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Comparison of corneal ultrastructure and cell response after femtosecond laser small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK)

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Session Details

Session Title: Interactive Free Paper Session: Femtosecond Small Lenticule Extraction I

Session Date/Time: Monday 07/09/2015 | 09:00-11:00

Paper Time: 10:24

Venue: Room 19

First Author: : W.Mayer GERMANY

Co Author(s): :    M. Dirisamer   R. Schumann   T. Kreutzer   S. Priglinger   R. Scheler   D. Kook     

Abstract Details


To describe the ultrastructure and the immunohistochemistry of the corneal stroma after femtosecond laser small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (LASIK).


Experimental study at Ludwig-Maximilians University Munich, Germany and General Hospital Linz, Austria.


Eighteen human corneoscleral buttons were stored in organ culture for a maximum of 21 days. SMILE procedure was performed in ten corneas for two refraction corrections (-5.0 dpt, and -2.50 dpt), while another eight corneas were treated with LASIK (-5.0 dpt, and -2.50 dpt). Corneas were analyzed for wound healing abilities and stromal cell death reaction using immunohistochemistry with different cell markers (Ki67, Fibronectin, TUNEL, HLA-DR, CD11b and TGF beta 1) and for morphological characteristics of the stromal bed using transmission electron microscopy (TEM).


Ultrastructural analyzes showed in both surgical approaches a well-preserved architecture of the stroma. However, jagged edges were seen in SMILE images caused by instruments used for lenticule extraction. We observed no significant difference in inflammatory or apoptotic cell response using either SMILE or LASIK (p<0.05), but extracellular matrix deposition was more pronounced in the LASIK group. Furthermore, in both treatment groups wound-healing response is correlated with the level of corrected refraction.


The in vitro study of human corneas has shown more structural changes in the stromal wound bed after SMILE compared to LASIK but less response in corneal cell reaction.

Financial Interest:


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