Outcomes

Several studies have compared refractive outcomes of SMILE with those of LASIK. Overall, studies have shown that SMILE results are nearly identical to those of femtosecond laser–assisted LASIK. Currently, the disadvantage of SMILE is its slightly slower visual recovery on postoperative day 1. In a study comparing SMILE with femtosecond laser–assisted LASIK, the uncorrected visual acuity (UCVA; also called uncorrected distance visual acuity, UDVA) in the LASIK group was at first statistically better than in the SMILE group, but at 6 months, no difference in vision was observed between the 2 groups. Incidentally, spherical aberration was lower in the SMILE group. Another study reported that 84% of eyes in each group achieved a UCVA of 20/20; however, 12% in the SMILE group and 4% in the LASIK group achieved a UCVA of 20/15. Higher-order aberrations, postoperative dry eye difficulty, and glare were significantly more common in the LASIK group.

• Ganesh S, Gupta R. Comparison of visual and refractive outcomes following femtosecond laser–assisted LASIK with SMILE in patients with myopia or myopic astigmatism. J RefractSurg. 2014;30(9):590–596.

• Liu M, Chen Y, Wang D, et al. Clinical outcomes after SMILE and femtosecond laser–assisted LASIK for myopia and myopic astigmatism: a prospective randomized comparative study. Cornea. 2016;35(2):210–216.

Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.