The visual outcomes and corneal biomechanical properties after PRK and SMILE in low to moderate myopia

Purpose: To compare the corneal biomechanical parameters, visual outcome, and epithelial remodeling after small-incision lenticule extraction (SMILE) and photorefractive keratectomy (PRK) for low to moderate myopia. Design: Prospective, interventional, randomized, comparative study. Methods: Eighty...

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Main Authors: Shivani Joshi, Aafreen Bari, Chetan Shakkarwal, Tushar Agarwal, Tanuj Dada, Rajesh Sinha, Jeewan Singh Titiyal, Namrata Sharma
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/IJO.IJO_1250_24
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Summary:Purpose: To compare the corneal biomechanical parameters, visual outcome, and epithelial remodeling after small-incision lenticule extraction (SMILE) and photorefractive keratectomy (PRK) for low to moderate myopia. Design: Prospective, interventional, randomized, comparative study. Methods: Eighty eyes of 40 patients undergoing bilateral SMILE or PRK for low to moderate myopia (<-5 D SE) were included. They were divided into two groups based on the planned refractive surgery. Visual acuity, corneal biomechanics using Corvis-ST, epithelial mapping via anterior segment optical coherence tomography, and higher-order aberrations were recorded both preoperatively and postoperatively at 6 months and compared. Results: At 6 months follow-up, the corrected distance visual acuity as well as the postoperative spherical equivalent of both the groups were comparable (P = 0.13 and P = 0.32, respectively). The biomechanical parameters like deformation amplitude ratio (P < 0.01), inverse concave radius (P = 0.006), integrated ratio (P < 0.01), stress–strain index (P < 0.01), Ambrosio’s relational thickness (ArTH) (P < 0.01), and corneal biomechanical index-laser vision correction (P = 0.02) were altered more in the SMILE group than in the PRK group, while the biomechanically corrected intraocular pressure (P = 0.16) was comparable. Epithelial remodeling (P = 0.59), higher-order aberrations (P = 0.53), and stromal keratocyte loss (P = 0.16) in both the groups were comparable. Conclusion: Both SMILE and PRK are comparably effective procedures for correction of low to moderate myopia in terms of visual outcomes; however, the corneal biomechanical stability in PRK is superior than that in SMILE.
ISSN:0301-4738
1998-3689