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Topography-guided LASIK found superior to SMILE
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A prospective study comparing the results of femtosecond-assisted topography-guided LASIK and SMILE in eyes with myopia or myopic astigmatism showed superior results of LASIK. According to the authors, this is likely due to the more sophisticated technology currently available for LASIK.
The study included 22 patients with bilateral myopia or myopic astigmatism. One eye was randomly assigned to the topography-guided LASIK procedure, and the contralateral eye was assigned to small incision lenticule extraction (SMILE). Patients were not aware of which eye received either of the two procedures.
Most patient (95.4%) reported more comfort during SMILE than LASIK, but visual acuity outcomes were significantly different in favor of the LASIK group. With LASIK, 86.4% of the eyes achieved uncorrected distance visual acuity of 20/20, and 59.1% achieved UDVA of 20/16. In the SMILE group, 68% had UDVA of 20/20, and 31.8% had UDVA of 20/16.
A gain of two lines of corrected distance visual acuity was achieved by 9.1% of the eyes in the LASIK group as compared with 4.5% in the SMILE group. Refractive predictability was also higher in the LASIK eyes, both for sphere and cylinder.
According to the author, the superior results of LASIK “should probably be attributed to its topographic customization with additional centration and cyclorotation intraoperative compensation by the excimer laser.” In comparison, SMILE is still an evolving technique, in which centration is manually guided by the surgeon.
“Possible future technological evolution enabling cyclorotation tracking and adjustment may offer improvement in refractive and quality of vision results,” the author wrote. “Additionally, possible future topographic data customization of SMILE-like procedures may also improve visual outcomes.”– by Michela Cimberle
Disclosure: Kanellopoulos is a consultant for Alcon, Allergan, Avedro, i-Optics, Keramed, ISP Surgical and Zeiss.
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