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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Comparing the results of retreatment procedures after ReLEx SMILE: CIRCLE vs PRK

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Session Details

Session Title: Smile: Small Intrastromal Lenticule Extraction II

Session Date/Time: Tuesday 13/09/2016 | 16:00-17:30

Paper Time: 16:00

Venue: Hall C3

First Author: : R.Pérez Izquierdo SPAIN

Co Author(s): :    F. Poyales   A. Matamoros   D. Medel              

Abstract Details


To compare the results of CIRCLE vs PRK (PhotoRefractive Keratectomy) as retreatment techniques following an initial ReLEx SMILE (Refractive Lenticule Extraction as Small-Incision Lenticule Extraction) surgical procedure.


IOA Madrid Innova Ocular, Spain


The study included all eyes undergoing ReLEx SMILE refractive surgery from September 2013 to December 2015 that later required retreatment. Those eyes were split into two groups, according to the technique employed for retreatment (i.e., either PRK or CIRCLE), and the following parameters were compared: Age, pre-Smile myopic spherical equivalent (i.e., prior to the initial ReLEx SMILE surgery), pre-Smile astigmatism, spherical equivalent prior to retreatment, astigmatism prior to retreatment, lenticule depth in the SMILE procedure, final visual acuity after retreatment and time elapsed since retreatment until maximum visual acuity was achieved.


9 surgeries were performed using CIRCLE and 7 using PRK. In the CIRCLE group best visual acuity (VA) was 0.98± 0.01 and time elapsed until maximum VA was achieved was 40.87 ± 14.08 days. In the PRK group best VA was 0.91 ± 0.09 and time elapsed until maximum VA was achieved was 243.14 ± 231.74 days. The results for the two groups were compared, and statistically significant differences emerged for age (p=0.0025) and pre-Smile spherical equivalent (p=0.0179). As for the time elapsed since retreatment until maximum VA was achieved, the difference doesn’t go beyond the statistical significance threshold.


Despite the difference not being statistically significant by a narrow margin, in clinical practice we have observed that following an initial Smile treatment, recovery after a CIRCLE enhancement surgery is much quicker and more comfortable for the patient than recovery after a PRK enhancement surgery. The differences in pre-Smile spherical equivalent are due to the fact that PRK was the enhancement technique initially used, in a time when we were performing SMILE surgery on patients having higher preoperative refraction values. Therefore, nowadays our technique of choice for post-Smile enhancement surgery is CIRCLE, because patient recovery is much quicker.

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