SMILE proponent defends all-femtosecond procedure for low myopia

Dan Reinstein LASIK is without a doubt an excellent procedure for correcting low myopia, and it cannot be claimed that small incision lenticule extraction (SMILE) differs significantly with respect to efficacy or safety, said Dan Z Reinstein MD, speaking at the Journal of Cataract and Refractive Surgery Symposium at the XXXIV Congress of the ESCRS in Copenhagen yesterday. “But, I can tell you why SMILE is now my procedure of choice,” said Dr Reinstein, London, UK, as he noted that SMILE avoids the flap-related complications of LASIK and the practical disadvantages associated with an excimer laser. He said that when it comes to efficacy and safety, SMILE has “come of age”. “The data for SMILE were not that good in earlier publications. Now, however, SMILE procedures are getting the same efficacy as LASIK and comparable safety,” he said. Presenting his personal data from a series of more than 100 eyes treated for -1.00 to -3.50D myopia, Dr Reinstein reported that at 12 months post-op, uncorrected visual acuity was 20/20 in 96% of eyes, 91% of eyes had no change or gained lines of best corrected visual acuity (BCVA), and none lost two or more lines of BCVA. He also presented data to refute a variety of “myths” surrounding SMILE which might raise concerns about delayed visual acuity recovery, a difficult learning curve, treatment centration accuracy, inability to treat high cylinder or to control for cyclotorsion, lack of custom ablation possibilities, and limited opportunity for retreatment.