Femtosecond Small Incision Lenticular Extraction in comparison to Femtosecond Laser In situ Keratomileusis Regarding Dry Eye Disease

Najah Kadhum Mohammad; Suzan Rattan; Ahmed Shaker Ali Al Wassiti; Zaid Al-Attar

doi:10.3889/oamjms.2022.8040

Authors

Najah Kadhum Mohammad Department of Surgery and Ophthalmology, Baghdad College of Medicine, University of Baghdad, Baghdad, Iraq
Suzan Rattan Department of Surgery, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
Ahmed Shaker Ali Al Wassiti Department of Surgery and Ophthalmology, Baghdad College of Medicine, University of Baghdad, Baghdad, Iraq
Zaid Al-Attar Department of Pharmacology, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2022.8040

Keywords:

Dry eye, Corneal sensitivity, Small incision lenticule extraction, Femtosecond laser-assisted laser, In situ keratomileusis, Refractive surgery

Abstract

Abstract

Objective: Comparison of femtosecond small incision lenticule extraction (FS-SMILE) versus Femtosecond laser Insitu keratomileusis (FS-LASIK) regarding dry eye disease (DED) and corneal sensitivity (CS) after those refractive surgeries.

Methods: A comparative prospective study conducted for a period of 2 years; from March 2017 until February, 2019. Enrolled patients were diagnosed with myopia. Fifty patients (100 eyes) were scheduled for bilateral FS-SMILE and the other 50 patients (100 eyes) had been scheduled for bilateral FS-LASIK. Both groups were followed for six months after surgery. The age, gender, and preoperative refraction for both groups were matched. Complete evaluation of dry eye disease had been performed for the intervals of one week pre-operatively, one and six months postoperatively. The evaluation included history of symptoms according to scoring systems, investigations and clinical examination.

Results: One month postoperatively and in both groups, there was significant DED (P < .01), although the incidence was lower in femtosecond SMILE group, overall severity score (0-4): 0.3 ± 0.3 (FS-SMILE) vs. 1.4 ± 0.9 (LASIK). One month postoperatively, CS was lower in FS- LASIK more than FS-SMILE eyes (2.3 ± 2.2 vs 3.6 ± 1.8, respectively, P < .01) and then return to not statistically significant sensitivities at six-month duration. DED was negatively correlated with CS (P < 0.01).

Conclusions: The FS-LASIK surgery had a more pronounced effect on the CS and DED compared with FS-SMILE, with higher incidence of DED postrefractive surgery.

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