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Outcomes of femtosecond laser lenticular extraction (FLEx, SMILE) vs 6th generation excimer laser in the correction of myopia

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Session Details

Session Title: Presented Poster Session 04: Femto Laser 1

Session Date/Time: Saturday 13/09/2014 | 15:00-17:00

Paper Time: 15:45

Venue: Pod 1 (Poster Village)

First Author: : J.Alio SPAIN

Co Author(s): :    A. Angelov   M. El Bahrawy           

Abstract Details


Outcome analysis (refractive and visual) of pateints who performed Femtosecond refractive Lenticular Extraction (FLEx, SMILE) in comparison to a control group of 6th generation excimer laser, for correction of myopia, in patients with identical age, gender and spherical equivelant (SE) refractive error.


Vissum Instituto Oftalmologico, Alicante, Spain. Resbiomed-Vissum Sofia Eye Clinic, Sofia, Bulgaria.


Comparetive retrospective serial of cases inculding 128 eyes, divided into four groups, each including a sample of 16 eyes, each of which was matched to a case of identical age, gender and spherical equivelant refractive error , that performed 6th generation excimer (LASIK). Groups represented: FLEx (Males);34,18 years (+/-12,18) with SE -4,36 diopters (+/- 3,39). FLEx (Females); 33 years (+/- 11) with SE -4,33 diopters (+/- 4,92). SMILE (Males);31,75 years (+/-12,25) with SE -4,78 diopters (+/-3,34). SMILE (Females);33,75 years (+/-10,75) with SE -4,81diopters (+/- 3,44). Cases of FLEx and SMILE were performed by VisuMax of Carl Ziess Meditec(Jena,Germany), and control excimer cases were performed by Amaris 7505 of Schwind (Kleinosthein,Germany),and Intralace FS of AMO(California,USA). Follow ups were done up to 6 months, varients of comparison included: visual acuity on LogMAR, residual refractive errors, safety and efficacy of treatment modality with topographic and aberrometric data reported by Zernike ANSI Z80.28 and Eyetop of CSO.


The FLEx groups showed a slight decrease in BCVA while the SMILE groups showed a slight increase, more evident in female groups; 0,093 +/-0,1 (P=0,083), -0,025 +/-0,1 (P=0,014) on LogMAR respectively. Female groups had more residual refractive error, highest with FLEx, -0,21D(+/- 2,16). Horizontal coma changes were most significant in male groups, (P=0,06) in SMILE, and (P=0,026) in FLEx, with no significant changes reported in vertical coma in all 4 groups. In case to case comparison with identical (age, gender and refractive error) cases of 6th generation excimer laser, similar patterns of stability in preoperative and postoperative changes were reported, with enhancement treatments done in 24,65% of the control group to achieve target refraction.


Femtolaser lenticular extraction techinques; FLEx and SMILE, had statisfying stable refractive and visual outcomes in both male and females groups, with comparable results, to patients performed 6th generation excimer laser refractive error correction, with identical gender, age and myopic spherical equivelant.

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