Visual Outcomes After Smile From The First-Year Experience At A Us Military Refractive Surgery Center And Comparison With Prk And Lasik Outcomes

Purpose: To assess the visual outcomes of small-incision lenticule extraction (SMILE) after the first year of treatments at a military refractive surgery center and compare with photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) outcomes during the same period.Setting: Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir, VA.Design: Retrospective study.Methods: Records of service members who underwent SMILE, PRK, or LASIK for myopia from March 2017 to February 2018 were reviewed. Preoperative and up to 6-month postoperative data were collected. Visual outcomes were compared between treatments.Results: Of 563 treated eyes, 173 (30.7%) underwent SMILE, 304 (54.0%) PRK, and 86 (15.3%) LASIK. In comparing SMILE with PRK 1 month postoperatively, SMILE (145 eyes [87.9%]) attained uncorrected distance visual acuity (UDVA) =20/20 more vs PRK (214 eyes [73.8%]; P <.01). Similarly, SMILE (152 eyes [94.4%]) achieved more eyes with manifest spherical equivalent (MSE) within +/- 0.50 diopters (D) fromintended target vs PRK (250 eyes [85.9%]; P =.01). None lost >= 1 line of corrected distance visual acuity in SMILE vs PRK (16 eyes [5.5%]; P <.01). Thereafter, there were no other significant differences except SMILE had 117 eyes (95.1%) vs PRK with 224 eyes (99.6%) achieving UDVA >= 20/20 at 3 months postoperatively (P =.01). In assessing SMILE vs LASIK, all parameters were comparable; however, 77 SMILE eyes (96.3%) hadMSEwithin +/- 0.50 D from target vs 31 LASIK eyes (83.8%) at 6 months postoperatively (P =.02).Conclusions: The first year after SMILE treatments in a U.S. military center demonstrated early postoperative outcomes superior to PRK. SMILE seemed more predictable compared with LASIK. Copyright (C) 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.