Refractive Error
Conditions
Keywords
SMILE surgery, FS-LASIK surgery, multicenter
Brief summary
The purpose of this study is to carry out an international multicenter trial to get more convincing and valuable results of the SMILE surgery and compare the outcomes between the SMILE surgery and the FS-LASIK (femtosecond laser assisted-laser in situ keratomileusis) surgery. The investigators hope to investigate the differences between the SMILE and the FS-LASIK surgery comprehensively, including the comparison of visual acuity, refraction, the correction of cylindrical diopter, the high order aberrations, the corneal biomechanics, the corneal ectasia, the characteristics of the changes of central corneal thickness and the complications. To meet the demands of a multi center trial, all the examination equipments should be same in each center, and this will limit the variations within a study
Detailed description
Hypothesis: To compare the novel refractive surgery (SMILE, the intervention group) with traditional refractive surgery (FS-LASIK, the control group) in terms of visual acuity, the higher order aberrations, corneal biomechanical parameters and the complications. SMILE surgery might offer some advantages in some aspects compared with FS-LASIK surgery. Study program The procedures of the study are listed as follows: All the participants accept the refractive surgery which were selected at first, and patients' routine postoperative examinations included UCVA, BCVA, slit lamp microscopy, non-contact IOP, corneal topography with the Scheimpflug tomography system, ocular higher order aberrations using the WASCA analyzer (Carl Zeiss Meditec AG), corneal biomechanical properties acquired by the Ocular Response Analyzer and/or the Corvis ST (Corvis ST, OCULUS, Wetzlar, Germany) at 1 week, 1 month, 3 months and 6 months follow-up periods after surgery. Statistics: Patients who have decided to choose the SMILE surgery or the FS-LASIK will be selected as participants. The propensity matching method will be used to choose proper cases for the two groups. The propensity matching method can be calculated by SPSS software. The independent variables include: the central corneal thickness (CCT), the Km (mean Pentacam keratometry), the spherical diopter (from manifest refraction), and the cylindrical diopter (from manifest refraction), the UCVA, the BCVA, the corneal resistance factor (CRF) and the corneal hysteresis (CH) (if the investigator have the Ocular Response Analyzer) of the cornea at preoperative. The closest score of eyes in the two groups will be matched. The data will be preserved by each site, and will be systematically collected and analyzed by TianjinEH center. The statistical expert Dr Hayes from American Pacific University will be the statistical consultant, and will also in charge of the sample size calculation, the instructor of statistical analysis, and the quality control.
Interventions
PROCEDURESMILE surgery
SMILE surgery and FS-LASIK surgery are both effective method for the correction of myopia and myopic astigmatism. They have been proved to offer many advantages in terms of visual acuity, corneal sensitivity and corneal biomechanics compared with traditional refractive surgeries.
OTHERFS-LASIK surgery
SMILE surgery and FS-LASIK surgery are both effective method for the correction of myopia and myopic astigmatism. They have been proved to offer many advantages in terms of visual acuity, corneal sensitivity and corneal biomechanics compared with traditional refractive surgeries.
Sponsors
Nethradhama Superspeciality Eye Hospital
Alexandria University
Belgian Ocular Laser Centre
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Jinan Mingshui Eye Hospital
Tianjin Eye Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* be accompanied by a parent or guardian who is able to give informed consent as demonstrated by signing a record of informed consent; * at baseline, be within the age range of 18 to 45 years old inclusive * normal corneal morphology with no corneal nebula or corneal macula, the range of preoperative K2 (the steep curvature of the 3mm area at the center of cornea) from 38.0 to 47.0 diopter * manifest spherical equivalent of -1.0 to -10.0 diopters (D) * cylindrical diopter no more than -5.0D * refractive diopter maintained stable for more than2 years * preoperative BCVA≥0.8, and the scotopic pupil diameter≥5.0mm when measured by WASCA analyzer (Carl Zeiss Meditec AG) * picked off soft contact lens for more than 2 weeks * picked off RGP for more than 1 month * preoperative corneal central thickness measured by Pentacam \>500μm, non-contact IOP\<21mmHg * be willing to comply with the clinical trial visit schedule as directed by the investigator.
Exclusion criteria
* any corneal diseases, corneal operations, eyes trauma or systemic diseases history; keratoconus or tendency of keratoconus * corneal macula and obvious pannus; current enrolment in another clinical trial/research project.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| corrected visual acuity | change from baseline with EDTRS chart at 6 months |
Secondary
| Measure | Time frame |
|---|---|
| uncorrected visual acuity | change from baseline with EDTRS chart at 6 months |
| cylindrical dioptor | change from baseline with manifest refraction at 6 months |
| central corneal thickness | change from baseline with the Pentacam system at 6 months |
| corneal curvature assessed by the Pentacam system | change from baseline with mean Pentacam keratometry at 6 months |
| corneal resistance factor assessed by the Ocular Response Analyzer | change from baseline at 6 months |
| spherical diopter | change from baseline with manifest refraction at 6 months |
| deformation amplitude assessed by the Corvis ST system | change from baseline at 6 months |
| spherical aberration | change from baseline with the WASCA system at 6 months |
| coma aberration | change from baseline with the WASCA system at 6 months |
| complication | intraoperative and postoperative at 6 months |
| corneal hysteresis assessed by the Ocular Response Analyzer | change from baseline at 6 months |
Countries
China
Contacts
Primary ContactYan Wang, director
Outcome results
None listed