Combined Refractive Surgeries Match Single Surgery Quality of Life at 3 Months

A refractive surgery approach that combines small-incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK) can match the quality of life improvements experienced by patients who received only one of the procedures in both eyes, according to findings published in the Journal of Cataract and Refractive Surgery. While quality of life differences may be notable at 1 month postoperative, these are typically attenuated by month 3, researchers explain.

The researchers compared 25 patients who received bilateral SMILE (BS), 25 who received bilateral LASIK (BL), and 70 who received SMILE in 1 eye and LASIK in the other. Rasch-scaled scores of the Quality of Life Impact of Refractive Correction (QIRC) questionnaire were compared between groups postoperatively at 1 and 3 months. 

The study found 3 scores were worse in the BSSL group, compared with the BL group, at month 1, namely ‘using sunglasses,’ ‘reliance of refractive correction’, and ‘medical complications from optical correction.’ In the BSSL group compared with the BS group, emotional well-being (overall) and items ‘feeling able to do things’ and ‘feeling eager to try new things’ were better. At month 3, no substantive differences were observed between any of the groups.

The researchers explain that, although their results do not suggest any negative quality of life associations with BSSL surgery, some disparities were observed in RC-QOL at 1 month postoperative that may be driven by differences between the SMILE and LASIK surgeries.

“Surgeons may need to counsel patients receiving SMILE (either in one eye or both eyes) about initial but temporary added concerns they may have after postoperative refractive correction,” the researchers explained.

Study limitations include nongeneralizability to Western populations due to differences in clinical presentation of refractive error in Asian populations; possible confounding due to period and cohort effects; and the lack of adjustment for possible preconceptions in the BSSL group regarding receiving 2 different surgeries.