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Related Experiment Video

Updated: Jun 6, 2025

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
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Visual and refractive outcomes after SMILE versus FS-LASIK: a paired-eye study.

Arturo Ramirez-Miranda1, Angie De-la Mota1, Guillermo García-De la Rosa1,2

  • 1Departamento de Córnea y Cirugía Refractiva, Instituto de Oftalmología Conde de Valenciana, Ciudad de México.

Cirugia Y Cirujanos
|November 26, 2024
PubMed
Summary

Small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) offer comparable visual outcomes for myopia correction. SMILE demonstrated greater posterior corneal elevation changes over time.

Keywords:
AberrometryAberrometríaCirugía refractivaCorneaCórneaFS-LASIKMiopíaMyopiaRefractive surgerySMILE

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Area of Science:

  • Ophthalmology
  • Refractive Surgery
  • Corneal Biomechanics

Background:

  • Small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) are advanced refractive surgery techniques.
  • Understanding their comparative effects on corneal physiology and visual outcomes is crucial for patient selection.

Purpose of the Study:

  • To compare visual acuity, refraction, tear film stability, corneal sensitivity, optical quality, and posterior corneal elevation after SMILE and FS-LASIK.
  • To evaluate the longitudinal changes in these parameters over a 12-month follow-up period.

Main Methods:

  • A paired-eye, randomized cohort study design.
  • Inclusion of measurements for visual acuity, refraction, Schirmer test, tear break-up time (TBUT), esthesiometry, optical quality, higher-order aberrations, and posterior corneal elevation.
  • Follow-up assessments at 1 and 7 days, and 1, 3, 6, and 12 months post-operatively.

Main Results:

  • No significant differences were observed in corrected and uncorrected distance visual acuity, cylinder, TBUT, Schirmer test, or esthesiometry between SMILE and FS-LASIK.
  • A statistically significant difference in spherical error and spherical equivalent was noted (p < 0.01).
  • SMILE showed a statistically significant greater change in posterior corneal elevation over time compared to FS-LASIK (p < 0.01).

Conclusions:

  • Both SMILE and FS-LASIK provide similar visual acuity and functional outcomes for myopic patients.
  • SMILE is associated with more pronounced and progressive posterior corneal elevation changes during the follow-up period.