Study Shows Superior Outcomes With SMILE vs LASIK

New Vision clinic, main center for refractive surgery in France, with cutting-edge technology for all eye laser operations. Eye operation using the SMILE, Small Incision Lenticule Extraction, laser technique. It is a new generation of treatment which enables short-sightedness to be corrected without removing the superficial layer of the cornea, nor opening it. The SMILE technique involves producing with the Femtosecond laser, a lenticule, thin slice, in 3D in the thickness of the cornea, and removing it with a micro incision in the shape of a smile. The worse the short-sightedness, the thicker the lenticule. (Photo by: BSIP/Universal Images Group via Getty Images)
The study evaluated the refractive, visual, and aberrometric outcomes of the refractive procedures.

This article is part of Ophthalmology Advisor’s Dry Eye Disease In-Depth coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the dry eye disease experts at the AAO. Check back for more from the AAO 2021 Meeting.


Patients undergoing small incision lenticule extraction (SMILE) for myopia demonstrated better refractive, visual, and aberrometric outcomes than those who were treated using wavefront-optimized lasik laser-assisted in situ keratomileusis (LASIK), according to a study presented at the American Academy of Ophthalmology 2021 meeting, held in New Orleans, November 12-15. The study utilized a ray-tracing aberrometry device to measure the participants’ parameters.

The researchers reviewed 152 eyes of 72 patients who underwent either of the refractive procedures. Visual parameters were assessed using iTrace® (Tracey Technologies), contrast sensitivity, Schirmer score, and subjective questionnaires were conducted at baseline and again 3 month postoperatively. 

The patients who underwent the SMILE procedure were found to have a postoperative manifest refraction spherical equivalent of -0.05±0.20 vs -0.02±0.17 in the patients who received LASIK (P =.47). In SMILE patients, corneal aberrations induced were 0.05±0.05 D, while they were 0.08±0.06 (P =.017) in LASIK patients. Their spherical aberration were measured at 0.003±0.008, vs 0.010±0.013 in LASIK patients. Additional metrics included Strehl ratio, (-0.05±0.072 in SMILE patients vs -0.08±0.078 in LASIK patients, P =.027),  modulation transfer function, (-0.02±0.059 in SMILE vs -0.02±0.058 in LASIK, P =.493), and Q value, (0.16±0.073 in SMILE vs 0.18±0.064 in LASIK). 

The study also found superior Schirmer and dry eye score numbers for the patients who underwent SMILE than LASIK. 

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Gupta A, Thakur A, Kulshrestha A, Dhar S, Malhotra C. SMILE vs LASIK in myopic eyes using ray-tracing aberrometry. Paper presented at: American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract PA036.