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SMILE Clinical CompendiumPeer-reviewed journal articles
// INNOVATION MADE BY ZEISS
Contents
Introduction of SMILE technology 3
Clinical advantages of SMILE 4
Corneal sensitivity and dry eye
Nerve fibre regeneration
Corneal biomechanical stability
Higher order aberrations
Visual outcomes 7
Myopia
Low myopia
Moderate to high myopia
Myopic astigmatism
Comparison with LASIK
Treatment parameters 9
Cap thickness
Energy setting
Laser firing pattern
Optical zone
Incision size
Nomogram
Surgical techniques 10
Pocket irrigation
Alternative surgical techniques
Rescue instruments
SMILE enhancement 10
Possible complications 11
Safety and complications
Suction Loss
Diffuse lamellar keratitis
SMILE and forme fruste keratoconus
Safety related investigations 12
VisuMax laser cut quality and accuracy
Changes to cornea curvature and power
Wound healing/inflammatory response
Effect on endothelial cells
Effect on the ocular posterior segment
Centration accuracy
Experimental applications 14
SMILE and lenticule re-implantation
SMILE with collagen cross linking
SMILE with keratoplasty/keratotomy
Future development 15
Hyperopia correction
3
Small-incision lenticule extraction. Abstract
Journal of Cataract & Refractive Surgery 2015 Mar, Moshirfar M,
McCaughey MV, Reinstein DZ, Shah R, Santiago-Caban L, Fenzl CR
Advances in refractive surgery. Full text
Asia-Pacific Journal of Ophthalmology 2015 Mar, Mysore N
and Krueger R
Small Incision Lenticule Extraction (SMILE) in 2015.
Cornea 2015 Apr, Reinstein DZ Full text
New developments in the lenticule extraction procedure.
US Ophthalmic Review 2014 Apr, Hjortdal J, Ivarsen A Full text
Small incision lenticule extraction (SMILE) history,
fundamentals of a new refractive surgery technique
and clinical outcomes. Full text
Eye and Vision 2014, Reinstein DZ, Archer TJ, Gobbe M
One-year refractive results, contrast sensitivity, high-order
aberrations and complications after myopic small-incision
lenticule extraction (ReLEx SMILE). Abstract
Graefes Archive for Clinical Experimental Ophthalmology
2014 May, Sekundo W, Gertnere J, Bertelmann T, Solomatin I
Efficacy, safety, predictability, contrast sensitivity, and
aberrations after femtosecond laser lenticule extraction.
Journal of Cataract & Refractive Surgery 2014, Vestergaard AH,
Grauslund J, Ivarsen AR, Hjortdal JØ Abstract
Femtosecond laser refractive surgery: small incision lenticule
extraction vs. femtosecond laser-assisted LASIK.
Current Opinion in Ophthalmology 2015 July, Lee JK, Chuck RS,
Park CY Abstract
Introduction of SMILE technology
“The all-femtosecond-based flap-free intracorneal refractive procedure has been documented to be a predictable, efficient, and safe procedure for correction of myopia and astigmatism.”Jesper Hjortdal, Clinical Professor, Department of Ophthalmology, Aarhus University
Hospital, Denmark
“Visual and refractive outcomes and safety have been shown to be similar to LASIK. A number of studies have demonstrated a lower reduction and faster recovery of corneal sensitivity and subbasal nerve fiber density after SMILE than LASIK, as expected since the anterior stroma is disturbed only by the small incision.”Dan Z Reinstein, Medical Director, London Vision Clinic, London, UK
4
Dry eye disease after refractive surgery: comparative
outcomes of small incision lenticule extraction
versus LASIK. Abstract
Ophthalmology 2015 Apr, Denoyer A, Landman E, Trinh L,
Faure JF, Auclin F, Baudouin C
Dry eye after small incision lenticule extraction and LASIK
for myopia. Abstract
Journal of Refractive Surgery 2014 Mar, Xu Y, Yang Y
Comparison of dry eye and corneal sensitivity between
Small Incision Lenticule Extraction and femtosecond LASIK
for myopia. Full text
PLOS one 2013 Oct, Meiyan Li, Jing Zhao, Yang Shen, Tao Li,
Li He, Hailin Xu, Yongfu Yu, and Xingtao Zhou
Corneal sensitivity after small-incision lenticule extraction
and laser in situ keratomileusis. Abstract
Journal of Cataract & Refractive Surgery 2015 Aug,
Reinstein DZ, Archer TJ, Gobbe M, Bartoli E
Comparison of corneal sensitivity between FS-LASIK and
