scholarly journals From lasik to smile: Time to change laser refractive surgery

2021 ◽  
pp. 007-011
Author(s):  
Bellucci Roberto
Keyword(s):  
Refractive Surgery ◽  
Point Of View ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Clinical Point ◽  
Lenticule Extraction ◽  
Refractive Change ◽  
Myopic Astigmatism ◽  
Visual Results ◽  
Better Than

Purpose: To illustrate the advantages and limitations of Small Incision Lenticule Extraction (SMILE) over Laser Assisted Intrastromal Keratomileusis (LASIK) in the correction of myopia and myopic astigmatism. Materials and methods: The two procedures are analysed and compared for the technical aspects. While LASIK directly depends on the laser efficacy to get the refractive change, SMILE only depends on the computer ability to design the refractive lenticule. The loss in precision taking place in the peripheral cornea with LASIK is not possible with SMILE. Tissue consumption and postoperative dry eye are also lower with SMILE. Procedure abortion has less consequences with SMILE. From a clinical point of view, refractive and visual results with SMILE are similar as those of Wavefront Optimized and Wavefront Guided LASIK, but re-operations are easier after LASIK than after SMILE. Conclusion: When indicated, SMILE is better than LASIK from a technical and procedural standpoint and is equal to Wavefront Lasik as for the obtained results. LASIK is still more versatile and it is better for re-operations.

Vector analysis of small incision lenticule extraction and toric implantable collamer lens implantation for astigmatism correction

2020 ◽  
pp. 112067212093060
Author(s):  
Ting Wan ◽  
Houfa Yin ◽  
Zhiyi Wu ◽  
Yabo Yang
Keyword(s):  
Vector Analysis ◽  
Small Incision Lenticule Extraction ◽  
Implantable Collamer Lens ◽  
Small Incision ◽  
Astigmatism Correction ◽  
Induced Astigmatism ◽  
Lenticule Extraction ◽  
The Difference ◽  
Surgically Induced ◽  
Myopic Astigmatism

Objectives: To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis. Methods: In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis. Results: At 3-months postoperatively, the residual cylinder was −0.10 ± 0.21 D in the SMILE group and −0.30 ± 0.32 D in the TCL group ( p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, −0.19 ± 0.25, −2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, −0.05 ± 0.20, −0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group ( p < 0.05). Conclusion: Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.

scholarly journals Comparative Study between Femtosecond Laser Assisted in-situ Keratomileusis and Femtosecond Small Incision Lenticule Extraction for Correction of Myopia and Myopic Astigmatism

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Abutaleb ◽  
M G Metwally ◽  
T M Elraggal ◽  
O A Salem
Keyword(s):  
Visual Acuity ◽  
Comparative Study ◽  
Dry Eye ◽  
Small Incision Lenticule Extraction ◽  
Schirmer Test ◽  
Corneal Sensation ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Breakup Time ◽  
Myopic Astigmatism

Abstract Purpose This study aimed at comparing femto-LASIK with small incision lenticule extraction (SMILE) as regards the safety, efficacy, accuracy and post-operative complications with special emphasis on the post-operative dry eye, corneal sensation and corneal biomechanics in cases of myopia and myopic astigmatism. Patients and Methods The study was a prospective comparative study that was conducted in a private eye hospital on 60 eyes of 30 patients with myopia or myopic astimgatism. Each patient was fully assessed preoperatively including visual acuity, refraction, tear breakup time, Schirmer test, corneal sensation & Ocular Response Analyzer®. Femto-LASIK was done to 15 patients and SMILE was done to 15 patients. Postoperative visual acuity, refraction, tear breakup time, Schirmer test, corneal sensation at 1 month, 3 months and 6 months and Ocular Response Analyzer® at 6 months were done and data was retrieved and analyzed. Results Cylindrical error was higher in SMILE group at all postoperative points. Tear breakup time was better in SMILE group in 1st month, but no significant difference in later follow ups. Corneal sensation was better in SMILE group in 1 month and 3 months, but this difference disappeared at 6 months. Corneal hysteresis & corneal resistance factor were significantly better in SMILE group. Conclusion Both techniques are safe and efficient. Femto-LASIK is more efficient in correcting cylindrical error. SMILE is better in early postoperative dry eye, corneal sensation and in corneal biomechanics.

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