Comparing femtosecond LASIK and small-incision lenticule extraction (SMILE)

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Refractive surgery aims to correct vision by reshaping the cornea.
• Femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) are advanced laser vision correction techniques.
• Comparing these modalities is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare FS-LASIK and SMILE based on efficacy, safety, recovery, and patient-reported outcomes.
• To provide an updated review of recent scientific findings.
• To identify research gaps for improving surgical results and patient selection.

Main Methods:

• Systematic review of recent comparative studies on FS-LASIK and SMILE.
• Analysis of visual outcomes, safety profiles, postoperative recovery, and patient satisfaction.
• Evaluation of corneal biomechanical stability and dry eye incidence.

Main Results:

• Both FS-LASIK and SMILE achieve excellent visual outcomes for myopia and astigmatism.
• SMILE may reduce dry eye risk and eliminate flap complications; FS-LASIK offers faster visual recovery.
• Customized FS-LASIK (wavefront/topography-guided) may outperform SMILE in specific visual metrics like uncorrected visual acuity and higher-order aberration reduction.

Conclusions:

• FS-LASIK is a gold standard due to rapid recovery and predictability.
• SMILE offers benefits in corneal biomechanics and potentially reduced dry eye symptoms, with possible long-term stability advantages.
• Evidence suggests customized FS-LASIK may yield superior visual outcomes; further long-term comparative studies are needed.