title: Comparison of visual acuity and higher-order aberrations after femtosecond lenticule extraction and small-incision lenticule extraction.
abstract: OBJECTIVE
  To compare postoperative visual acuity and higher-order aberrations (HOAs) after femtosecond lenticule extraction (FLEX) and after small-incision lenticule extraction (SMILE).
  
  
  METHODS
  Medical records of refractive lenticule extraction patients were retrospectively reviewed. Twenty patients were treated with FLEX. A comparable group of 20 SMILE patients were retrospectively identified. Only one eye of each patient was randomly chosen for the study. Visual acuity, subjective manifest refraction and corneal topography before and 6 months after the surgery were analyzed for both groups. Total HOAs, spherical aberrations, coma and trefoil were calculated from topography data over the 4- and 6-mm-diameter central corneal zone.
  
  
  RESULTS
  The mean preoperative SE was -4.03 ± 1.61 in the SMILE group and -4.46 ± 1.61 in the FLEX group. One year after surgery, the mean SE was -0.33 ± 0.25 in the SMILE group and -0.31 ± 0.41 in the FLEX group (p=0.86). In the SMILE group a greater number of eyes were within ±0.50D of the target refraction (95% versus 75%); however, the difference was not statistically significant (p=0.18). Furthermore, 80% of FLEX eyes and 95% of SMILE eyes had an uncorrected distance visual acuity of 20/25 or better (p=0.34). Total HOAs, spherical aberration, coma and trefoil increased postoperatively in both groups. However, there was no statistically significant difference between the groups preoperatively and postoperatively.
  
  
  CONCLUSIONS
  FLEX and SMILE result in comparable refractive results. In addition, corneal aberrations induced by different techniques of lenticule extraction seemed similar to each other.
authors.affiliation: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey. Electronic address: agcaalper@yahoo.com.
authors.forename: Alper
authors.initials: A
authors.lastname: Ağca
authors.affiliation: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirok
authors.affiliation: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
authors.forename: Kadir İ
authors.initials: Kİ
authors.lastname: Cankaya
authors.affiliation: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Yaşa
authors.affiliation: Rize Government Hospital, Rize, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Demircan
authors.affiliation: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yildirim
authors.affiliation: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ozkaya
authors.affiliation: Private Practice, Istanbul, Turkey.
authors.forename: Omer F
authors.initials: OF
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D048988:Corneal Surgery, Laser / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012030:Refractive Errors / Q000209:etiology* / Q000517:prevention & control*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D014792:Visual Acuity