Comparison of corneal optical quality after SMILE, wavefront-optimized LASIK and topography-guided LASIK for myopia and myopic astigmatism

Abstract

\n Purpose: To compare visual outcomes and corneal optical quality after small incision lenticule extraction (SMILE) , wavefront-optimized (WFO) FS-LASIK and topography-guided customized ablation treat\xadment (TCAT) FS-LASIK for myopia. Methods: This prospective study included 283 eyes of 283 myopic patients who underwent SMILE or FS-LASIK according to the patient s wishes. FS-LASIK patients were randomly assigned to use WFO or TCAT ablation. There were 102 eyes, 100 eyes and 81eyes in the SMILE group, WFO group and TCAT group, respectively. The combined corneal topographer and tomographer system (Sirius) was used to measure corneal aberrations and optical quality. Visual outcomes and corneal aberrations were compared among the three groups.Results: At postoperative 1 and 6 months, there were no significant differences in uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) among the three groups (P > .05). Postoperative manifest refractive spherical equivalent was similar among the groups (P > .05). There was statisti\xadcally significant difference in cylinder at 1 month among the three groups, with the highest mean value in TCAT group (P < .05). The corneal optical path difference (OPD), root mean square of corneal astigmatism and strehl ratio (SR) were the most superior in the TCAT group at postoperative 1 and 6 months (P < .05).Conclusion: SMILE, WFO FS-LASIK and TCAT FS-LASIK provided similar visual results. TCAT FS-LASIK could induce fewer corneal OPD and astigmatism, and higher SR than the others. However, a better algorithm for TCAT FS-LASIK is needed to decrease postoperative residual astigmatism.