Bilateral sequential small-incision lenticule extraction and LASIK result in similar short-term quality-of-life outcomes

Abstract

Purpose: To compare quality of life (QoL) between patients who receive bilateral small-incision lenticule extraction (SMILE) or laser in situ keratomileusis (LASIK) vs bilateral sequential SMILE–LASIK (BSSL) surgery. Setting: Singapore National Eye Centre, Singapore. Design: Retrospective cohort study. Methods: 2 patient cohorts were recruited (2010-2012; 2014-2016). The bilateral SMILE (BS) and bilateral LASIK (BL) groups comprised patients (mean ± SD age: 30.3 ± 6.5, 50% male) from a prospective nonrandomized study who chose SMILE and LASIK, respectively. The BSSL group comprised patients (mean ± SD age: 28.6 ± 6.2, 64.3% male) randomized to receive SMILE in 1 eye and LASIK in the other. Rasch-scaled scores of the QoL Impact of Refractive Correction questionnaire between groups postoperatively at 1 and 3 months were compared. Results: At month 1, scores on 3 QoL without emotional well-being items were worse in the BSSL (n = 70) compared with the BL group (n = 25), specficially, “using sunglasses” (β: −20.6, 95% CI, −34.3 to −6.9), “reliance on refractive correction” (−23.1, 95% CI, −40.9 to −5.4), and “medical complications from optical correction” (β: −14.8, 95% CI, −27.9 to −1.7). Emotional well-being (overall), and items “feeling able to do things” (β: 11.0, 95% CI, 1.6-20.4) and “feeling eager to try new things” (β: 14.1, 95% CI, 3.6-24.6) were better in the BSSL compared with the BS group (n = 25). No substantive differences were observed at month 3. Conclusions: Refractive correction-related QoL differences at month 1 between BSSL and BS/BL patients attenuated by month 3. Bilateral sequential SMILE–LASIK surgery appeared unlikely to negatively affect QoL beyond 3 months.