femtosecond lenticule extraction or small-incision lenticule
extraction for myopic eyes. Full text
Graefe’s Archive for Clinical and Experimental Ophthalmology
2013 Oct, Wei S, Wang Y
Early outcomes of corneal sensitivity changes after
small incision lenticule extraction and femtosecond
lenticule extraction. Abstract
Graefe’s Archive for Clinical and Experimental Ophthalmology
2013 Jun, Wei SS, Wang Y, Geng WL, Jin Y, Zuo T, Wang L, Wu D
Influence of femtosecond lenticule extraction and small incision
lenticule extraction on corneal nerve density and ocular surface:
A 1-year prospective, confocal, microscopic study. Abstract
Journal of Refractive Surgery 2015 Jan, Ishii R, Shimizu K,
Igarashi A, Kobashi H, Kamiya K
Central corneal sensitivity after small incision lenticule
extraction versus femtosecond laser-assisted LASIK for
myopia: a meta-analysis of comparative studies. Full text
BioMed Central Opthalmology 2015 April, He M, Huang W, Zhong X
Clinical advantages of SMILE
Corneal sensitivity and dry eye
“The SMILE procedure has a less pronounced impact on the ocular surface and corneal innervation compared with LASIK, further reducing the incidence of dry eye disease and subsequent degradation in quality of life after refractive surgery.”Denoyer et al, Ophthalmology 2015 Apr
“Dry eye after corneal refractive surgery usually occurs transiently. The SMILE procedure had better dry eye parameters (Schirmer secretion test without anesthesia, tear break-up time) and relatively fewer subjective symptoms (the McMonnies questionnaire) than LASIK.”Xu et al, Journal of Refractive Surgery 2014 Mar
5
Influence of Femtosecond Lenticule Extraction and Small
Incision Lenticule Extraction on Corneal Nerve Density
and Ocular Surface: A 1-Year Prospective, Confocal,
Microscopic Study. Abstract Journal of Refractive Surgery
2015 Jan, Ishii R, Shimizu K, Igarashi A, Kobashi H, Kamiya K
Confocal comparison of corneal reinnervation after Small
Incision Lenticule Extraction (SMILE) and Femtosecond
Laser In Situ Keratomileusis (FS-LASIK). Full text
PLOS One 2013 Dec, Meiyan Li, Lingling Niu, Bing Qin,
Zimei Zhou, Katherine Ni, Qihua Le, Jun Xiang, Anji Wei,
Weiping Ma, Xingtao Zhou
Corneal regeneration after femtosecond laser small-
incision lenticule extraction: a prospective study. Abstract
Graefe’s Archive for Clinical and Experimental Ophthalmology 2015
Mar, Liu M, Zhang T, Zhou Y, Sun Y, Wang D, Zheng H, Liu Q
Nerve fibre regeneration
Early corneal nerve damage and recovery following small
incision lenticule extraction (SMILE) and laser in situ
keratomileusis (LASIK). Abstract
Investigative Ophthalmology & Vision Science 2014 Mar, Mohamed-
Noriega K, Riau AK, Lwin NC, Chaurasia SS, Tan DT, Mehta JS
Fellow eye comparison of nerve fiber regeneration after
SMILE and femtosecond laser-assisted LASIK: A confocal
microscopy study. Abstract
Journal of Refractive Surgery 2015 Sep, Agca A, Cankaya KI,
Yilmaz I, Yildirim Y, Yasa D, Olcucu O, Demircan A, Demirok A
Subbasal nerve morphology, corneal sensation, and tear
film evaluation after refractive femtosecond laser
lenticule extraction. Abstract
Graefe’s Archive for Clinical Experimental Ophthalmology 2013 Nov,
Vestergaard AH, Grønbech KT, Grauslund J, Ivarsen AR, Hjortdal JØ
Clinical advantages of SMILE
Comparison of corneal biomechanical characteristics after
surface ablation refractive surgery and novel lamellar
refractive surgery. Abstract
Cornea 2015 Nov, Dou R, Wang Y, Xu L, Wu D, Wu W, Li X
Differences in the corneal biomechanical changes after
SMILE and LASIK. Abstract
Journal of Refractive Surgery 2014 Oct, Wang D, Liu M,
Chen Y, Zhang X, Xu Y, Wang J, To CH, Liu Q
Evaluation of corneal biomechanical properties
modification after small incision lenticule extraction using
Scheimpflug-based noncontact tonometer. Full text
Biomed Research International 2014 Aug, Mastropasqua L,
Calienno R, Lanzini M, Colasante M, Mastropasqua A,
Mattei PA, Nubile M
Corneal biomechanical effects: Small-incision lenticule extraction
versus femtosecond laser–assisted laser in situ keratomileusis.
