To prospectively compare outcomes between wavefront-guided LASIK and SMILE surgery in the treatment of myopia with and without astigmatism. Outcome measures include high contrast snellen acuity, low contrast snellen acuity (5 and 25%), safety, predictability, efficacy and higher order aberration analysis.
80 eyes of 40 consecutive patients underwent SMILE surgery in one eye and LASIK in their fellow eye. Eyes were randomized according to ocular dominance. The mean pre-operative spherical equivalent refraction was -3.79 +/-1.75 diopters and -3.93 +/- 1.70 diopters in the wavefront-guided group and SMILE group respectively (p = 0.93).
At month 12, with 50 eyes of 25 patients available, mean spherical equivalent was -0.10 +/- 0.16 diopters in the LASIK group and -0.14 +/- 0.27 diopters in the SMILE group (p = 0.73). At month 12, 90% and 85% of eyes had an UDVA of 20/20 in the LASIK and SMILE groups respectively. 70 and 75% of eyes had an UDVA of 20/16 in the LASIK and SMILE groups respectively. 55 and 15% of eyes had an UDVA of 20/12.5 in the LASIK and SMILE groups respectively. 70 and 15% of eyes gained one or more lines of CDVA in the LASIK and SMILE groups respectively (p = 0.05). There were no significant differences in the induction of higher order aberrations between the two groups.
Wavefront-guided LASIK and SMILE have similar clinical outcomes with excellent safety, efficacy and predictability in both groups. LASIK has faster recovery of uncorrected visual acuity compared to SMILE surgery.