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Clinical Outcomes After SMILE and Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism

A Prospective Randomized Comparative Study

Liu, Manli PhD; Chen, Yile PhD; Wang, Danyang PhD; Zhou, Yugui PhD; Zhang, Xiaoying BM; He, Jiexu BM; Zhang, Ting PhD; Sun, Yuan PhD; Liu, Quan MD, PhD

doi: 10.1097/ICO.0000000000000707
Clinical Science

Purpose: To compare the clinical outcomes of small-incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK) for the correction of myopia and myopic astigmatism.

Methods: In this prospective, randomized, comparative study, SMILE surgery was performed in 113 eyes with a mean spherical equivalent (MSE) of −5.22 ± 1.70 diopters (D) and FS-LASIK was performed in 84 eyes with an MSE of −5.18 ± 1.93 D. Contrast sensitivity and uncorrected and corrected distance visual acuities were measured preoperatively and 1 day, 1 week, 1, 3, and 6 months postoperatively. Higher-order aberrations were evaluated preoperatively and 6 months postoperatively.

Results: At postoperative day 1, the uncorrected distance visual acuity in the FS-LASIK group was better (P < 0.05), whereas no statistically significant difference was found at 6 months postoperatively (P = 0.9). There was no significant difference in terms of logMAR corrected distance visual acuity and MSE during the 6 months of follow-up between the SMILE and FS-LASIK groups (all P > 0.05). The contrast sensitivity in the SMILE group was lower at 1 day and 1 week postoperatively (all P < 0.05). The spherical aberration at 6 mm diameter at 6 months postoperatively was lower (P < 0.05) in the SMILE group (0.12 ± 0.22 μm) than in the FS-LASIK group (0.28 ± 0.26 μm).

Conclusions: Both FS-LASIK and SMILE procedures achieved good visual outcomes in the correction of myopia and myopic astigmatism. SMILE had a lower induction rate of spherical aberration at 6 months postoperatively in the analysis of 6 mm diameter than that of FS-LASIK.

Refractive Surgery Center, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Reprints: Quan Liu, MD, PhD, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 S. Xianlie Road, Guangzhou 510060, China (e-mail:

Supported by Grants from the Natural Science Foundation of Guangdong (2015A030310098).

The authors have no conflicts of interest to disclose.

M. Liu and Y. Chen contributed equally to this work.

Received May 29, 2015

Received in revised form October 11, 2015

Accepted October 15, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.