Journal of Cataract & Refractive Surgery 2014 Jun, Di Wu,
Yan Wang, Lin Zhang, Shengsheng Wei, Xin Tang Abstract
Comparison of biomechanical effects of small incision
lenticule extraction and laser in situ keratomileusis:
finite-element analysis. Abstract
Journal of Refractive Surgery 2014 Jun, Sinha Roy A,
Dupps WJ Jr, Roberts CJ
Mathematical model to compare the relative tensile
strength of the cornea after PRK, LASIK, and Small Incision
Lenticule Extraction. Abstract
Journal of Refractive Surgery 2013 Jul, Reinstein DZ, Archer TJ,
Randleman JB
Corneal biomechanical stability
“Both SMILE and FS-LASIK can cause biomechanical changes in the cornea. However, changes in the cornea’s viscoelastic properties were less after lenticule extraction than after LASIK.” Wu et al, Journal of Cataract & Refractive Surgery 2014 Jun
6
Aberration compensation between anterior and
posterior corneal surfaces after Small incision lenticule
extraction and Femtosecond laserassisted laser in-situ
keratomileusis Abstract
Ophthalmic & Physiological Optic 2015 Jun, Li X, Wang Y, Dou R
Comparison of corneal shape changes and aberrations
induced by FS-LASIK and SMILE for myopia. Abstract
Journal of Refractive Surgery 2015 Apr, Gyldenkerne A,
Ivarsen A, Hjortdal JØ
One-year refractive results, contrast sensitivity, high-order
aberrations and complications after myopic small-incision
lenticule extraction (ReLEx SMILE). Abstract
Graefe’s Archive for Clinical and Experimental Ophthalmology
2014 Mar, Sekundo W, Gertnere J, Bertelmann T, Solomatin I
Statistical characteristics of aberrations of human eyes
after small incision lenticule extraction surgery and
analysis of visual performance with individual eye model.
Applied Optics 2015 Sep, Lou Q, Wang Y, Wang Z, Liu Y,
Zhang L, Fang H Abstract
Postoperative ocular higher-order aberrations and contrast
sensitivity: Femtosecond lenticule extraction versus
pseudo small-incision lenticule extraction.
Journal of Cataract & Refractive Surgery 2015 Mar, Tan DK,
Tay WT, Chan C, Tan DT, Mehta JS Abstract
Optical quality and intraocular scattering after
femtosecond laser small incision lenticule extraction.
