Laser refractive surgery in ophthalmology

Abstract

   Objective. To evaluate the effiacy of surgical treatment for myopia through laser refractive surgeries utilizing an innovative technology – Refractive Lenticule Extraction/ Small-incision Lenticule Extraction (ReLEx SMILE).

   Materials and methods. The study involved 92 eyes with myopia (spherical equivalent (S.E.) ranging from −2.0 to −10.0 diopters and astigmatism not exceeding −3.0 diopters). The main group consisted of 21 patients (42 eyes) who underwent bilateral surgical treatment using ReLEx SMILE via femtosecond lamellar extraction through a small incision. In the control group, 25 patients (50 eyes) underwent bilateral standard Laser-Assisted in Situ Keratomileusis (LASIK) surgery.

   Results. One month after surgery, the S.E. in the ReLEx SMILE group accounted for −0.1 ± 0.2 diopters, −0.13 ± 0.34 diopters at three months, and −0.13 ± 0.40 diopters at six months. In the control group, S.E. comprised 0.15 ± 0.31 diopters at one month, −0.09 ± 0.27 diopters at three months, and −0.18 ± 0.43 diopters at six months of observation. Six months after surgery, 36 % (15 eyes) in the ReLEx SMILE group gained one line on the visual acuity chart; 48 % (20 eyes) remained unchanged, while 14 % (6 eyes) lost one line, and one eye lost two lines. In the LASIK control group, 28 % (14 eyes) gained one line, 62 % (31 eyes) remained unchanged, and 10 % (5 eyes) lost one line. No patients lost two lines. In the ReLEx SMILE group, all 42 eyes achieved a visual acuity of 0.7–0.9 or better six months after surgery, with 66 % (28 eyes) achieving 1.0–1.2. In the LASIK group, all 50 eyes had a visual acuity of 0.7–0.9 or better, with 75 % (38 eyes) achieving 0.9–1.0 or better.

   Conclusion. The ReLEx SMILE method for refractive correction of moderate to high myopia demonstrates comparable efficacy, safety, and predictability to LASIK surgery, while exhibiting superior stability.