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SMILE a competitive option for refractive correction
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NEW YORK — Refractive results and corneal integrity with small incision lenticule extraction are on par with those of LASIK, according to speaker here who recounted his experience with the minimally invasive procedure.
“I am convinced that femtosecond lenticule extraction can compete commercially,” John F. Doane, MD, FACS, said at OSN New York 2017. “Surgery is quick, recovery is quick, there are no flap issues, and essentially from a refractive standpoint [of] metrics, SMILE is equal to LASIK.”
There is about a 10-fold decrease in incision chord length created with SMILE vs. LASIK, according to Doane, which consequently reduces the amount of surface area affected. A 9-mm LASIK flap involves 64 mm2 of surface area, whereas a 7.5 mm SMILE cap affects 44 mm2 of surface area. These smaller incisions incorporate fewer nerves, leading to less dry eye, while optimizing postoperative cornea tensile strength and increasing biomechanical stability, he said.
“It is a small incision and I do think patients will gravitate to that. With no flap there should be no flap risks or complications,” Doane said.
In addition, environmental factors, such as humidity, barometric pressure, altitude and particulate matter, can vary LASIK results, whereas SMILE is done in a vacuum under a patient interface cone, which eliminates those environmental hindrances. – by Rebecca L. Forand
Reference:
Doane JF. Small incision lenticule extraction: What you need to know. Presented at: OSN New York 2017; Oct. 20-22, 2017; New York.
Disclosure: Doane reports doing contracted research for Carl Zeiss Meditec and RxSight, and having ownership interest in Presbyopia Therapies.