Journal of Refractive Surgery 2014 May, Miao H, He L, Shen Y,
Li M, Yu Y, Zhou X Abstract
Clinical advantages of SMILE
Higher order aberrations
“ReLEx® SMILE produced satisfactory refractive outcomes with moderate induction of HOA and unaffected contrast sensitivity after 1 year.”Graefe’s Archive for Clinical Experimental Ophthalmology 2014 Mar
“SMILE and FS-LASIK produced distinct changes in anterior corneal shape evident in different postoperative corneal curvatures and power measurements between the two groups. Postoperative HOAs were much lower after SMILE as compared to FS-LASIK.” Gyldenkerne et al, Journal of Refractive Surgery 2015 Apr
7
Visual outcomes
One-year outcomes of small-incision lenticule extraction
(SMILE): mild to moderate myopia vs. high myopia. Full text
BioMed Central Ophthalmology 2015 Jun, Kim JR, Kim BK, Mun
SJ, Chung YT, Kim HS
One-year results of Small Incision Lenticule Extraction
(SMILE) in myopia. Abstract
Klinische Monatsblätter für Augenheilkunde 2014 Oct,
Kunert KS, Melle J, Sekundo W, Dawczynski J, Blum M
Efficacy, predictability, and safety of small incision lenticule
extraction: 6-months prospective cohort study. Full text
BioMed Central Ophthalmology 2014 Oct, Kim JR, Hwang HB,
Mun SJ, Chung YT, Kim HS
Small-Incision Lenticule Extraction for myopia: Results of
a 12-month prospective study. Full text
Optometry & Vision Science 2014 Nov, Xu Y, Yang Y
Visual and refractive outcomes of femtosecond lenticule
extraction and Small-Incision Lenticule Extraction for myopia.
American Journal of Ophthalmology 2013 Oct, Kamiya K,
Shimizu K, Igarashi A, Kobashi H Abstract
Outcomes of Small Incision Lenticule Extraction (SMILE)
in low myopia. Abstract
Journal of Refractive Surgery 2014 Dec, Reinstein DZ, Carp G
SMILE: Refractive lenticule extraction for myopic correction.
Journal Français D’Ophtalmologie 2015 Mar, Albou-Ganem C,
Lavaud A, Amar R Abstract
“Small incision lenticule extraction for low myopia was found to be safe and effective with outcomes similar to those previously reported for LASIK.”Reinstein et al, Journal of Refractive Surgery 2014 Dec
“SMILE is a predictable and safe technique for the surgical correction of moderate to high myopia.”Albou-Ganem et al, Journal Français D’Ophtalmologie 2015 Mar
Myopia Low myopia
Moderate to high myopia
8
Visual outcomes
Comparison of visual and refractive outcomes following
femtosecond laser assisted LASIK with SMILE in patients
with myopia or myopic astigmatism. Abstract
Journal of Refractive Surgery 2014 Sep, Sri Ganesh, Rishika Gupta
Comparison of the Visual Results After SMILE and
Femtosecond Laser-Assisted LASIK for Myopia. Abstract
Journal of Refractive Surgery 2014 Apr, Lin F, Xu Y, Yang Y
Comparison of small incision lenticule extraction and
femtosecond laser assisted LASIK for myopia.
International Eye Science 2013 Oct, Hu Y-K, Li W-J, Gao X-W,
Guo Y-L, Dong J
Comparison with LASIK
“Three-month results demonstrate that refractive accuracy, dry eye, contrast, and induced aberrations are better following SMILE rather than LASIK.” Ganesh et al, Journal of Refractive Surgery 2014 Sep
“SMILE and FS-LASIK are safe, effective, and predictable surgical procedures to treat myopia. SMILE has a lower induction rate of higher-order aberrations and spherical aberration than the FS-LASIK procedure.”Lin et al, Journal of Refractive Surgery 2014 Apr
Clinical study of femtosecond laser corneal small incision
lenticule extraction for correction of myopia and myopic
astigmatism. Abstract
Chinese Journal of Ophthalmology 2013 Apr, Wang Y, Bao XL,
Tang X, Zuo T, Geng WL, Jin Y
Comparison of astigmatic correction after femtosecond
lenticule extraction and small incision lenticule extraction
for myopic. Full text
PLOS One 2015 Apr, Kobashi H, Kamiya K, Ali MA, Igarashi A,
Elewa ME, Shimizu K
Anterior and Posterior Corneal Astigmatism after Refractive
Lenticule Extraction for Myopic Astigmatism. Full text
Journal of Ophthalmlogy 2015 May, Kamiya K, Shimizu K,
Mayumi Yamagishi, Igarashi A, and Kobashi H
Small incision lenticule extraction (SMILE) procedure for
the correction of myopia and myopic astigmatism.
