Comparative analysis of myopia correction outcomes and aberration changes between PRK and SMILE: A study based on strict refractive criteria.

Abstract

Purpose: To analyze the refractive outcomes and changes in corneal aberrations after PRK and SMILE surgeries, and to compare these two methods.

Patients and methods: This retrospective comparative study investigated patients aged 20-40 years who underwent SMILE or PRK for the correction of myopia between - 1.00 D and - 2.00 D, along with a cylindrical power of -0.50 D or lower. Preoperative and 6-month postoperative assessments included uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and corneal aberrations such as higher-order aberrations (HOA), spherical aberrations (SA), vertical coma (Z3,-1), horizontal coma (Z3,1), oblique trefoil (Z3,-3), and horizontal trefoil (Z3,3).

Results: A total of 73 eyes from 73 patients (37 SMILE and 36 PRK) were analysed. Both groups showed significant improvement in UCVA and refractive parameters (p < 0.05), while BCVA remained stable (p > 0.05). Postoperative corneal aberrations increased in both groups, with no significant intergroup differences (p > 0.05).

Conclusions: Both SMILE and PRK are effective and safe for the correction of low myopia, with comparable refractive outcomes and visual quality. Despite an increase in corneal aberrations in both techniques, their impact on overall visual performance is similar. Procedure selection should be individualized based on patient-specific factors and lifestyle.