Outcomes of LASIK for Myopia or Myopic Astigmatism Correction with the FS200 Femtosecond Laser and EX500 Excimer Laser Platform

Purpose: To evaluate the efficacy, predictability, stability and safety of laser in situ keratomileusis (LASIK) using the FS200 femtosecond laser and EX500 excimer laser platform. Methods: The outcomes of 254 eyes of 129 consecutive patients with myopia or myopic astigmatism who underwent full correction femtosecond laser-assisted LASIK at CMU LASIK Center were assessed. Pre-operative and post-operative parameters including manifest refraction, Uncorrected Distance Visual Acuity (UDVA), Best Corrected Distance Visual Acuity (BDVA), corneal topography and tomography were analyzed. The results between low to moderate myopia and high myopia were compared up to 12 months. Results: Mean pre-operative Spherical Equivalent (SE) was -5.15±2.41 Diopters (D) (range -0.50 to -11.50 D) and -0.13±0.28 D, -0.13±0.27 D, -0.13±0.28 D and -0.14±0.30 D at 1, 3, 6, and 12 months, post-operatively. At 12 months, the propor¬tion of eyes achieving UDVA ≥ 20/20 was 90.0% and ≥20/40 was 98.8%. The proportion of eyes achieving post-operative mean SE ±0.5 D, and ±1 D was 91.3%, and 98.5%. No eyes lost more than two lines of BDVA. The low to moderate myopic group had a statistically significant better UDVA at one (p=0.017) and three months (p=0.014) but no difference at six (p=0.061) and 12 months (p=0.091). The mean post-operative SE was better in low to moderate myopic group at every follow-up visit (p=0.001, 0.007, <0.001 and <0.001). Conclusion: One-year clinical results of LASIK with the FS200 femtosecond laser and EX500 excimer laser showed high efficacy, predictability, stability and safety.

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Outcomes of Wavefront-Optimized Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for correction of Myopia and Myopic Astigmatism over One Year Follow-Up

The Open Ophthalmology Journal ◽

10.2174/1874364101812010256 ◽

2018 ◽

Vol 12 (1) ◽

pp. 256-263 ◽

Cited By ~ 1

Author(s):

Mohammad M. Shehadeh ◽

Mohammad T. Akkawi ◽

Ammar A. Aghbar ◽

Muna T. Musmar ◽

Malak N Khabbas ◽

...

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Photorefractive Keratectomy ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Corrected Distance Visual Acuity ◽

One Year ◽

Myopic Astigmatism

Background: Laser corneal refractive surgery suits, technology and nomograms are improving with time. This may improve the refractive and visual outcomes of the patients. Objectives: To evaluate the safety, efficacy, stability, and predictability of wavefront-optimized photorefractive keratectomy and Laser-assisted in-situ keratomileusis in patients with myopia and myopic astigmatism over 1-year using WaveLight® EX500 Excimer Laser machine. Methods: In this prospective cohort study, refractive and visual outcomes in 596 eyes (365 patients), either having myopia or myopic astigmatism were assessed. Patients were divided into Two groups: 1) Patients who underwent PRK (53 eyes have myopia and 217 eyes have myopic astigmatism), 2) Patients who underwent LASIK (53 eyes have myopia and 273 eyes have myopic astigmatism). Results: At 12 months postoperatively 94.3% of the myopic patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post PRK and LASIK. In patients with myopic astigmatism who underwent LASIK and PRK, 95.2%, and 96.3% of the patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post LASIK and PRK, respectively. The efficacy and safety indices were 1.00 or more for all groups with no eye lost any line of best corrected distance visual acuity. Conclusion: Our study results confirm the excellent efficacy, safety, good predictability and stability of myopia / myopic astigmatism correction by either wavefront- optimized LASIK or PRK over 1-year follow-up without significant differences between them using the WaveLight® EX500 excimer laser system.

