After investigating the three-year clinical outcomes of laser-assisted laser in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE), researchers found both are safe and equally effective for myopic and astigmatic correction.

A retrospective long-term follow-up analysis looked at 101 eyes that underwent SMILE (n=60) or FS-LASIK (n=41) three years prior. The researchers measured uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction and corneal wavefront aberrations.

While SMILE induced a lower rate of keratocyte apoptosis, proliferation and inflammation, the study found no significant differences in long-term refractive outcomes between the two groups. The study also did not observe any postoperative complications, such as cornea ectasia or infection. Vector analysis revealed no significant differences in astigmatic correction between the two groups.  Nevertheless, SMILE exhibited significant reductions in induced spherical aberration.

Researchers noted that further long-term observation of outcomes following these two surgeries, which use different lasers and follow different surgical procedures, may help facilitate the future development and application of refractive surgeries.

Han T, Xu Y, Han Xet al. Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism. Br J Ophthalmol. July 30, 2018 [Epub ahead of print].