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A Prospective, Contralateral, Eye to Eye Comparison of SMILE Surgery to LASIK Surgery

Primary Purpose

Myopia

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
SMILE
LASIK
Sponsored by
Stanford University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myopia focused on measuring SMILE, LASIK, Myopia, Wavefront-guided

Eligibility Criteria

22 Years - 59 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Subjects age 22 and older with healthy eyes. Nearsightedness between -0.75 diopters and -8.00 diopters.
  • Subjects with up to 3.00 diopters of astigmatism.

Exclusion Criteria:

  • Subjects under the age of 22.
  • Subjects with excessively thin corneas.
  • Subjects with topographic evidence of keratoconus.
  • Subjects with ectatic eye disorders.
  • Subjects with autoimmune diseases.
  • Subjects who are pregnant or nursing.
  • Subjects must have similar levels of nearsightedness in each eye. They can not be more than 1.5 diopter of difference between eyes.
  • Subjects with 3.25 or more diopters of astigmatism
  • Subjects must have similar levels of astigmatism in each eye. They can not have more than 0.50 diopters of difference between eyes.

Sites / Locations

  • Byers Eye Institute at Stanford

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

SMILE

Wavefront-guided LASIK

Arm Description

SMILE surgery

Wavefront-guided LASIK

Outcomes

Primary Outcome Measures

Percentage of Participant Eyes With an Uncorrected Visual Acuity of 20/20 or Better
ETDRS testing lane

Secondary Outcome Measures

Number of Participant Eyes Losing 2 or More Lines of Corrected Distance Visual Acuity
ETDRS testing lane
Aberrometry Measurements
Increase in total higher order RMS (root mean squared) by greater than 0.5 microns
Patient Satisfaction
Percentage of patients satisfied with surgery. Patients were asked yes or no.
Change in Corneal Sensation
A decrease in corneal sensation of more than 4 cm as measured by Cochet-Bonnet Aesthesiometry
Dry Eye Symptoms as Measured by OSDI Index
Worsening of ocular surface disease index (OSDI) score of greater than 25. The overall OSDI score defined the ocular surface as normal (0-12 points) or as having mild (13-22 points), moderate (23-32 points), or severe (33-100 points) disease.
Analysis of Astigmatism
Participant eyes with an increase in astigmatism of greater than 1.0 diopter
Anterior Segment Ocular Coherence Topography Analysis
Humphrey Visante AS OCT
Predictability
Number of eyes within +/- 0.5 and +/- 1.00 diopter of the intended correction
Stability
Change in refractive error greater than one diopter over 1 to 12 months

Full Information

First Posted
February 16, 2017
Last Updated
January 5, 2022
Sponsor
Stanford University
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1. Study Identification

Unique Protocol Identification Number
NCT03067077
Brief Title
A Prospective, Contralateral, Eye to Eye Comparison of SMILE Surgery to LASIK Surgery
Official Title
A Prospective, Randomized Comparison of SMILE Surgery to Wavefront-guided LASIK Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
March 12, 2017 (Actual)
Primary Completion Date
March 15, 2021 (Actual)
Study Completion Date
March 15, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Stanford University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Subjects will undergo SMILE surgery in one eye and LASIK surgery in their other eye to correct myopia.
Detailed Description
Subjects will have a comprehensive eye examination once they express an interest in the study. This includes a slit lamp examination of the front of the eye and a dilated fundoscopic examination of the back of the eye. If there is any pathology noted that would exclude the subject from the study, then we will inform the patient and make an appropriate referral. if the subject is deemed appropriate for the study after a comprehensive examination included computerized videokeratography, then they can be enrolled. Subjects will undergo bilateral simultaneous eye surgery. Which eye is treated with the WFG-LASIK and which eye is treated with SMILE will be randomized so there is a 50% chance for either eye to receive one treatment. Subjects will be seen on the day of surgery, post op day one, one week, one month, three months, six months and one year. Subjects will receive topical antibiotics in each eye for one week following the procedure. Subjects will receive topical steroid ophthalmic drops for one week after treatment. Subjects will also receive topical antibiotic ophthalmic drops for four days after treatment. All of this is within the usual and customary standard of care for the treatment of subjects undergoing LASIK and SMILE surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myopia
Keywords
SMILE, LASIK, Myopia, Wavefront-guided

