Vision-related quality of life and visual outcomes after small-incision lenticule extraction and laser in situ keratomileusis

PURPOSE: To compare vision-related quality of life (VRQoL) scores and clinical outcomes between small-incision lenticule extraction and laser in situ keratomileusis (LASIK). SETTING: Singapore National Eye Centre, Singapore. DESIGN: 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. CONCLUSION: The study, 3,month predictability, safety, and VRQL scores were not statistically different between small-incision lenticule extraction and LASIK. (C) 2015 ASCRS and ESCRS