Article
Treatment of cases by SMILE not considered candidates for LASIK or PRK
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Published: | March 4, 2014 |
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This talk will discuss the all-in-one femtosecond laser corneal refractive surgery procedure called small incision lenticule extraction (ReLEx smile) – a keyhole intra-stromal form of keratomileusis – using the VisuMax femtosecond laser. The talk will discuss the potential advantages of the smile procedure compared with LASIK and PRK due to the anterior stromal lamellae remaining intact. Firstly, dry eye symptoms may be improved as the anterior corneal nerve plexus is less affected, which has been demonstrated by faster recovery of corneal sensation and corneal reinnervation. Secondly, SMILE leaves the cornea with greater postoperative tensile strength as the anterior stromal lamellae, the strongest part of the stroma, are not cut; this results in less biomechanically induced spherical aberration. Despite SMILE lenticule profiles being spherical, induction of spherical aberration in SMILE is lower than the most modern aspheric LASIK ablation profiles for equivalent tissue removal. In preserving stronger anterior stromal lamellae, SMILE optical zones can be safely increased to improve spherical aberration control while still leaving postoperative relative corneal tensile strength higher than for an equivalent modern highly spherically optimised LASIK procedure.