Official ESCRS | European Society of Cataract & Refractive Surgeons
Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance

10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits


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Effect of femtosecond laser cutting parameters on the results of small incision lenticule extraction

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Session Details

Session Title: SMILE: Small Intrastromal Lenticule Extraction I

Session Date/Time: Sunday 11/09/2016 | 08:00-10:00

Paper Time: 08:58

Venue: Hall H1

First Author: : X.Chen NORWAY

Co Author(s): :    A. Stojanovic   M. Olsen   A. Lyngstadaas   S. Enayati   T. Utheim        

Abstract Details


To evaluate the effect of femtosecond laser cutting parameters on the results of small incision lenticule extraction (SMILE) in terms of interface light scattering, cap thickness, and refractive outcome.


SynsLaser Kirurgi, Oslo, Norway


Fifty-eight right eyes treated by SMILE with programmed cap thickness of 130 µm were divided into two groups according to laser settings: Pulse energy and spot separation were 165 nJ and 4.5 µm in group 1 (n=36) and 125 nJ and 4.2 µm in group 2 (n= 22). Postoperative grading of interface light scattering under slit-lamp microscopy were performed by subjective evaluation of the area presenting light scattering: grade 0: no scattering; grade 1: ≤25%; grade 2: 25-50%; grade 3: 50-75%; and grade 4: 100%. Cap thickness within central 5 mm of horizontal meridian was measured with SD-OCT


At 3 months postoperatively, for group 1 and 2, the interface scattering grading was 0.9±1.0 and 0.3±0.9 (p<0.05), while clear interface was detected in 33.3% and 86.4% of the eyes. For group 1 and 2, respectively, the cap thickness was 138.9±6.2 µm and 149.4±3.5 µm (p<0.001); the spherical equivalent changed from -4.00±1.84 D to -0.03±0.44 D and from -3.81±2.11 D to -0.04±0.31 D; 83.3% and 95.5% of the eyes were within ±0.5 D of the desired outcome; and 69.4% and 86.4% of the eyes achieved uncorrected distance visual acuity of 20/20.


This study shows that lower pulse energy with tighter spot improved interface light scattering with possibly better refractive outcome. The femtosecond laser cutting parameters demonstrated a significant influence in the cap thickness.

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