Background: To comparatively evaluate of the visual and refractive outcomes after small-incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and transepithelial photorefractive keratectomy (T-PRK) surgery.
Methods: This was a retrospective, case-series, non-blinded clinical study. Consecutive eligible patients underwent SMILE, FS-LASIK, and T-PRK at the Department of Ophthalmology of Peking Union Medical Hospital, a tertiary referral center. All myopic patients were treated with corneal refractive surgery (SMILE, FS-LASIK, and T-PRK) using the VisuMax (Carl Zeiss Meditec AG, Jena, Germany) 500-kHz femtosecond laser system and the Amaris 750S excimer laser platform (SCHWIND eye-tech solutions, Kleinostheim, Germany). Visual and topographic astigmatism changes at 6 months were the main outcome measure. Secondary outcomes were the efficacy index at 1, 3, and 6 months postoperatively.
Results: We recruited 75 consecutive patients (mean age, 27.88 ± 5.76 years; 68% women; all Asian) with no significant differences between groups in terms of preoperative demographic data, except in preoperative spherical equivalent (SE) (-5.54 ± 1.86 D, -5.64 ± 1.66 D, and -3.78 ± 1.30 D, respectively; P<0.001), astigmatism (1.24 ± 1.62 D, 1.16 ± 0.75 D, and 0.72 ± 0.42 D, respectively; P=0.008), and residual bed thickness (313.08 ± 32.18 μm, 427.59 ± 30.69 μm, and 427.09 ± 41.07 μm, respectively; P<0.001). A superior efficacy index was shown in SMILE and FS-LASIK compared to T-PRK 1 month after surgery.
Conclusions: The results from this retrospective, non-blind, case-series clinical study suggest that all of the corneal refractive surgery options are safe and effective. However, while SMILE and FS-LASIK procedures have equal visual outcomes, they have superior efficacy index values in the early postsurgical period.

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Posted 25 Feb, 2021
On 18 May, 2021
Invitations sent on 13 Apr, 2021
On 16 Feb, 2021
On 16 Feb, 2021
On 16 Feb, 2021
On 10 Jan, 2021
Posted 25 Feb, 2021
On 18 May, 2021
Invitations sent on 13 Apr, 2021
On 16 Feb, 2021
On 16 Feb, 2021
On 16 Feb, 2021
On 10 Jan, 2021
Background: To comparatively evaluate of the visual and refractive outcomes after small-incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and transepithelial photorefractive keratectomy (T-PRK) surgery.
Methods: This was a retrospective, case-series, non-blinded clinical study. Consecutive eligible patients underwent SMILE, FS-LASIK, and T-PRK at the Department of Ophthalmology of Peking Union Medical Hospital, a tertiary referral center. All myopic patients were treated with corneal refractive surgery (SMILE, FS-LASIK, and T-PRK) using the VisuMax (Carl Zeiss Meditec AG, Jena, Germany) 500-kHz femtosecond laser system and the Amaris 750S excimer laser platform (SCHWIND eye-tech solutions, Kleinostheim, Germany). Visual and topographic astigmatism changes at 6 months were the main outcome measure. Secondary outcomes were the efficacy index at 1, 3, and 6 months postoperatively.
Results: We recruited 75 consecutive patients (mean age, 27.88 ± 5.76 years; 68% women; all Asian) with no significant differences between groups in terms of preoperative demographic data, except in preoperative spherical equivalent (SE) (-5.54 ± 1.86 D, -5.64 ± 1.66 D, and -3.78 ± 1.30 D, respectively; P<0.001), astigmatism (1.24 ± 1.62 D, 1.16 ± 0.75 D, and 0.72 ± 0.42 D, respectively; P=0.008), and residual bed thickness (313.08 ± 32.18 μm, 427.59 ± 30.69 μm, and 427.09 ± 41.07 μm, respectively; P<0.001). A superior efficacy index was shown in SMILE and FS-LASIK compared to T-PRK 1 month after surgery.
Conclusions: The results from this retrospective, non-blind, case-series clinical study suggest that all of the corneal refractive surgery options are safe and effective. However, while SMILE and FS-LASIK procedures have equal visual outcomes, they have superior efficacy index values in the early postsurgical period.

Figure 1

Figure 2
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