title: Postoperative ocular higher-order aberrations and contrast sensitivity: femtosecond lenticule extraction versus pseudo small-incision lenticule extraction.
abstract: OBJECTIVE
  To evaluate and compare changes in contrast sensitivity and ocular higher-order aberrations (HOAs) after femtosecond lenticule extraction (FLEx) and pseudo small-incision lenticule extraction (SMILE).
  
  
  METHODS
  Singapore National Eye Centre, Singapore.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Patients had femtosecond lenticule extraction (Group 1) or pseudo small-incision lenticule extraction (Group 2) between March 2010 and December 2011. The main outcome measures were manifest refraction, HOAs, and contrast sensitivity 1, 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  Fifty-two consecutive patients (102 eyes) were recruited, 21 patients (42 eyes) in Group 1 and the 31 patients (60 eyes) in Group 2. The uncorrected and corrected distance visual acuities were significantly better in Group 2 than in Group 1 at 12 months (P = .032). There was no significant increase in 3rd- or 4th-order aberrations at 1 year and no significant difference between the 2 groups preoperatively or postoperatively. At 1 year, there was a significant increase in mesopic contrast sensitivity in Group 2 at 1.5 cycles per degree (cpd) (P = .008) that was not found in Group 1, and photopic contrast sensitivity at 6.0 cpd was higher in Group 2 (P = .027).
  
  
  CONCLUSIONS
  These results indicate that refractive lenticule extraction is safe and effective with no significant induction of HOAs or deterioration in contrast sensitivity at 1 year. Induction of HOAs was not significantly different between both variants of refractive lenticule extraction. However, there was significant improvement in photopic contrast sensitivity after pseudo small-incision lenticule extraction, which persisted through 1 year.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: From the Singapore Eye Research Institute (D.K.L. Tan, Tay, Chan, D.T.H. Tan, Mehta), the Department of Ophthalmology (D.T.H. Tan), Yong Loo Lin School of Medicine, National University of Singapore, the Singapore National Eye Center (D.K.L. Tan, Chan, D.T.H. Tan), the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, and the Lee Kong Chian School of Medicine (D.T.H. Tan), Nanyang Technological University, Singapore.
authors: Deborah K L
authors: DK
authors: Tan
authors: From the Singapore Eye Research Institute (D.K.L. Tan, Tay, Chan, D.T.H. Tan, Mehta), the Department of Ophthalmology (D.T.H. Tan), Yong Loo Lin School of Medicine, National University of Singapore, the Singapore National Eye Center (D.K.L. Tan, Chan, D.T.H. Tan), the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, and the Lee Kong Chian School of Medicine (D.T.H. Tan), Nanyang Technological University, Singapore.
authors: Wan Ting
authors: WT
authors: Tay
authors: From the Singapore Eye Research Institute (D.K.L. Tan, Tay, Chan, D.T.H. Tan, Mehta), the Department of Ophthalmology (D.T.H. Tan), Yong Loo Lin School of Medicine, National University of Singapore, the Singapore National Eye Center (D.K.L. Tan, Chan, D.T.H. Tan), the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, and the Lee Kong Chian School of Medicine (D.T.H. Tan), Nanyang Technological University, Singapore.
authors: Cordelia
authors: C
authors: Chan
authors: From the Singapore Eye Research Institute (D.K.L. Tan, Tay, Chan, D.T.H. Tan, Mehta), the Department of Ophthalmology (D.T.H. Tan), Yong Loo Lin School of Medicine, National University of Singapore, the Singapore National Eye Center (D.K.L. Tan, Chan, D.T.H. Tan), the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, and the Lee Kong Chian School of Medicine (D.T.H. Tan), Nanyang Technological University, Singapore.
authors: Donald T H
authors: DT
authors: Tan
authors: From the Singapore Eye Research Institute (D.K.L. Tan, Tay, Chan, D.T.H. Tan, Mehta), the Department of Ophthalmology (D.T.H. Tan), Yong Loo Lin School of Medicine, National University of Singapore, the Singapore National Eye Center (D.K.L. Tan, Chan, D.T.H. Tan), the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, and the Lee Kong Chian School of Medicine (D.T.H. Tan), Nanyang Technological University, Singapore. Electronic address: jodmehta@gmail.com.
authors: Jodhbir S
authors: JS
authors: Mehta
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000601:surgery; D015350:Contrast Sensitivity / Q000502:physiology*; D003319:Corneal Stroma / Q000601:surgery*; D057108:Corneal Wavefront Aberration / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult