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J Cataract Refract Surg. 2018 Sep;44(9):1073-1079. doi: 10.1016/j.jcrs.2018.06.044. Epub 2018 Aug 2.

Early recovery of quality of vision and optical performance after refractive surgery: Small-incision lenticule extraction versus laser in situ keratomileusis.

Author information

1
From the Quinze-Vingts National Ophthalmology Hospital, Clinical Center for Investigation 503 (Chiche, Trinh, Saada, Auclin, Baudouin, Denoyer), New Vision Space Center (Trinh, Faure), the Vision Institute, French National Institute of Health and Medical Research, Pierre and Marie Curie University, U968 (Baudouin, Denoyer), Paris, the University of Versailles Saint-Quentin en Yvelines (Baudouin), Versailles, the Robert Debré University Hospital (Denoyer), and the University of Reims Champagne-Ardenne (Denoyer), Reims, France.
2
From the Quinze-Vingts National Ophthalmology Hospital, Clinical Center for Investigation 503 (Chiche, Trinh, Saada, Auclin, Baudouin, Denoyer), New Vision Space Center (Trinh, Faure), the Vision Institute, French National Institute of Health and Medical Research, Pierre and Marie Curie University, U968 (Baudouin, Denoyer), Paris, the University of Versailles Saint-Quentin en Yvelines (Baudouin), Versailles, the Robert Debré University Hospital (Denoyer), and the University of Reims Champagne-Ardenne (Denoyer), Reims, France. Electronic address: alexandre.denoyer@gmail.com.

Abstract

PURPOSE:

To assess the early time course of the visual function after small-incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK).

SETTING:

Quinze-Vingts National Ophthalmology Hospital, Paris, France.

DESIGN:

Prospective case series.

METHODS:

Patients scheduled for bilateral small-incision lenticule extraction or LASIK were consecutively enrolled. In addition to standard refraction and visual acuity, contrast sensitivity, aberrometry, and patient-reported quality of vision and overall satisfaction were measured 1 day, 7 days, and 1 month postoperatively.

RESULTS:

Each group comprised 23 patients (46 eyes). The postoperative contrast sensitivity was better in the LASIK group at 1 day (P = .014) and 7 days (P = .001) but not at 1 month. No significant differences in visual acuity, efficacy, or safety were found between the 2 groups throughout the follow-up. The objective scatter index assessed by double-pass aberrometry was better after LASIK 1 day postoperatively (P = .036) but was not statistically different thereafter. The patient-reported quality of vision was significantly worse in the small-incision lenticule extraction group than in the LASIK group at 7 days (P = .010). Global satisfaction did not differ between groups throughout the study. Significant correlations were found between contrast sensitivity and aberrometry in both groups at all examinations.

CONCLUSIONS:

Targeted analysis of early quality of vision through objective and subjective methods suggested that compared with LASIK, a slight delay in corneal optical recovery after small-incision lenticule extraction might lead to reduced contrast sensitivity and specific patient-reported visual disturbance during the first postoperative week with no effect on overall patient satisfaction.

PMID:
30078538
DOI:
10.1016/j.jcrs.2018.06.044

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