Eyeworld

22 | EYEWORLD | APRIL 2022 ASCRS NEWS and patients noted significant improvements in double images and starbursts, but no improve- ments in halos or glare. A major strength of this study is that authors assessed rifle marksmanship as an outcome measure in a subset of the study population. Six to 8 weeks following SMILE, marksmanship without optical correction slight- ly exceeded preoperative baseline testing with optical correction, though this difference did not achieve statistical significance. Limitations of this study include that this was a single-center observational study with a unique study population that may limit general- izability of the study results. The study was also limited to a brief 3-month follow-up period, and refinement in the surgical technique over time may have led to outcome variability and bias. Despite these limitations, the scope of this study gives vital information to U.S. military provid- ers in determining return to service timelines following SMILE. During the ASCRS Journal Club, panel- ists discussed their personal experiences with SMILE and noted improvements in safety and efficacy of the procedure with refinements of femtosecond laser parameters and increased surgeon experience. continued from page 21 Small incision lenticule extraction (SMILE) in the U.S. military: prospective study of visual and military task performance Rose Sia, MD, Denise Ryan, MS, Hind Beydoun, PhD, Jennifer Eaddy, OD, Lorie Logan, OD, Samantha Rodgers, MD, Bruce Rivers, MD J Cataract Refract Surg. 2021;47(12):1503–1510 n Purpose: To assess early visual outcomes and military task performance following small incision lenticule extraction (SMILE) among U.S. military service members n Setting: Warfighter Refractive Eye Surgery Program and Research Center and Night Vision and Electronic Sensors Directorate, Fort Belvoir, VA, U.S. n Design: Single-center, prospective, observational study n Methods: The study was comprised of active duty service members (n=37) electing to undergo SMILE for myopia or myopic astigmatism. Testing performed preoperatively and at 1 and 3 months postoperatively included uncorrected and corrected distance visual acuity (UDVA and CDVA), wavefront aberrometry, low contrast visual acuity (LCVA), contrast sensitivity, and vision-related questionnaire. Fourteen subjects underwent rifle marksmanship with spectacle correction before and without correction at 6 to 8 weeks after surgery. n Results: At 3 months postoperatively, the efficacy index was 0.96, and the safety index was 1.03. UDVA was ≥20/20 in 96% of eyes. LCVA change from baseline was significant under night vision conditions. Eye problems contributed to 10% work and 20% activity impairments, both of which decreased to 0% (p=0.001). The overall satisfaction rating for SMILE was high at 90.9 (95% CI, 85.3–96.5), and 95% of participants would be willing to undergo the procedure again. The median scores between pre- and 6–8 weeks postoperative firing performance were comparable (34 vs. 35, with and without correction, respectively; p=0.247). n Conclusion: After the early recovery period, SMILE seems to preserve quality of vision, which appears to facilitate the accomplishment of tasks related to their work as military service members as well as performing activities outside of work. Contact Friske: tyler-friske@dmei.org Siatkowski: RMichael-Siatkowski@dmei.org

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