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More than 6 million small-incision lenticule extraction (SMILE) procedures have been performed worldwide since 2011. Therefore, its long-term safety and efficacy should be investigated. This study aimed to evaluate 10-year refractive outcomes, corneal stability, axial length, and wavefront aberrations in patients who underwent SMILE to correct myopia. Thirty two patients (32 eyes) who underwent SMILE-based myopic correction. Corrected distance visual acuity, uncorrected distance visual acuity, corneal stability, axial length, and wavefront aberrations were evaluated preoperatively and at 1 month and 1, 5, and 10 years postoperatively. At 10 years postoperatively, the safety and efficacy indices for the patients included in this study were 1.19 ± 0.21 and 1.04 ± 0.27, respectively. For 26 (81%) and 30 eyes (94%), correction to within ±0.50 D and ±1.00 D of the target was achieved, respectively. Over the 10-year follow-up duration, a mean −0.32 ± 0.56 D regression was observed (−0.03 ± 0.06 D/year). Relative to baseline, horizontal and vertical comas significantly increased, as did the incidence of higher-order aberrations (all P < 0.001), whereas axial length and corneal elevation remained stable during follow-up. These results indicate that the SMILE-based correction for myopia of up to -10 Dioptres is safe, effective, and stable, with relatively constant wavefront aberrations and corneal stability over time after treatment. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the visual quality of myopic patients after non‐toric versus toric implantable collamer lens (ICL and TICL, respectively) V4c, and to investigate the potential risk factors of postoperative night vision disturbances. Methods: This prospective cohort study included 42 eyes of 21 patients treated with ICL and 46 eyes of 23 patients treated with TICL. Refractive parameters and ocular aberrations were examined before and 6 months after surgery. Subjective quality of vision was scored by a validated questionnaire. Results: The efficacy index at 6 months was 1.14 ± 0.20 for ICL and 1.17 ± 0.16 for TICL; the safety index was 1.20 ± 0.17 for ICL and 1.20 ± 0.19 for TICL. The root mean square of total higher‐order aberrations (HOAs) and trefoil was significantly increased, and no statistical differences between groups were detected in HOA changes. Many patients reported haloes (85.7% for ICL and 100% for TICL) and glare (76.2% for ICL and 65.2% for TICL), but most (94.4% for ICL and 95.5% for TICL) were satisfied or very satisfied with visual outcomes. Implantable collamer lens (ICL) toricity was the risk factor for frequency (OR = 2.81, p = 0.01), severity (OR = 3.85, p = 0.003) and bothering effect (OR = 2.89, p = 0.01) of haloes. Conclusions: Implantable collamer lens and TICL provided comparable efficacy, safety and predictability, induced acceptable level of HOAs and achieved high satisfaction in correcting myopia and myopic astigmatism. Although not severe, haloes and glare have a non‐negligible prevalence and ICL toricity is a potential risk factor of haloes. [ABSTRACT FROM AUTHOR]

Purpose: To compare visual outcomes and aberration outcomes in small incision lenticule extraction (SMILE) versus femtosecond laser LASIK (FS‐LASIK). Methods: This prospective, comparative, nonrandomized clinical study included 68 eyes of 37 patients receiving SMILE and 55 eyes of 30 patients receiving FS‐LASIK between December 2011 and January 2013 at the Fudan University Eye and ENT Hospital (Shanghai, People's Republic of China). Patients were followed up at 3, 6 months and 5 years after surgery. Main outcome measurements included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, central corneal thickness (CCT), total corneal refractive power (TCRP) and wavefront aberrations. Results: About 98% (49/50) of treated eyes in the SMILE group and 95% (39/41) in the FS‐LASIK group had a postoperative logMAR UDVA of 0 or better. Spherical equivalent (SE) after 5 years was −0.01 ± 0.35 D in the SMILE group and −0.23 ± 0.41 D in the FS‐LASIK group. A regression of −0.02 ± 0.39 D in the SMILE group and −0.12 ± 0.32 D in the FS‐LASIK group was observed between 6 months and 5 years postoperative time‐points. TCRP increased by 0.39 ± 0.38 D in the SMILE group and 0.45 ± 0.49 D in the FS‐LASIK group between 6‐month and 5‐year time‐points. However, no statistically significant difference was found between the SMILE and FS‐LASIK groups in terms of ∆SE, ∆CCT and ∆TCRP between 6 months and 5 years postoperative time‐points. Conclusion: Myopic regression was observed in terms of TCRP but not in subjective refraction. No statistically significant difference in stability was found between SMILE and FS‐LASIK. [ABSTRACT FROM AUTHOR]