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
44 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SMILE
Arm Type
Active Comparator
Arm Description
SMILE surgery
Arm Title
Wavefront-guided LASIK
Arm Type
Active Comparator
Arm Description
Wavefront-guided LASIK
Intervention Type
Procedure
Intervention Name(s)
SMILE
Intervention Description
SMILE surgery
Intervention Type
Procedure
Intervention Name(s)
LASIK
Intervention Description
LASIK surgery
Primary Outcome Measure Information:
Title
Percentage of Participant Eyes With an Uncorrected Visual Acuity of 20/20 or Better
Description
ETDRS testing lane
Time Frame
One year
Secondary Outcome Measure Information:
Title
Number of Participant Eyes Losing 2 or More Lines of Corrected Distance Visual Acuity
Description
ETDRS testing lane
Time Frame
One year
Title
Aberrometry Measurements
Description
Increase in total higher order RMS (root mean squared) by greater than 0.5 microns
Time Frame
One year
Title
Patient Satisfaction
Description
Percentage of patients satisfied with surgery. Patients were asked yes or no.
Time Frame
One year
Title
Change in Corneal Sensation
Description
A decrease in corneal sensation of more than 4 cm as measured by Cochet-Bonnet Aesthesiometry
Time Frame
One year
Title
Dry Eye Symptoms as Measured by OSDI Index
Description
Worsening of ocular surface disease index (OSDI) score of greater than 25. The overall OSDI score defined the ocular surface as normal (0-12 points) or as having mild (13-22 points), moderate (23-32 points), or severe (33-100 points) disease.
Time Frame
One year
Title
Analysis of Astigmatism
Description
Participant eyes with an increase in astigmatism of greater than 1.0 diopter
Time Frame
One year
Title
Anterior Segment Ocular Coherence Topography Analysis
Description
Humphrey Visante AS OCT
Time Frame
One year
Title
Predictability
Description
Number of eyes within +/- 0.5 and +/- 1.00 diopter of the intended correction
Time Frame
One year
Title
Stability
Description
Change in refractive error greater than one diopter over 1 to 12 months
Time Frame
One year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Maximum Age & Unit of Time
59 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subjects age 22 and older with healthy eyes. Nearsightedness between -0.75 diopters and -8.00 diopters. Subjects with up to 3.00 diopters of astigmatism. Exclusion Criteria: Subjects under the age of 22. Subjects with excessively thin corneas. Subjects with topographic evidence of keratoconus. Subjects with ectatic eye disorders. Subjects with autoimmune diseases. Subjects who are pregnant or nursing. Subjects must have similar levels of nearsightedness in each eye. They can not be more than 1.5 diopter of difference between eyes. Subjects with 3.25 or more diopters of astigmatism Subjects must have similar levels of astigmatism in each eye. They can not have more than 0.50 diopters of difference between eyes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Edward E Manche, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Byers Eye Institute at Stanford
City
Palo Alto
State/Province
California
ZIP/Postal Code
94303
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34788593
Citation
Chiang B, Valerio GS, Manche EE. Prospective, Randomized Contralateral Eye Comparison of Wavefront-Guided Laser In Situ Keratomileusis and Small Incision Lenticule Extraction Refractive Surgeries. Am J Ophthalmol. 2022 May;237:211-220. doi: 10.1016/j.ajo.2021.11.013. Epub 2021 Nov 14.
Results Reference
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A Prospective, Contralateral, Eye to Eye Comparison of SMILE Surgery to LASIK Surgery

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