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KMID : 0360220170580101122
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Journal of the Korean Ophthalmological Society
2017 Volume.58 No. 10 p.1122 ~ p.1130
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Comparison of the Early Clinical Outcomes between Combined SMILE and Collagen Cross-linking versus SMILE
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Kim Bu-Ki
Mun Su-Joung
Choi Hyun-Tae
Yang Young-Hoon
Chung Young-Taek
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Abstract
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Purpose: To compare the clinical outcome of combined small incision lenticule extraction and collagen cross-linking (SMILE Xtra) with SMILE.
Methods: This study included 30 eyes from 15 patients who had undergone SMILE Xtra and a random sample of 30 eyes from 15 patients receiving SMILE alone during the same period. We obtained the following parameters from all patients: uncorrected (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), efficacy and safety index, and corneal high-order aberrations.
Results: The SMILE Xtra group had higher preoperative SE and thinner central corneal and residual stromal bed thickness and optic zone diameter compared to the control group (p < 0.001). At 6 months, there was no significant difference in UDVA or CDVA between the two groups. The efficacy indices were 0.97 ± 0.16 and 1.05 ± 0.17 in the SMILE Xtra and control groups, respectively (p = 0.044), and there was no significant difference in safety index between the two groups during the follow-up period. Total corneal high-order aberrations numbered 2.59 ± 0.56 and 2.02 ± 0.41 in the SMILE Xtra and control groups, respectively (p <0.001), and there was significant increase in spherical aberration and horizontal corneal aberration in both groups compared to preoperative results. Corneal haze was observed in 20% of eyes in the SMILE Xtra group, and no complication such as corneal ectasia was observed during the follow-up period.
Conclusions: SMILE Xtra had good early clinical outcome compared to SMILE alone. It appears that SMILE Xtra can be a good modality when the cornea is thin or SE is high. However, postoperative corneal haze should be considered.
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KEYWORD
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Cross linking, Small incision lenticule extraction, Small incision lenticlue extraction (SMILE), SMILE Xtra
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