Audit & Research | Singapore National Eye Centre

Audit and Research

The numbers, efficacy, predictability and safety of laser refractive surgery procedures are shown in Figures 9.1 to 9.4.

A total of 64,932 laser refractive surgery procedures were performed at SNEC from 1992 to 2014.

Over the past 10 years, nearly 100% of patients achieved an unaided visual acuity of 6/12 or better after laser refractive surgery procedures.

Since 2010, predictability has been consistently greater than 95% at SNEC.

Complication rates versus total number of cases (1992 to 2014)

The complication rates of post-refractive surgery have been consistently low, at <3%, over the audit period (1998 to 2014). Over the last five years of audit, the complication rates decreased further to 0.1 to 0.45%.

Latest audit results

In 2014, LASIK procedures were performed and audited in 1,276 eyes from 645 patients. 99.3% of eye achieved unaided visual acuity of 6/12 or better and 79.7% of eyes achieved that of 6/6 or better. 98.6% of eyes were within +/- 1.0 dioptre of attempted correction.

TABLE 9.1 Laser refractive surgery procedures: comparison of the FDA's 2003 study with SNEC's efficacy and safety rates in 2014.
	Post-operative 3-month comparison	FDA (Allegretto laser) (U.S. Food and Drug Administration, 2003) N = 290 ≤ -7D	SNEC (EX500 laser) (2014) N = 357 ≤ -7D
Efficacy (%)	Eyes with UAVA 6/12 or better	96.4	99.7
	Eyes with UAVA 6/6 or better	68.9	83.8
Predictability (%)	Eyes with predictability +/- 1.00D	-	98.8
	Eyes with predictability +/- 0.50D	-	90.9
Safety (%)	Eyes with loss of ≥ 2 lines BCVA	1.8	0
	Cases with improved or unchanged BCVA	-	94.4

BCVA, best-corrected visual acuity; D, dioptre; FDA, Food and Drug Administration; UAVA, unaided visual acuity.

References

Liu, Y. C., Pujara, T., & Mehta, J. S. (2014). New instruments for lenticule extraction in small incision lenticule extraction (SMILE). PLoS One, e113774.
Mohamed- Noriega, K., Riau, A. K., Lwin, N. C., Chaurasia, S. S., Tan, D. T., & Mehta, J. S. (2014). Early corneal nerve damage and recovery following small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK) Investigative Ophthalmology & Visual Science, 55, 1823-1834.
U.S. Food and Drug Administration. (2003). Summary of safety and effectiveness data for a supplemental premarket approval application. Retrieved from here.