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[Limitations of SMILE (Small Incision Lenticule Extraction)].

T Seiler1, T Koller1, V V Wittwer1

  • 1Augenarzt, Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Schweiz.

Klinische Monatsblatter Fur Augenheilkunde
|January 31, 2017
PubMed
Summary
This summary is machine-generated.

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Small Incision Lenticule Extraction (SMILE) shows comparable biomechanical effects to LASIK but has slower visual recovery and a lower refractive success rate. Further improvements are needed for SMILE to match LASIK.

Area of Science:

  • Ophthalmology
  • Refractive Surgery

Background:

  • Small Incision Lenticule Extraction (SMILE) is an emerging refractive surgery technique for moderate to high myopia.
  • The full potential and limitations of SMILE are still under investigation.

Purpose of the Study:

  • To compare the biomechanical and clinical outcomes of SMILE versus LASIK.
  • To identify areas for improvement in SMILE technology and application.

Main Methods:

  • Literature review of PubMed database up to October 1, 2016.
  • Analysis of axial 2D-strain-stress measurements and clinical outcomes.

Main Results:

  • Corneal biomechanical impairment is comparable between SMILE and LASIK, with no significant difference in elastic moduli.

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  • Visual rehabilitation is significantly longer with SMILE (weeks) compared to LASIK (days).
  • SMILE's refractive success rate (88%) is lower than LASIK (95%) but has improved over time. Reoperation challenges persist.

    • Conclusions:

    • SMILE requires further technical and clinical advancements to achieve LASIK's success rates and patient convenience.
    • The biomechanical advantages of SMILE over LASIK are not substantial.
    • Commercial competition may drive necessary improvements in femtosecond laser technology for SMILE.