Five-Year Results of Small-Incision Lenticule Extraction compared with Femto-LASIK

Washington, Barcelona 2018

Diese Präsentation wurde von Dr. Breyer sowohl auf der ASCRS 2018 in Washington als auch beim Weltkongress der Ophthalmologen (WOC) in Barcelona vorgetragen. Die Ergebnisse zeigen, dass ReLEx SMILE auch 5 Jahre später der Femto-LASIK hinsichtlich der Sicherheit, Vorhersagbarkeit und Sehqualität ebenbürtig ist. Trockene Augen traten nach ReLEx SMILE deutlich seltener auf.

Presenter / Co-Authors: Timon Ax (1,4), Detlev Breyer (1,4), Hakan Kaymak (1,4), Karsten Klabe (1,4), Philipp Hagen (1,4), Florian Kretz (2,4), Gerd Auffarth (3,4)

Affiliations: (1) Breyer, Kaymak & Klabe Augenchirurgie,(2) Dr. Gerl & Kollegen Ahaus-Raesfeld-Rheine,(3) Universitaets-Augenklinik Heidelberg, (4) International Vision Correction Research Center Network(IVCRC.net)

Purpose:
The aim of this retrospective quality management investigation was to answer the question whether 5 years after surgery the visual outcomes for ReLEx smile are as safe, predictable and efficient as those after Femto-LASIK.

Setting/Venue:
All ReLEx SMILE (VisuMax, CZM) and Femto-LASIK (Mel 80, CZM) surgeries were performed at the Breyer-Kaymak-Klabe Eyesurgery in Duesseldorf, Germany, which is part of the International Vision Correcton Research Center (IVCRC.net).

Methods:
So far the results of 982 eyes in the ReLEx smile group and 366 eyes operated with Femto-LASIK in the control group are evaluated. In all cases target refraction was emmetropia. Follow up was performed between 6 months and 5 years after treatment. For clinical evaluation visual acuity at far, subjective refraction and wave front analysis (KR-1W, Topcon) were compared. Additionally patient questionnaires were evaluated for dry eye symptoms, comfort and recovery time.

Results:
Concerning safety, predictability and efficiency we could not detect significant differences between both methods. 1 year after ReLEx SMILE and LASIK, the mean monocular UDVA was (-0.01+-0.11)logMAR and (0.02+-0.12)logMAR, respectively. These means remained stable within the 5 year follow up, with (0.01+-0.12)logMAR and (0.05+-0.13)logMAR being the 5-year values. With respect to aberrometry, there were significantly lower total higher order aberrations in the ReLEx SMILE group.

Conclusions:
Five years after surgery, ReLEx SMILE and Femto-LASIK show equally good results in terms of safety, predictability and efficacy. However, no dry eyes were observed in the ReLEx SMILE group compared to the Femto-LASIK group. Therefore, we clearly favor the ReLEx SMILE technique in patients who ask for painless refractive correction.