Five‐year results of small incision lenticule extraction (SMILE) and femtosecond laser LASIK (FS‐LASIK) for myopia

Purpose To compare visual outcomes and aberration outcomes in small incision lenticule extraction ( SMILE ) versus femtosecond laser LASIK ( FS ‐ LASIK ). Methods This prospective, comparative, nonrandomized clinical study included 68 eyes of 37 patients receiving SMILE and 55 eyes of 30 patients receiving FS ‐ LASIK between December 2011 and January 2013 at the Fudan University Eye and ENT Hospital (Shanghai, People's Republic of China). Patients were followed up at 3, 6 months and 5 years after surgery. Main outcome measurements included uncorrected ( UDVA ) and corrected ( CDVA ) distance visual acuity, manifest refraction, central corneal thickness ( CCT ), total corneal refractive power ( TCRP ) and wavefront aberrations. Results About 98% (49/50) of treated eyes in the SMILE group and 95% (39/41) in the FS ‐ LASIK group had a postoperative log MAR UDVA of 0 or better. Spherical equivalent ( SE ) after 5 years was −0.01 ± 0.35 D in the SMILE group and −0.23 ± 0.41 D in the FS ‐ LASIK group. A regression of −0.02 ± 0.39 D in the SMILE group and −0.12 ± 0.32 D in the FS ‐ LASIK group was observed between 6 months and 5 years postoperative time‐points. TCRP increased by 0.39 ± 0.38 D in the SMILE group and 0.45 ± 0.49 D in the FS ‐ LASIK group between 6‐month and 5‐year time‐points. However, no statistically significant difference was found between the SMILE and FS ‐ LASIK groups in terms of ∆ SE , ∆ CCT and ∆ TCRP between 6 months and 5 years postoperative time‐points. Conclusion Myopic regression was observed in terms of TCRP but not in subjective refraction. No statistically significant difference in stability was found between SMILE and FS ‐ LASIK .