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Correction of Myopia and Myopic Astigmatism by Femtosecond Laser in Situ Keratomileusis

Czech and Slovak Ophthalmology ◽

10.31348/2019/2/2 ◽

2019 ◽

Vol 75 (2) ◽

pp. 65-71

Author(s):

Tereza Řeháková ◽

Věra Veliká ◽

Naďa Jirásková

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

High Myopia ◽

Laser In Situ Keratomileusis ◽

Patient’S Satisfaction ◽

The Mean ◽

One Year ◽

Myopic Astigmatism

Aim: We analysed one-year refractive results and the incidence of complications in patients with correction of low-to-high myopia or myopic astigmatism by femtosecond laser in situ keratomileusis (FS-LASIK) using femtosecond laser LenSx® (Alcon, Fort Worth, Texas, USA) a excimer laser Excimer Amaris 500 (Schwind eye-tech-solutions GmbH and Co KG, Kleinostheim, Germany). Methods: To the retrospective study were included 171 eyes of 87 patients (38 men, 49 women) who underwent correction of myopia and myopic astigmatism by FS-LASIK in the outpatient Department of Ophthalmology, University Hospital in Hradec Králové between 2013-2017. We assessed uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), subjective refraction, central corneal thickness (CCT) in the thinnest point, patient’s satisfaction and the incidence of complications in the one-year follow-up period. Results: At the time of laser procedure the mean patient‘s age was 29,26 ± 6,47 years (range 18 to 46 years). In 21 eyes was corrected myopia (range -6,5 to -2,5 D sph) and in 150 eyes myopic astigmatism (range -8,75 to -0,25 D sph and -3,0 to -0,25 D cyl). The mean preoperative UCVA 0,06 ± 0,08 (range 0,02 to 0,8) got better to 1,12 ± 0,17 (range 0,8 to 1,5) at the end of follow-up period. There wasn’t statistically significant change in BCVA between preoperative and postoperative values. Preoperative mean value of subjective refraction was -4,14 ± 1,43 D sph (range -8,5 to -1 D sph) and -0,57 ± 0,58 D cyl (range -3 to 0 D cyl) and after 12 months -0,02 ± 0,16 D sph (range -0,1 to 0,75 D sph) and -0,01 ± 0,1 D cyl (range -0,5 to 0,5 D cyl). The initial mean CCT was 554,76 ± 30,07 μm (range 485 to 660 μm), after 6 months 494,06 ± 34,99 μm (range 421 to 594 μm) and after 12 months 492,92 ± 34,55 μm (range 411 to 592 μm). We observed peroperative complications in 3 eyes. The suction loss of femtosecond laser occurred during flap creation due to sudden eye movement. Postoperatively in one case we enrolled flap pucker first postoperative day. In other case flap dislocation occurred after abdonimal surgery under general anesthesia which was performed 3 months after refractive procedure and we had to indicate flap reposition. The mean grade of patient’s satisfaction was at the end of follow-up period 1,04. The most often complaints were the sensation of dry eye (10 patients) and blurry vision during computer working, inadequate lighting and fatique (6 pacients). Conclusions: According to our experience correction of low-to-high myopia or myopic astigmatism by using FS-LASIK is an effective, relatively safe and predictable method. The basic assumption of good postoperative results and patient’s satisfaction is thorough and comprehensive preoperative examination with respect to indication criteria.

