Purpose:

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.

Methods:

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).

Results:

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.

Conclusions:

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.