Clinical outcomes of small-incision lenticule extraction and femtosecond laser–assisted wavefront-guided laser in situ keratomileusis

Small-incision lenticule extraction and wavefront-guided femtosecond-assisted laser in situ keratomileusis (LASIK) provide good visual outcomes and an efficacious correction of myopia or myopic astigmatism with similar levels of safety. Some differences in predictability and the percentage of eyes gaining lines of corrected distance visual acuity are present. A higher level of coma is present after small-incision lenticule extraction, with no clear differences between techniques in spherical aberration. Better contrast sensitivity is achieved in the early postoperative period after wavefront-guided femtosecond laser-assisted LASIK, possibly because of less intrastromal light backscattering and Bowman layer microdistortions. Corneal sensitivity decreased less after small-incision lenticule extraction because of less severe decrease in subbasal nerve density, which has a significant effect on symptomatology and dry-eye tests (P < .05). Significant corneal biomechanical changes occurred after both techniques (P < .05), with no scientific evidence supporting the superiority of 1 technique over the other.Dr. Piñero received an unrestricted educational grant from Abbott Medical Optics, Inc. Neither author has a financial or proprietary interest in any material or method mentioned.