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Two-year successful results of femto-LASIK in steep and opacified corneas

Medical Hypothesis, Discovery & Innovation in Optometry ◽

10.51329/mehdioptometry106 ◽

2020 ◽

Vol 1 (1) ◽

pp. 37-43

Author(s):

Amr Mounir ◽

Emad Latif Matthias ◽

Islam Awny

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Intraoperative Complications ◽

Anterior Segment ◽

Laser In Situ Keratomileusis ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Refractive Correction ◽

Corneal Opacities ◽

The Right

Background: Flap creation is the most critical step of laser in situ keratomileusis (LASIK). The introduction of the femtosecond laser with its uniform flaps, which enhance the accuracy of LASIK, has decreased the risk of flap-related complications like buttonholes and incomplete flaps. We recommended femtosecond laser-assisted LASIK (FS-LASIK) in the presence of superficial corneal opacities. Case Presentation: We report a case of a 31-year-old female who reported to the Cornea clinic of the Sohag Center for LASIK and Corneal Surgeries, Sohag, Egypt, complaining of bilateral decreased vision due to refractive error. The uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.01 and 0.7 with a refractive correction of -3.50Ds/ –3.00Dc x 172° in the right eye and 0.01 and 0.6 with a refractive correction of -1.75 Ds/-6.00Dc x164° in the left eye, respectively. Slit-lamp examination of the anterior segment showed bilateral superior vascularized corneal scars and a linear superior conjunctival scar suggestive of old trachoma. Corneal tomographic imaging with a Scheimpflug based tomography device (Oculus Inc., Wetzlar, Germany) revealed a symmetrical bow tie with a very steep cornea without other ectatic changes. The patient underwent bilateral FS-LASIK with an excimer laser. No intraoperative complications occurred. She was followed up for two years with serial corneal topographies and stable post-LASIK results and visual outcomes. Conclusions: FS-LASIK, in the presence of superficial corneal opacities, was safe and effective and induced no complications with special precautions. However, these findings are yet to be confirmed using well‐designed clinical studies with larger samples and longer follow-ups.

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Comparison of outcomes after topography-modified refraction versus wavefront-optimized versus manifest topography-guided LASIK

BMC Ophthalmology ◽

10.1186/s12886-020-01459-0 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Jaeryung Kim ◽

Sung-Ho Choi ◽

Dong Hui Lim ◽

Gil-Joong Yoon ◽

Tae-Young Chung

Keyword(s):

Visual Acuity ◽

Vector Analysis ◽

Laser In Situ Keratomileusis ◽

Distance Visual Acuity ◽

Postoperative Astigmatism ◽

Uncorrected Distance Visual Acuity ◽

Manifest Refraction ◽

Corrected Distance Visual Acuity ◽

Myopic Astigmatism

Abstract Background To compare the outcomes of myopia and myopic astigmatism corrected with topography-modified refraction laser in situ keratomileusis (TMR-LASIK), wavefront-optimized (WFO) LASIK, and topography-guided (TG) LASIK with a correction target based on the manifest refraction (manifest TG-LASIK). Methods This observational, retrospective cohort study included patients who underwent LASIK using the WaveLight® EX500 excimer laser to correct myopia and myopic astigmatism between August 2016 and July 2017. Patients who underwent TMR-LASIK (85 patients), WFO-LASIK (70 patients), or manifest TG-LASIK (40 patients) were enrolled, and only one eye from each patient was analyzed. All participants underwent measurement of the uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), manifest refraction, vector analysis of astigmatic change, corneal topography, and corneal wavefront analysis at baseline and at every posttreatment visit. Results Three months postoperatively, a UDVA of 0.0 logMAR or better and manifest refraction spherical equivalent (MRSE) within ±0.5 diopters (D) did not differ across the TMR-, WFO-, and manifest TG-LASIK groups. However, the residual cylinder in the TMR group was significantly larger than that in the WFO and manifest TG groups. The magnitude of error in the TMR group measured using astigmatism vector analysis was significantly higher than that in the WFO and manifest TG groups. Conclusions Although these three LASIK platforms achieved the predicted surgical outcomes, TMR-LASIK overcorrected astigmatism and showed a higher residual postoperative astigmatism compared with WFO- and manifest TG-LASIK.