Journal of Emmetropia 2013 Oct, Verdaguer P, El-Husseiny MA,
Elies D, Gris O, Manero F, Biarnés M, Güell JL Full text
Myopic astigmatism
9
Treatment parameters
Contralateral eye comparison between femtosecond
Small Incision Intrastromal Lenticule Extraction at depths
of 100 and 160μm. Abstract
Cornea 2015 Oct, El-Massry AA, Goweida MB, Shama Ael-S,
Elkhawaga MH, Abdalla MF
SMILE procedures with four different cap thicknesses
for the correction of myopia and myopic astigmatism.
Abstract
Journal of Refractive Surgery 2015 Sep, Güell JL, Verdaguer P,
Mateu-Figueras G, Elies D, Gris O, El Husseiny MA, Manero F, Morral M
”Undercorrection of 0.25 D and small effects of patient age and corneal curvature suggest that the standard nomogram for SMILE need only minor adjustments. This study suggests that safety and efficacy are not influenced to any clinically significant degree by easily discernible patient factors.”Hjortdal et al, Journal of Refractive Surgery 2012 Dec
Cap thickness
Corneal power distribution and functional optical zone
following Small Incision Lenticule Extraction for myopia.
Journal of Refractive Surgery 2015 Aug, Qian Y, Huang J,
Zhou X, Hanna RB Abstract
Two millimeter micro incision lenticule extraction surgery
with minimal invasion: a preliminary clinical report. Abstract
Zhonghua Yan Ke Za Zhi 2014 Sep, Wang Y, Wu Z, Tang X,
Zhang J, Dou R, Geng W, Jin Y, Zuo T
Optical zone
Incision size
Effect of femtosecond laser setting on visual performance
after small-incision lenticule extraction for myopia. Abstract
The British Journal of Ophthalmology 2015 Apr, Kamiya K,
Shimizu K, Igarashi A, H
Effect of different femtosecond laser-firing patterns on
collagen disruption during refractive lenticule extraction.
Journal of Cataract & Refractive Surgery 2012 Aug, Riau AK,
Angunawela RI, Chaurasia SS, Tan DT, Mehta JS Abstract
Predictors for the outcome of Small-incision Lenticule
Extraction for myopia. Abstract
Journal of Refractive Surgery 2012 Dec, Hjortdal JØ,
Vestergaard AH, Ivarsen A, Ragunathan S, Asp S
Vector analysis of low to moderate astigmatism with
small incision lenticule extraction (SMILE): results of a
1-year follow-up. Full text
BioMed Central Ophthalmology 2015 Jan, Zhang J, Wang Y,
Wu W, Xu L, Li X, Dou R
Correction of myopic astigmatism with Small Incision
Lenticule Extraction. Abstract
Journal of Refractive Surgery 2014 Apr, Ivarsen A, Hjortdal J
Energy setting
Laser firing pattern
Nomogram
10
Effect of intraoperative corneal stromal pocket irrigation in
Small Incision Lenticule Extraction. Full text
Biomed Research International 2015 Jul, Liu YC, Jayasinghe L,
Ang HP, Lwin NC, Yam GH, Mehta JS
Preliminary evidence of successful enhancement after
a primary SMILE procedure with the sub-cap-lenticule-
extraction technique. Abstract
Journal of Refractive Surgery 2015 Oct, Donate D, Thaëron R
Comparison of four different VisuMax circle patterns
for flap creation after Small Incision Lenticule Extraction.
Journal of Refractive Surgery 2013 Apr, Riau AK, Ang HP,
Lwin NC, Chaurasia SS, Tan DT, Mehta JS Abstract
Development of the continuous curvilinear lenticulerrhexis
technique for Small Incision Lenticule Extraction. Abstract
Journal of Refractive Surgery 2015 Jan, Zhao Y, Li M, Yao P,
Shah R, Knorz MC, Zhou X
New instruments for Lenticule Extraction in Small
Incision Lenticule Extraction (SMILE). Full text
PLOS One 2014 Dec, Liu YC, Pujara T, Mehta JS
Pocket irrigation
Alternative surgical techniques
Rescue instruments
Surgical techniques
SMILE enhancement
11
Possible complications
Safety and complications of more than 1500 Small-Incision
Lenticule Extraction procedures. Abstract
Ophthalmology 2014, Ivarsen A, Asp S, Hjortdal J
“SMILE had acceptable safety. Although 1.5% of eyes had reduced CDVA by 3 months, visual acuity was restored in the long term. Likewise, patient satisfaction was high.”Ivarsen et al, Ophthalmology 2014
Safety & complications
Incidence and management of suction loss in refractive
lenticule extraction. Abstract
Journal of Cataract & Refractive Surgery 2014 Dec,
Chee Wai Wong, Cordelia Chan, Donald Tan, Jodhbir S. Mehta
Implications and management of suction loss during
Refractive Lenticule Extraction (ReLEx). Abstract
Journal of Refractive Surgery 2013 Jul, Sharma R, Vaddavalli PK
Diffuse lamellar keratitis after small-incision lenticule
extraction. Abstract
Journal of Cataract & Refractive Surgery 2015 Feb, Zhao J,
He L, Yao P, Shen Y, Zhou Z, Miao H, Wang X, Zhou X
Corneal ectasia after femtosecond laser-assisted small-incision
lenticule extraction in eyes with subclinical keratoconus/
forme fruste keratoconus.
Journal of Cataract & Refractive Surgery 2015 Jul, Remy M,
Kohnen T Abstract
Bilateral ectasia after femtosecond laser-assisted small-
incision lenticule extraction. Abstract
Journal of Cataract & Refractive Surgery 2015 Jun, Mastropasqua L
Corneal ectasia 6.5 months after small-incision lenticule
extraction. Abstract
Journal of Cataract & Refractive Surgery 2015 May, Wang Y,
Cui C, Li Z, Tao X, Zhang C, Zhang X, Mu G
Suction loss
Diffuse lamellar keratitis
SMILE and forme fruste keratoconus
12
Safety related investigations
Lenticule thickness readout for Small Incision Lenticule
Extraction compared to Artemis three-dimensional very
high-frequency digital ultrasound stromal measurements.
Journal of Refractive Surgery 2014 May, Reinstein DZ,
Archer TJ, Gobbe M Abstract
The Morphology of corneal cap and its relation to
refractive outcomes in femtosecond laser Small Incision
Lenticule Extraction (SMILE) with anterior segment optical
coherence tomography observation. Full text
PLOS ONE 2013 Aug, Zhao J, Yao P, Li M, Chen Z, Shen Y,
Zhao Z, Zhou Z, Zhou X
Changes to cornea curvature and power
Assessing the corneal power change after refractive
surgery using Scheimpflug imaging. Abstract
Ophthalmic & Physiological Optic 2015 May, Gyldenkerne A,
Ivarsen A, Hjortdal JØ
Surface quality of human corneal lenticules after
SMILE assessed using environmental scanning electron
microscopy. Abstract
Journal of Refractive Surgery 2014 Jun, Ziebarth NM, Lorenzo MA,
Chow J, Cabot F, Spooner GJ, Dishler J, Hjortdal JØ, Yoo SH
Surface quality of human corneal lenticules after
femtosecond laser surgery for myopia comparing different
laser parameters. Full text
Graefe’s Archive for Clinical and Experimental Ophthalmology
2011 Sep, Kunert KS, Blum M, Duncker GI, Sietmann R, Heichel J
Accuracy and reproducibility of cap thickness in Small
Incision Lenticule Extraction. Abstract
Journal of Refractive Surgery 2013 Oct, Reinstein DZ,
Archer TJ, Gobbe M
Accuracy and precision of cap thickness in small incision
