title: Vision-related quality of life and visual outcomes after small-incision lenticule extraction and laser in situ keratomileusis.
abstract: OBJECTIVE
  To compare vision-related quality of life (VRQoL) scores and clinical outcomes between small-incision lenticule extraction and laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Singapore National Eye Centre, Singapore.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Patients had small-incision lenticule extraction using the Visumax 500 kHz femtosecond laser; or LASIK excimer ablation with the Wavelight Allegretto 400 Hz laser. Primary outcomes were 3-month predictability, efficacy, and safety. Secondary outcomes were intraoperative experience, visual symptoms, and VRQoL (validated Quality of Life Impact of Refractive Correction [QIRC] questionnaire) in 25 a subgroup of patients in each group. Following Rasch analysis, "Functional" and "Emotional," QIRC dimensions were analysed separately.
  
  
  RESULTS
  At 3 months, predictability (82.5% versus 85.3%, ±0.5 diopters attempted correction, P =.453), safety index (1.13 ± 0.19 [SD] versus 1.07 ± 0.16, P = .158), and efficacy index (0.91 ± 0.21 versus 0.97 ± 0.19; P = .002) were found when comparing small-incision lenticule extraction (172 eyes) and LASIK (matched 688 eyes). Intraoperative experience between groups was not statistically different; visual fluctuations (P = .020) and episodes of visual blurring (P = .008) were greater after small-incision lenticule extraction than after LASIK at 1 month but not at 3 months. There was no difference in "functional" (66.7 ± 15.7 versus 55.3 ± 22.2, P = .064) and "emotional" (42.7 ± 23.2 versus 37.9 ± 23.8, P = .394) QIRC dimensions between the 2 groups (25 patients in each group) at 3 months.
  
  
  CONCLUSIONS
  The study, 3-month predictability, safety, and VRQL scores were not statistically different between small-incision lenticule extraction and LASIK.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Henrietta
authors.initials: H
authors.lastname: Ho
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Eva
authors.initials: E
authors.lastname: Fenwick
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Ecosse
authors.initials: E
authors.lastname: Lamoureux
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Hla M
authors.initials: HM
authors.lastname: Htoon
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Koh
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia.
authors.forename: Donald
authors.initials: D
authors.lastname: Tan
authors.affiliation: From the Singapore National Eye Centre (Ang, Ho, Koh, Tan, Mehta), the Singapore Eye Research Institute (Ang, Ho, Lamoureux, Htoon, Tan, Mehta), Duke-NUS Graduate Medical School (Lamoureux, Htoon, Tan, Mehta), and the National University Health System (Tan), Singapore; the Centre for Eye Research Australia (Fenwick, Lamoureux), University of Melbourne, Melbourne, Australia. Electronic address: jodmehta@gmail.com.
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008866:Microsurgery / Q000379:methods; D009216:Myopia / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*