmatic Changes After Small-incision Lenticule Extraction versus Femtosecond Laser...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• High astigmatism presents unique challenges in refractive surgery.
• Small-incision lenticule extraction (SMILE) and femtosecond laser in-situ keratomileusis (FS-LASIK) are advanced laser vision correction techniques.
• Comparing visual outcomes is crucial for patient selection and surgical planning.

Purpose of the Study:

• To compare the visual outcomes of SMILE versus FS-LASIK.
• To evaluate efficacy, predictability, and safety in eyes with myopia and high astigmatism.
• To analyze refractive and astigmatic correction between the two surgical methods.

Main Methods:

• Retrospective study at a tertiary eye hospital (January 2021 - December 2022).
• Inclusion criteria: myopia up to -10.00 D and cylinder ≥ 2.50 D.
• Comparison of 170 eyes (83 SMILE, 87 FS-LASIK) with 3-month follow-up.

Main Results:

• No significant difference in uncorrected visual acuity (UCVA) or spherical equivalent (SEQ) between SMILE and FS-LASIK (P > 0.05).
• High percentages of eyes achieved 20/20 UDVA: 90.4% (SMILE) vs. 80.46% (FS-LASIK).
• Comparable outcomes in target-induced astigmatism, difference vector, and angle of error (P > 0.05).

Conclusions:

• SMILE and FS-LASIK show comparable efficacy, predictability, and safety for correcting myopia with high astigmatism (≥ 2.50 D).
• Both procedures are effective options for patients with complex refractive errors.
• Further research may explore long-term outcomes and patient satisfaction.