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This prospective, randomised, single surgeon, contralateral-eye clinical trial compared the results in myopic patients undergoing wavefront-guided femtosecond laser in situ keratomileusis (LASIK) in one eye and small-incision lenticule extraction (SMILE) in the fellow eye. The patient-reported outcomes with laser in situ keratomileusis (PROWL) questionnaire was used over the 12-month postoperative period. At the 12-month visit, 46% and 19% of 37 participants preferred the vision from the eye that underwent LASIK and SMILE, respectively. This could be due to the better uncorrected distance visual acuity (UDVA) in the LASIK eye (r= 0.52, p< .01) but was not correlated with residual spherical equivalent refractive error (r= 0.12, p= 0.93). Throughout the study period, there was no difference in the scaled scores for the presence or severity of adverse visual symptoms between both procedures (p ≥ .85 for each comparison). At the postoperative month 12 visit, there was a moderate statistically significant correlation between residual spherical equivalent refractive error and severity of halos and between UDVA and severity of halos and starbursts in SMILE eyes, but not for other visual symptoms or LASIK eyes. This study found both procedures were highly satisfactory with excellent outcome with results leaning slightly in preference of LASIK over SMILE.

Patient-reported quality of vision in a prospective randomized contralateral-eye trial comparing LASIK and small-incision lenticule extraction.
Ma KK, Manche EE.
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Mahmoud Ahmed

Royal Liverpool University Hospital, UK.

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