Refractive Lenticule Extraction Compared With Femto LASIK in Patients With Low Myopia: 1-Year Results

Monday, April 20, 2015: 8:49 AM
Room 4 (San Diego Convention Center)
Corinna Pohl, PhD
Detlev R. Breyer, MD
Hakan Kaymak, MD
Karsten Klabe, MD
Florian T. Kretz, MD
Gerd U. Auffarth, MD

Purpose
Small incision lenticule extraction (ReLEx Smile) represents an alternative technique to treat myopic and astigmatic patients without a flap creation. Former studies showed comparable visual and aberrometric results with ReLEx smile compared to the traditional Femto-LASIK. The present study analyses whether patients with low myopic eyes with a SEQ from -1.0D to -3.0D and the wish for painless, flap free refractive surgery can be treated with ReLEx smile as precise as with Femto-LASIK.

Methods
So far the results of 40 eyes in the ReLEx smile group (cap thickness ranging from 130 – 140 μm) and 50 eyes operated with Femto-LASIK in the control group are evaluated. Follow up was performed between 1 day up to 12 month after treatment. For clinical evaluation wave front analysis, and subjective refraction were compared. Additionally patient questionnaires were evaluated for dry eye symptoms, comfort and recovery time.

Results
Concerning safety, predictability and efficiency of each method we could not detect significant differences. Both laser treatments, either SMILE or Femto-LASIK represent comparable results. Both groups showed a mean UDVA of < 0.05 logMAR on year after surgery. Visual recovery with the ReLEx smile group was as fast as with the Flap-based LASIK. There was a significant difference in wave front analysis between the Femto-LASIK and ReLex smile group. Less dry eyes as well as better patient comfort and less pain sensation were observed in the ReLEx smile group. No complications occurred when preparing the ultrathin lenticule.

Conclusion
Visual recovery and results are fastened without any deficits in comfort, safety, effectiveness and predictability with ReLEx smile procedure. No dry eyes were observed in the ReLEx smile group compared to the Femto-LASIK group. Therefore we clearly favor the ReLEx smile technique in patients who ask for painless refractive correction of low myopia compared to the traditional FLAP-based LASIK. Because of the ultrathin lenticule this method is not recommended for beginners with ReLEx smile.