SMILE versus ICL in a questionnaire survey investigating intraoperative experience and subjective satisfaction

To design a questionnaire to quantify and compare the patients’ intraoperative experience and satisfaction in patients undergoing Small Incision Lenticule Extraction(SMILE) or Implantable Collamer Lens(ICL) and to analyze the latent factors influencing patients’ satisfaction. In this observational study, a questionnaire was specially designed, and its internal consistency and structural validity were verified. The final version of the questionnaire includes 14 questions divided into four dimensions: intraoperative experience, willingness, duration and appraisals. 142 (109 SMILE and 33 ICL V4c)patients was recruited and finished the questionnaire in 20 days postoperatively. Propensity score matching(PSM) was used to assemble a cohort of patients with similar baseline characteristics.The multiple linear regression analysis was conducted to analyze the influencing factors of subjective satisfaction. Among 142 patients, 40 patients were matched after PSM. ICL patients experience more pronounced sensation during the operation compared to SMILE patients like soreness(4(2,5.75)vs. 2(0,3.75),Z=-2.188,p = 0.029) and swelling (2.60 ± 2.01 vs. 4.50 ± 3.04,95% Confidence Interval: [-3.548,-0.252], p = 0.025). Both procedures received high satisfaction scores and no significant difference was found. Significant correlations between patient satisfaction and many subjective factors including burning sensation, willingness, duration, surgeon’s guidance and patient’s cooperation were found.(p < 0.05). More severe swelling sensation and photophobia were found during ICL compared to SMILE surgery. Patients’ satisfaction can be influenced by various factors investigated by the questionnaire.