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Corneal Stability following Hyperopic LASIK with Advanced Laser Ablation Profiles Analyzed by a Light Propagation Study

Journal of Ophthalmology ◽

10.1155/2018/3060939 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Almutez M. Gharaibeh ◽

Asier Villanueva ◽

David Mas ◽

Julian Espinosa ◽

Jorge L. Alió

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Light Propagation ◽

Corneal Surface ◽

Surface Stability ◽

Distance Visual Acuity ◽

Propagation Algorithm ◽

One Year ◽

The Stability

Purpose. To assess anterior corneal surface stability 12 months following hyperopic LASIK correction with a light propagation algorithm.Setting. Vissum Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain.Methods. This retrospective consecutive observational study includes 37 eyes of 37 patients treated with 6th-generation excimer laser platform (Schwind Amaris). Hyperopic LASIK was performed in all of them by the same surgeon (JLA) and completed 12-month follow-up. Corneal topography was analyzed with a light propagation algorithm, to assess the stability of the corneal outcomes along one year of follow-up.Results. Between three and twelve months postoperatively, an objective corneal power (OCP) regression of 0.39 D and 0.41 D was found for 6 mm and 9 mm central corneal zone, respectively. Subjective outcomes at the end of the follow-up period were as follows: 65% of eyes had spherical equivalent within ±0.50 D. 70% of eyes had an uncorrected distance visual acuity 20/20 or better. 86% of eyes had the same or better corrected distance visual acuity. In terms of stability, 0.14 D of regression was found. No statistically significant differences were found for all the study parameters evaluated at different postoperative moments over the 12-month period.Conclusions. Light propagation analysis confirms corneal surface stability following modern hyperopic LASIK with a 6th-generation excimer laser technology over a 12-month period.

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Corneal Spherical Aberration and Corneal Asphericity after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK

Journal of Ophthalmology ◽

10.1155/2017/4921090 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Hui Zhang ◽

Yan Wang ◽

Hua Li

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Spherical Aberration ◽

Laser In Situ Keratomileusis ◽

Anterior Surface ◽

Small Incision Lenticule Extraction ◽

Distance Visual Acuity ◽

Small Incision ◽

Corneal Asphericity ◽

Lenticule Extraction

Purpose. To investigate corneal spherical aberration and corneal asphericity after small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods. This study enrolled 70 patients having SMILE and 64 subjects receiving FS-LASIK. The preoperative spherical equivalent (SE) was −5.83 ± 1.23 diopters (D) and −6.20 ± 1.52 D, respectively. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), SE, corneal spherical aberration, and asphericity over the 6.0 mm cornea were evaluated preoperatively and postoperatively. Results. At 6 months, the UDVA, CDVA, and SE were −0.12 ± 0.11, −0.05 ± 0.05, and −0.16 ± 0.19 D in SMILE and −0.10 ± 0.06, −0.03 ± 0.06, and −0.08 ± 0.25 D in FS-LASIK. There was no difference between groups in the postoperative UDVA, CDVA, or SE (P>0.05). SMILE showed lower inductions of spherical aberration along the anterior surface and the total cornea and less increases in corneal asphericity of the anterior surface postoperatively than FS-LASIK (P<0.01). There were significant correlations between the changes in spherical aberration and corneal asphericity (P<0.001). Conclusions. SMILE and FS-LASIK exhibited excellent visual results and refractive outcomes. SMILE induced less increase in corneal spherical aberration and better preserved the corneal asphericity of the anterior corneal surface than FS-LASIK. Corneal asphericity changes contributed to the corneal spherical aberration changes following SMILE and FS-LASIK.

