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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Background Patients who develop dry eyes after refractive surgery also have elevated risks of developing subsequent refractive regression and ocular surface damage. Objective To measure the level of dryness after small incision lenticule extraction (SMILE) in comparison with the level of dryness after femtosecond laser using the tear film break-up time test and Schirmer test. Patients and methods The study was conducted as a prospective (cohort) study on 52 patients who were recruited before and after the surgery from the outpatient clinic, Faculty of Medicine, Menoufia University. All participants included in this study were divided into group I, which included 26 patients (52 eyes) who were examined before and after SMILE surgery, and group II, which included 26 patients (52 eyes) who were examined before and after femtosecond-laser assisted in situ keratomileusis (femto-LASIK) surgery. History of dry eye symptoms including stinging, burning sensation, foreign body sensation, and sensitivity to light before surgery was obtained by direct patient interview and by follow-up after 1 and 6 months postoperatively. Results Dryness symptoms were greatly improved in both groups 6 months postoperatively compared with the symptoms detected after 1-month postoperatively, but the SMILE group had significantly better results than the LASIK group, where 48 patients had no symptoms in the SMILE group versus 39 in the LASIK group, with a significant difference. Conclusion The SMILE procedure had no profound harm on the ocular surface compared with femto-LASIK. Therefore, it reduces the incidence of dry eye disease and rapidly improves the quality of life after refractive surgery.

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