ABSTRACT
BACKGROUND: This study aimed to compare long-term postoperative quality of life and satisfaction differences between SMILE and FS-LASIK for myopia correction. METHODS: This cross-sectional study enrolled patients under the age of 39 years, who chose to undergo SMILE or FS-LASIK surgery to both eyes 3 years previously. Patients completed a common vision test and Quality of Life Impact of Refractive Correction (QIRC) questionnaire, together with the surgical satisfaction, adverse symptoms subjective survey. Patients with preoperative corrected distance visual acuity and postoperative uncorrected distance visual acuity of 20/20 or greater were included. Propensity score matching (PSM) was used to match the preoperative and postoperative spherical equivalent, age, and designed optical zones of the left and right eyes between the two groups. RESULTS: Forty-nine patients were included in each group after PSM from 188 patients. No significant difference in the total QIRC score was found between the SMILE and FS-LASIK groups (45.89 ± 5.91 vs 45.09 ± 5.65, p = 0.492). There were no differences in surgical satisfaction between the groups (p = 0.178). Compared to the SMILE group, the FS-LASIK group had more glare (2.12 ± 2.25 vs 3.22 ± 2.54, p = 0.026) and severe dryness (1.80 ± 1.98 vs 2.79 ± 2.19, p = 0.021). CONCLUSION: Postoperative quality of life is similar after SMILE or FS-LASIK. Dry eye symptoms and glare were milder in the SMILE group than in the FS-LASIK group.
Subject(s)
Corneal Surgery, Laser/psychology , Keratomileusis, Laser In Situ/methods , Lasers, Excimer/therapeutic use , Myopia/surgery , Quality of Life , Adult , Corneal Surgery, Laser/instrumentation , Cross-Sectional Studies , Dry Eye Syndromes/etiology , Female , Humans , Lasers, Excimer/adverse effects , Male , Postoperative Period , Propensity Score , Retrospective Studies , Surveys and QuestionnairesABSTRACT
PURPOSE: To confirm the clinical interest of pupillary diameter measurement for selecting indications and determining surgical protocols, to look for clinical factors predisposing to night vision symptoms, and to the assess patient satisfaction level for photoablation techniques not based on aberrometry. METHODS: This retrospective study was conducted on 111 consecutive myopic patients (219 eyes, with a mean spherical equivalent of -4.25+/-1.84 D); they underwent Lasik (91.3% of cases) or photorefractive keratectomy, after having their pupillary diameter measured by the Colvard pupillometer. Clinical data were collected from medical files, and an anonymous questionnaire was sent in order to assess quality of vision and postoperative satisfaction. RESULTS: Preoperative aims were reached (r=0.41, p<0.0001). The response rate for the questionnaire was 81.1%. Daytime vision was the same or better for 91.1% of the patients, but 25.6% had worse night vision than before. Night vision symptoms were mentioned by 46.7% of the patients, and the most frequent complaint was halos. However, 97.8% of the patients declared themselves as satisfied and would recommend such surgery to their family and friends. A preoperative myopia greater than 4.50D (RR=1.52, p<0.05) and a postoperative keratometry greater than 8.44 mm (RR=1.62, p<0.05) were risk factors for having night vision symptoms, but pupillary diameter was not a risk factor. CONCLUSION: This survey gives an indirect confirmation of the interest of scotopic pupillary diameter measurement and taking it into account in photoablation protocols. However, night vision symptoms remain frequent but do not influence patient satisfaction. Knowledge of risk factors and technical progress should provide a better quality of vision after Lasik.