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Effect of Transepithelial Photorefractive Keratectomy without Mitomycin C in the Treatment of Femtosecond Laser In Situ Keratomileusis Corneal Flap Complications

Journal of Ophthalmology ◽

10.1155/2021/8847922 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Jing Wang ◽

Weiqian Cao ◽

Liming Tao

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Mitomycin C ◽

Laser In Situ Keratomileusis ◽

Photorefractive Keratectomy ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Haze Formation

Purpose. To assess the efficacy and safety of transepithelial photorefractive keratectomy (TPRK) without mitomycin C as treatment for femtosecond laser in situ keratomileusis (FS-LASIK) corneal flap complications. Methods. Eight patients with corneal flap complications that occurred after FS-LASIK (five with eccentric flaps, two with buttonhole flaps, and one with a thick flap) were included in the study. Patients were treated with TPRK without mitomycin C between two weeks and twelve months after surgery. The postoperative manifest refraction, uncorrected distance visual acuity, and haze formation were assessed during six months of follow-up. Results. The mean manifest refractive spherical and cylinder refraction was 0.16 ± 0.26 and −0.44 ± 0.33 diopters, respectively, at six months postoperatively. The uncorrected distance visual acuity was above 20/25 in all patients after six months of follow-up. No haze formation was detected. Conclusions. TPRK without mitomycin C appears to be a safe and effective treatment for FS-LASIK corneal flap complications.

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Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312140 ◽

2018 ◽

Vol 103 (4) ◽

pp. 565-568 ◽

Cited By ~ 15

Author(s):

Tian Han ◽

Ye Xu ◽

Xiao Han ◽

Li Zeng ◽

Jianmin Shang ◽

...

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Laser In Situ Keratomileusis ◽

Small Incision Lenticule Extraction ◽

Small Incision ◽

Lenticule Extraction ◽

Myopic Astigmatism

AimsTo compare long-term clinical outcomes following small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism correction.MethodsIn this retrospective study, we enrolled a total of 101 patients (101 eyes) who underwent SMILE or FS-LASIK 3 years prior. Measured parameters included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and corneal wavefront aberrations.ResultsNo significant differences in patient characteristics were found between the two groups. At the 3-year follow-up, UDVA was better than or equal to 20/20 in 90% and 85% (p=0.540) of the eyes; the efficacy indexes were 1.05±0.19 and 1.01±0.21 in the SMILE and FS-LASIK groups, respectively (p=0.352). Safety indexes were 1.19±0.17 and 1.15±0.20 in the SMILE and FS-LASIK groups, respectively (p=0.307). Eighty per cent and 65% of eyes were within ±0.50 D of the attempted spherical equivalent correction after SMILE and FS-LASIK, respectively (p=0.164). Vector analysis revealed no significant differences in astigmatic correction between the two groups (p>0.05). Surgically induced spherical aberration was higher in the FS-LASIK group than in the SMILE group (p<0.001).ConclusionLong-term follow-up analysis suggested that both SMILE and FS-LASIK were safe and equally effective for myopic and astigmatic correction.

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Correction of Myopic Astigmatism with Topography-Guided Laser In Situ Keratomileusis (TOPOLINK)

Healthcare ◽

10.3390/healthcare8040477 ◽

2020 ◽

Vol 8 (4) ◽

pp. 477

Author(s):

Pei-Lun Wu ◽

Chia-Yi Lee ◽

Han-Chih Cheng ◽

Hung-Yu Lin ◽

Li-Ju Lai ◽

...

Keyword(s):

