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ReLEx® SMILE: two years follow-up results and lenticules examination

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Session Details

Session Title: Femtosecond Small Lenticule Extraction II

Session Date/Time: Tuesday 08/09/2015 | 16:30-18:30

Paper Time: 16:30

Venue: Room 17

First Author: : A.Kachanov RUSSIA

Co Author(s): :    S. Nikulin   E. Togo                 

Abstract Details


To estimate two years follow-up results and lenticules features of ReLEx® SMILE surgery.


St.-Petersburg brunch of Sv. Fyodorov “Eye Microsurgery Clinic”, St.-Petersburg, Russia.


ReLEx® SMILE surgery was performed in 490 eyes (250 patients) (main group) by using VISUMAX femto-laser platform (“Carl Zeiss Meditec”). The “excimer” control groups consisted of LASIK (222 eyes, 116 patients) and PRK (276 eyes, 143 patients). We used two techniques of lenticule removal - forceps technique and “Cobra” spatula (single instrument) one. Some lenticules were examined by using histology and immunochemistry methods. The age of our patients in all groups was from 18 to 45 years. Follow-up period was up to 24 months.


SMILE surgery was without a flap, and we used only a small (from 2,0 to 4,14 mm) peripheral incision, from which the refractive lenticule could be removed, leaving the anterior lamellae of the cornea intact well in all patients. The incidence of complications after SMILE was very low. The authors observed a lot of histology findings of extracted lenticules. There were four types of lenticule in our study: lenticule with a lot of cavitation bubbles (1), without cavitation bubbles /HE stain/ (2), lenticule with a small number of nerve fibers (3) or with many nerve fibers (immunohistochemistry /CD56/) (4).


ReLEx® SMILE operation is very effective procedure in treating myopia and myopic astigmatism. There was a statistical significant difference of UCVA recovery in patients after SMILE, LASIK and PRK surgeries. In the first three months mean UCVA level after SMILE surgery was a little bit smaller, than after LASIK one. The authors suggested that visual recovery after SMILE depended on the “quality” and features of extracted lenticules.

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