Long-term (5 years) follow-up of small-incision lenticule extraction in mild-to-moderate myopia.

Purpose: To report long-term efficacy and safety of small-incision lenticule extraction (SMILE) in patients with mild-to-moderate myopia.

Setting: Beyoglu Eye Training and Research Hospital, İstanbul, Turkey.

Design: Retrospective case series.

Methods: Medical records of patients who had SMILE for surgical correction of myopia or myopic astigmatism were retrospectively reviewed. Patients with a preoperative spherical equivalent (SE) of manifest refraction of 6.00 D or less and a 5-year follow-up period were included in the study. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities and SE were analyzed preoperatively and at 1 year, 3 years, and 5 years postoperatively.

Results: The study comprised 54 eyes (34 patients). The mean SE of the intended correction was -4.11 diopters (D) ± 0.98 (SD) and ranged from -1.38 to -5.88 D. The mean preoperative UDVA and CDVA were 1.08 ± 0.29 logarithm of the minimum angle of resolution (logMAR) and 0.02 ± 0.08 logMAR, respectively. At the 5-year follow-up, the mean difference between the intended and achieved SE was -0.13 ± 0.29 D. The mean postoperative UDVA and CDVA were 0.04 ± 0.09 logMAR and 0.00 ± 0.04 logMAR, respectively. At the 5-year follow-up, the SE was within ±0.50 D of the intended correction in 32 (93%) of the 34 patients and within ±1.00 D of intended correction in all patients. The SE at the 5-year follow-up was within ±0.50 D of the 1-year visit in 33 (98%) of all patients. No patient lost CDVA lines, and no vision-threatening events occurred during the surgery or the postoperative period.

Conclusions: SMILE in mild-to-moderate myopia offers predictable correction of SE refractive error. Refractive results were stable at the long-term follow-up.