Issue: June 2012
April 16, 2012
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Surgeon prefers femtosecond laser-only refractive procedure over LASIK

Issue: June 2012
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BUSAN, Korea — Superior outcomes with a femtosecond laser-only small-incision lenticule extraction procedure have convinced one surgeon to make it his preferred refractive surgery technique for low to medium myopia.

In a presentation here at APAO/SOE 2012, Kimiya Shimizu, MD, presented results of a comparative study of 46 eyes of 23 patients involving two refractive procedures using the VisuMax femtosecond laser platform (Carl Zeiss Meditec). Femtosecond lenticule extraction (FLEx) was performed in one eye, and small-incision lenticule extraction (SMILE) was performed in the other.

Dr. Shimizu found similar efficacy in visual improvement in both FLEx and SMILE, but significantly lower pain scores and occurrence of dry eye in the SMILE group. Confocal microscopy also showed a significantly higher trigeminal nerve density, he said.

Patients reported a visual analogue scale pain score of 93.2 with the FLEx procedure vs. 37.9 with SMILE, he said.

Dr. Shimizu said that due to the good safety, predictability and efficacy, preservation of nerve fibers, and lack of dry eye, SMILE has become his preferred refractive procedure, and he no longer performs the FLEx procedure or LASIK.

The SMILE procedure uses a femtosecond laser to create a lenticule of corneal tissue, which is then removed with forceps through a small clear corneal incision also created by the femtosecond laser system.

  • Disclosure: Dr. Shimizu has no relevant financial disclosures.