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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Objectives To compare the refractive outcomes after photorefractive keratectomy (PRK) and small-incision lenticule extraction (SMILE) in moderate myopia. Background PRK and SMILE are two flapless procedures for the correction of myopia and astigmatism. In PRK, an excimer laser is used for photoablation, whereas in SMILE, a femtosecond laser is used to create the lenticule. Patients and methods A retrospective study was conducted on 80 patients (160 eyes) who were classified into two groups: PRK and SMILE. A total of 40 patients (80 eyes) were included in each group. Assessment was between 6 months and 3 years postoperatively comparing the uncorrected distance visual acuity, best-corrected distance visual acuity, and manifest refraction spherical equivalent with the preoperative data in addition to assessing the efficacy, safety, and predictability in each procedure. Results The two groups were matched for age, sex, and preoperative characteristics. The mean postoperative uncorrected distance visual acuity in the PRK group was 0.96 ± 0.06 and in the SMILE group was 0.95 ± 0.08 (P = 0.621). The mean postoperative best-corrected distance visual acuity in the PRK group was 0.96 ± 0.06 and in the SMILE group was 0.97 ± 0.07 (P = 0.735). The mean postoperative manifest refraction spherical equivalent in the PRK group was − 0.24 ± 0.34 and in the SMILE group was − 0.30 ± 0.20 (P = 0.186). The mean efficacy index in the PRK group was 0.99 ± 0.05 and in the SMILE group was 0.99 ± 0.07 (P = 0.456). The mean safety index in the PRK group of all eyes was 1.00 ± 0.03 and in the SMILE group was 1.00 ± 0.04 (P = 0.704). In the PRK group, 90% of all eyes were within ± 0.50 D of intended refraction and 100% were within ± 1.00 D. In the SMILE group, 95% of all eyes are within ± 0.50 D of intended refraction and 100% were within ± 1.00 D. Conclusion PRK and SMILE procedures showed excellent efficacy, safety, and predictability in moderate myopia, whereas SMILE was noticed to be better in predictability than PRK.

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