Refractive surgery: Is the new small-incision lenticule extraction (SMILE) technique equal to or better than the standard flap-and-ablation (FS-LASIK) technique for treating high-degree myopia?

Rasmus Søgaard Hansen, Niels Lyhne, Jakob Grauslund, Anders Højslet Vestergaard

Research output: Contribution to conference without publisher/journalPosterResearchpeer-review

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Corneal laser surgery for myopia (nearsightedness) is one of the most performed surgical procedures today. FS-LASIK has been the dominating surgical technique for almost two decades, but a shift to the new less invasive SMILE technique might be underway. However the literature on SMILE is sparse, especially for high-degree myopia (six or more dioptres (D)).
We hypothesize that the accuracy, efficacy, stability and safety after SMILE is equal to or better than FS-LASIK up to three months post-operatively for high-degree myopia.
Retrospective study of 1214 eyes treated with SMILE or FS-LASIK for high-degree myopia from 2011-2013 at the Department of Ophthalmology, Odense University Hospital, Denmark. Inclusion criteria: Best spectacle-corrected visual acuity (BSCVA) of 20/25 or better on Snellen chart, and no other ocular condition than high-degree myopia with or without astigmatism of maximum 3 D.
In total 799 eyes completed the three months follow-up examination, of which 545 eyes were treated with SMILE (mean pre-operative refraction -7.63±1.37 D, range: -6 to -14.75) and 254 with FS-LASIK (mean pre-operative refraction -7.94±1.72 D, range: -6 to -16.50)
Accuracy: After three months 80% of SMILE eyes and 71% of FS-LASIK (P=0.38) were within ±0.5 D of attempted post-operative refraction, whilst 96% of SMILE and 90% of FS-LASIK (P=0.54) were within ±1.0.
Efficacy: In 180 eyes the attempted post-operative refraction was 0 D. Of these, 69% of SMILE and 83% of FS-LASIK (P=0.55) had an uncorrected visual acuity of 20/25 or better one day post-operative. After three months, the results were 95% for SMILE and 81% for FS-LASIK (P=0.73).
Stability: In total 39% of SMILE and 51% of FS-LASIK (P=0.07) changed ≥0.5 D in refraction from one day to three months post-operatively.
Safety: One SMILE eye (0.2%) and no FS-LASIK eyes had lost two or more lines of BSCVA after three months.

This study is the most extensive of its kind, and our results indicate that the accuracy, efficiency, stability and safety of SMILE is equal to or better than FS-LASIK for high-degree myopia up to 3 months post-operatively.
Refractive surgery, SMILE, FS-LASIK, high-degree myopia
Original languageDanish
Publication date3. Jun 2014
Number of pages1
Publication statusPublished - 3. Jun 2014
EventISCOMS - Gronningen, Netherlands
Duration: 4. Jun 20146. Jun 2014



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