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Corneal epithelial remodeling in Myopic correction: SMILE vs Femtosecond laser-assisted LASIK

Poster Details

First Author: I.Kontari GREECE

Co Author(s):    G. Asimellis   A. Kanellopoulos           

Abstract Details


To comparatively evaluate epithelial remodeling differences between myopic correction performed with Small Incision Lenticule Extraction (SMILE) and Femto-second LASIK.

Setting: Clinical and Research Eye Institute, Athens, Greece


Fourier-domain OCT (Avanti, Optovue, Fremont, CA) corneal epithelial imaging was employed to instigate changes in epithelial thickness (Center over the 2 mm-diameter pupil center disk; Mid-peripherally between the 2 to 5 mm zones). Changes were observed six months postoperatively, in comparison to the pre-operative baseline. 50 myopic cases were investigated. Group-A involved 25 cases in which the SMILE procedure was applied (Visumax, Carl Zeiss Meditec, Jena Germany), while Group-B 25 cases in which the LASIK procedure was applied (FS200 femtosecond and EX500 excimer lasers, Alcon, Ft. Worth, TX).


In group A (SMILE) there was a central epithelial thickness increase of +1.86μm (p=0.0035) centrally, and mid-peripherally +4.01 μm (p<0.001). In group B (LASIK) there was a central epithelial thickness increase of +1.98μm (p=0.0022) centrally and mid-peripherally +4.58 μm (p<0.001). When comparing subgroups of matched myopic correction, significant differences between the two groups were noted. For high myopia (more than 6.00 D), in group A (SMILE) the mid-periphery epithelial thickness increase was +4.39μm and +4.75μm for the -7.00 to -8.00D and -8.00 to -9.00D subgroups, respectively. In group B (LASIK), the corresponding epithelial thickness increase was +7.07μm and +9.80μm, respectively.


Myopic SMILE and femto-second LASIK appear to result in comparable epithelial thickness remodeling for small myopia corrections; however there is a noted difference in high myopia corrections. FINANCIAL DISCLOUSRE: One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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