Visual Acuity ◽

Mixed Model ◽

Linear Mixed Model ◽

Laser In Situ Keratomileusis ◽

Primary Group ◽

Chi Square ◽

Chi Square Test ◽

One Year ◽

Myopic Astigmatism

We aim to assess the feasibility of topography-guided laser in situ keratomileusis (TOPOLINK) for correcting pre-existing and surgical-induced astigmatism. A retrospective, single center cohort study was conducted. Patients with pre-existing irregular myopic astigmatism were recruited into the primary group and those with irregular myopic astigmatism following laser in situ keratomileusis (LASIK) were recruited into the enhancement group. The changes in uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), maximum astigmatism, spherical equivalent (SE) and patient satisfaction were recorded. The Chi-square test, Mann–Whitney U test and Generalized Linear Mixed Model were utilized for the analysis in the current study. A total of 18 eyes were studied in the primary group and 14 eyes were examined in the enhancement group. One year postoperatively, the UCVA, BCVA, maximum astigmatism and SE improved significantly in both the primary and the enhancement groups (all p < 0.05). The UCVA (p = 0.046) and SE (p = 0.003) were worse in the primary group preoperatively but became similar in both groups postoperatively, while the BCVA and maximum astigmatism remained identical between groups throughout the study period (all p < 0.05). In addition, the rate of high and moderate satisfaction reached 90.0% in the primary and the enhancement groups, without significant differences (p = 0.871). In conclusion, the TOPOLINK showed high predictability and will contribute to similar outcomes between primary and postoperative irregular myopic astigmatism concerning visual acuity, refractive status and subject satisfaction.

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One year outcomes after small incision lenticule extraction ReLEX in the correction of myopia and myopic astigmatism

BMC Ophthalmology ◽

10.1186/s12886-021-02195-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Cristina Ariadna Nicula ◽

Dorin Nicula ◽

Sorana D. Bolboacă ◽

Adriana Elena Bulboacă

Keyword(s):

Visual Acuity ◽

Spherical Equivalent ◽

Small Incision Lenticule Extraction ◽

Distance Visual Acuity ◽

Small Incision ◽

Lenticule Extraction ◽

The Mean ◽

One Year ◽

Myopic Astigmatism

Abstract Purpose To report the visual and refractive outcomes of small incision lenticule extraction ReLEX (SMILE) technique using VisuMax femtosecond laser in myopia and myopic astigmatism patients. Material and methods A non-randomized clinical study has been conducted on patients with myopia and myopic astigmatism who underwent ReLEX SMILE technique, using the Zeiss VisuMax Laser system (Carl Zeiss Meditec AG, Jena, Germany) at Oculens Clinic, Cluj-Napoca, Romania. Patients older than 18 years, with ocular astigmatism up to -5 diopters (D), spherical equivalent up to -10.00 D, corrected distance visual acuity (CDVA) of 0.3 or better before the surgery, stable refraction for one year, and with a minimum calculated post operator residual stromal bed of 250μ were included in the study. Results The study involved a total of 25 myopic eyes (median of sphere diopters equal with -4D) and 67 myopic astigmatic eyes (median of cylinder diopters equal with -1.5 D). The mean refractive spherical equivalent (MRSE) on patients with myopic eyes reduced from -4.25D (median) to -0.5D at one month follow-up, -0.25 D at 6 and 12 months. The mean refractive spherical equivalent (MRSE) on patients with astigmatic myopic eyes reduced from-6.25 D to -0.67 D at one month, -0.62 D at six and twelve months. The value of sphere decreased postoperatively on myopic eyes with a median of -0.25D at one, six and twelve months. The value of cylinder decreased postoperatively on myopic astigmatic eyes with a median of -0.50 D at one month, -0.25 D at six months and -0.50 D at 12 months. At 6 and 12 months, 20 (80.0%) of myopic eyes were maintained within ±0.5 D and 22 (88.0%) with ±1D. On both groups (myopic eyes and myopic astigmatic eyes), statistically significant differences were observed when the keratometric baseline values were compared to each follow-up (P-values < 0.0001), without any significant differences between follow-ups (P-values>0.15). At 1-month follow-up, uncorrected distance visual acuity (UDVA) was better than or equal to 0.5 in 88.0% of myopic eyes and 82.1% of myopic astigmatic eyes. UDVA remained stable in all cases of myopic eyes at six months and the percentage increased at 92.0% in myopic eyes. UDVA slightly increased at 6-months (85.1%) and remained at the same value at 12-months in myopic astigmatism eyes. Conclusions SMILE proved an effective and safe refractive corneal procedure and provided a predictable and stable correction of myopia and myopic astigmatism. SMILE technique demonstrated very good outcomes in terms of keratometric, cylinder, spherical measurements.

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