SMILE – Small Incision Lenticule Extraction

Gernot Steinwender; Mehdi Shajari; Wolfgang J. Mayer; Daniel Kook; Martin Dirisamer; Thomas Kohnen

doi:10.1055/a-1291-9041

Klinische Monatsblätter für Augenheilkunde, Table of Contents

Klin Monbl Augenheilkd 2020; 237(12): e15-e34
DOI: 10.1055/a-1291-9041

CME-Fortbildung

SMILE – Small Incision Lenticule Extraction

Gernot Steinwender

,

Mehdi Shajari

,

Wolfgang J. Mayer

,

Daniel Kook

,

Martin Dirisamer

,

Thomas Kohnen

Abstract

Zusammenfassung

Die SMILE (small incision lenticule extraction) zählt zu den Verfahren der refraktiven Lentikel-Extraktion und hat sich im letzten Jahrzehnt zu einem etablierten Bestandteil des modernen refraktivchirurgischen Spektrums entwickelt. Dieser Beitrag gibt einen Überblick über Patientenselektion, Operationsmethode, mögliche Komplikationen und klinische Ergebnisse dieser Methode.

Abstract

Refractive lenticule extraction is a corneal surgical technique that uses a femtosecond laser exclusively to create an intrastromal refractive lenticule for the correction of myopia and myopic astigmatism. In small incision lenticule extraction (SMILE) the generated refractive lenticule is subsequently extracted through a small incision. The reported efficacy, predictability and safety of the flap-less SMILE procedure is similar to those of femtosecond laser in situ keratomileusis (LASIK). Advantages of SMILE over LASIK include less iatrogenic dry eye, fewer induced higher-order aberrations, and potentially less biomechanical weakening of the cornea. However, there is a steeper surgeon learning curve for SMILE as the procedure is technically more challenging than LASIK. Furthermore, the current SMILE laser platform cannot use cyclotorsion control or eye-tracking technology and retreatment options are more complex compared to LASIK. This review looks at patient selection, surgical method, possible complications, retreatment options, and postoperative outcome of the SMILE technique.

Schlüsselwörter

refraktive Chirurgie - SMILE - Operationsmethode - Komplikationen - Ergebnisse

Key words

refractive surgery - SMILE - surgical method - complications - results - refractive lenticule extraction

Full Text

References

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