Efficacy, safety, predictability, contrast sensitivity, and aberrations after femtosecond laser lenticule extraction.
OBJECTIVE
To compare femtosecond lenticule extraction and small-incision lenticule extraction to treat moderate to high myopia.


METHODS
Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.


METHODS
Prospective clinical single-masked paired-eye study.


METHODS
An intrastromal lenticule was cut by a femtosecond laser and manually extracted. In femtosecond lenticule extraction, a laser in situ keratomileusis-like flap allowed removal of the lenticule, whereas in small-incision lenticule extraction, it was removed through a small incision. Follow-up was 6 months.


RESULTS
Thirty-five patients were treated with femtosecond lenticule extraction in 1 eye and small-incision lenticule extraction in the other. The mean preoperative spherical equivalent was -7.6 diopters (D) ± 1.0 (SD) (range -6.0 to -9.9 D). After both procedures, 90% of eyes had an uncorrected distance visual acuity of 20/40 or better 1 day postoperatively, increasing to 100% after 6 months. At 6 months, the mean corrected distance visual acuity (CDVA) improved significantly by approximately 1.5 letters on the logMAR chart. No eyes lost or gained 2 lines or more of CDVA after either procedure. The achieved refraction was a mean of -0.04 ± 0.38 D from the attempted refraction after femtosecond lenticule extraction and -0.09 ± 0.39 D after small-incision lenticule extraction. After both procedures, 88% of eyes were within ±0.50 D. Contrast sensitivity was unchanged. The changes in higher-order aberrations were similar.


CONCLUSIONS
The all-femtosecond laser flap-based and cap-based techniques produced almost identical results up to 6 months postoperatively in eyes with moderate to high myopia.
From the Departments of Ophthalmology, Odense University Hospital (Vestergaard, Grauslund) and Aarhus University Hospital (Vestergaard, Ivarsen, Hjortdal), Aarhus, Denmark. Electronic address: vestergaard_anders@hotmail.com.
Anders H
AH
Vestergaard
From the Departments of Ophthalmology, Odense University Hospital (Vestergaard, Grauslund) and Aarhus University Hospital (Vestergaard, Ivarsen, Hjortdal), Aarhus, Denmark.
Jakob
J
Grauslund
From the Departments of Ophthalmology, Odense University Hospital (Vestergaard, Grauslund) and Aarhus University Hospital (Vestergaard, Ivarsen, Hjortdal), Aarhus, Denmark.
Anders R
AR
Ivarsen
From the Departments of Ophthalmology, Odense University Hospital (Vestergaard, Grauslund) and Aarhus University Hospital (Vestergaard, Ivarsen, Hjortdal), Aarhus, Denmark.
Jesper Ø
JØ
Hjortdal
D000328:Adult; D015350:Contrast Sensitivity / Q000502:physiology*; D003319:Corneal Stroma / Q000601:surgery*; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016037:Single-Blind Method; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology