Postoperative ocular higher-order aberrations and contrast sensitivity: femtosecond lenticule extraction versus pseudo small-incision lenticule extraction

J Cataract Refract Surg. 2015 Mar;41(3):623-34. doi: 10.1016/j.jcrs.2014.07.032.

Abstract

Purpose: To evaluate and compare changes in contrast sensitivity and ocular higher-order aberrations (HOAs) after femtosecond lenticule extraction (FLEx) and pseudo small-incision lenticule extraction (SMILE).

Setting: Singapore National Eye Centre, Singapore.

Design: Retrospective case series.

Method: Patients had femtosecond lenticule extraction (Group 1) or pseudo small-incision lenticule extraction (Group 2) between March 2010 and December 2011. The main outcome measures were manifest refraction, HOAs, and contrast sensitivity 1, 3, 6, and 12 months postoperatively.

Results: Fifty-two consecutive patients (102 eyes) were recruited, 21 patients (42 eyes) in Group 1 and the 31 patients (60 eyes) in Group 2. The uncorrected and corrected distance visual acuities were significantly better in Group 2 than in Group 1 at 12 months (P = .032). There was no significant increase in 3rd- or 4th-order aberrations at 1 year and no significant difference between the 2 groups preoperatively or postoperatively. At 1 year, there was a significant increase in mesopic contrast sensitivity in Group 2 at 1.5 cycles per degree (cpd) (P = .008) that was not found in Group 1, and photopic contrast sensitivity at 6.0 cpd was higher in Group 2 (P = .027).

Conclusions: These results indicate that refractive lenticule extraction is safe and effective with no significant induction of HOAs or deterioration in contrast sensitivity at 1 year. Induction of HOAs was not significantly different between both variants of refractive lenticule extraction. However, there was significant improvement in photopic contrast sensitivity after pseudo small-incision lenticule extraction, which persisted through 1 year.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Astigmatism / surgery
  • Contrast Sensitivity / physiology*
  • Corneal Stroma / surgery*
  • Corneal Wavefront Aberration / etiology
  • Corneal Wavefront Aberration / physiopathology*
  • Female
  • Humans
  • Laser Therapy / methods*
  • Lasers, Solid-State / therapeutic use*
  • Male
  • Middle Aged
  • Myopia / surgery*
  • Postoperative Complications*
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Surgical Flaps
  • Visual Acuity / physiology
  • Young Adult