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Evaluation of two different energy pattern outcomes in refractive lenticule extraction (ReLEx) and Femto-LASIK

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Session Details

Session Title: SMILE for Myopia II

Session Date/Time: Wednesday 17/09/2014 | 08:00-09:30

Paper Time: 08:24

Venue: Capital Hall B

First Author: : D.Breyer GERMANY

Co Author(s): :    H. Kaymak   K. Klabe   C. Pohl        

Abstract Details


Small incision lenticule extraction (SMILE) treatment with the Visumax Laser System by Carl Zeiss Meditec (CZM) represents an alternative technique to treat myopic & astigmatic patients. Our former investigations showed a delayed visual recovery with SMILE in the first month in comparison to the traditional Femto-LASIK (Mel 80 Excimerlaser, CZM) technique. This study adresses the question, whether an alternative corneal perforation pattern (altered energy distribution over area) with SMILE shows different results in visual recovery.


Breyer Kaymak Augenchirurgie


We retrospectively analyzed three different patient populations: Femto-LASIK, SMILE and SMILEAP. Results of wave front analysis and subjective refraction were accquired. Patients were questioned for dry eye symptoms, comfort and recovery. For accurate quality evaluation we compared the results to a controll population, which comprised 70 eyes treated with FemtoLASIK.


Concerning safety and efficiency of each method we could not detect significant differences. Both laser treatments, either SMILE or Femto-Lasik represent state-of-the-art status of both parameters, with a better achieved target refraction in SMILE in higher myopia. All groups show a high visual acuity even after longtime periods (average < 0.05 logMAR uncorrected decimal visus, both populations). Visual recovery was as fast as with the Flap-based LASIK, when the „new“ lenticule preparation pattern was used. Wave front analysis results differed between the „old“ and „new“ lenticule preparation method: SMILEAP showed less corneal higher order aberrations three months after surgery.


The alternative lenticule preparation energy profile clearly presents a big step in improvement of the SMILE technique. Visual recovery is fastened without any deficits in comfort and safety, which now clearly favours the SMILE technique in any aspects compared to the traditional FLAP-based LASIK.

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