Advantages and Disadvantagesof Femto-SMILE Procedure Compared To Other Refractive Surgeries

Abstract

Refractive surgery through laser vision correction (LVC) has evolved significantly within the past few decades. From the first generation techniques involving surface ablation to LASIK, refractive surgery has now become intrastromal with the advent of refractive lenticule extraction (ReLEx) technology. This procedure when performed through a small incision (2–4 mm) was described as small incision lenticule extraction (SMILE), which is essentially a bladeless, flapless and minimally invasive technique compared to LASIK, where a corneal flap is created using either a blade or a femtosecond laser. Currently, ReLEx SMILE corrects myopia up to −10.00 D, myopic astigmatism up to −5.00 D and a spherical equivalent (SE) of up to −12.5D.The correction of high myopia and high cylindrical errors are currently investigated as technique lacks automated centration and cyclotorsion control.Hyperopic SMILE treatments are not commercially available yet. In SMILE, a single laser (FSL) is used to make two curved cuts inside the cornea (without breaching the outside) that separate a lenticule of tissue. This part of tissue is removed as once piece rather than evaporated as in LASIK. Recent advancements in the laser frequency and energy delivery patterns, instrumentation, and surgical techniques have