lenticule extraction. Full text
Clinical Ophthalmology2013 Jul, Ozgurhan EB, Agca A,
Bozkurt E,Gencer B, Celik U, Cankaya KI,Demirok A, Yilmaz OF
VisuMax laser cut quality and accuracy
“The VisuMax readout lenticule depth was found to be 8μm thicker than the achieved stromal change. This can be partly explained by alignment errors between preoperative and postoperative scans.”Reinstein et al, Journal of Refractive Surgery 2013 Oct
13
Safety related investigations
Optical zone centration accuracy using corneal fixation-
based SMILE compared to eye tracker based femtosecond
laser-assisted LASIK for myopia. Abstract
Journal of Refractive Surgery 2015 Sep, Reinstein DZ, Gobbe M,
Gobbe L, Archer TJ, Carp GI
Topographic analysis of the centration of the treatment
zone after SMILE for myopia and comparison to FS-LASIK:
subjective versus objective alignment. Abstract
Journal of Refractive Surgery 2014 Oct, Lazaridis A,
Droutsas K, Sekundo W
Mild decentration measured by a Scheimpflug camera and
its impact on Visual Quality following SMILE in the early
learning curve. Full text
Investigative Ophthalmology & Vision Science 2014 May, Li M,
Zhao J, Miao H, Shen Y, Sun L, Tian M, Wadium E, Zhou X
Decentration of optical zone center and its impact on
visual outcomes following SMILE. Abstract
Cornea 2015 Apr, Liu M, Sun Y, Wang D, Zhang T, Zhou Y,
Zheng H, Liu Q
Centration accuracy
“The centration of the treatment zone as measured by the Pentacam was better for patient-controlled fixation during SMILE than active eye tracker-assisted FS-LASIK.”Lazaridis et al, Journal of Refractive Surgery 2014 Oct
Wound healing/ inflammatory response
Early changes in ocular surface and tear inflammatory
mediators after small-incision lenticule extraction and
femtosecond laserassisted laser in situ keratomileusis.
PLOS One 2014 Sep, Gao S, Li S, Liu L, Wang Y, Ding H, Li L,
Zhong X Full text
Small incision lenticule extraction (SMILE) and femtosecond
laser LASIK: comparison of corneal wound healing and
inflammation. Full text
The British Journal of Ophthalmology 2013 Nov, Dong Z,
Zhou X, Wu J, Zhang Z, Li T, Zhou Z, Zhang S, Li G
Early corneal wound healing and inflammatory response
after Refractive Lenticule Extraction (ReLEx). Full text
Investigative Ophthalmology & Visual Science 2011 Aug,
Riau A, Angunawela RI, Chaurasia SS, Lee WS, Tan D, Mehta JS
Effect on endothelial cells
Short-term and long-term effects of small incision lenticule
extraction (SMILE) on corneal endothelial cells. Abstract
Contact Lens & Anterior Eye 2015 Apr, Zhang H, Wang Y,
Xie S, Wu D, Wu W, Xu L
Effect on the ocular posterior segment
Effect of suction on macular and retinal nerve fiber layer
thickness during femtosecond lenticule extraction and
femtosecond laser-assisted laser in situ keratomileusis.
Journal of Cataract & Refractive Surgery 2014 Dec, Zhang J,
Zhou Y, Zheng Y, Liu Q, Zhai C., Wang Y Abstract
14
Experimental applications
The safety and predictability of implanting autologous
lenticule obtained by SMILE for hyperopia. Abstract
Journal of Refractive Surgery 2015 Jun, Sun L, Yao P, Li M,
Shen Y, Zhao J, Zhou X
Tailored stromal expansion with a refractive lenticule
for cross-linking the ultrathin cornea. Abstract
Journal of Cataract & Refractive Surgery 2015 May,
Sachdev MS, Gupta D, Sachdev G, Sachdev R
LASIK following Small Incision Lenticule Extraction (SMILE)
lenticule re-implantation: A feasibility study of a novel
method for treatment of presbyopia. Full text
PLOS One 2013 Dec, Lim CHL, Riau AK, Lwin NC, Chaurasia SS,
Tan DT, Mehta JS
Femtosecond laser-assisted keyhole endokeratophakia:
correction of hyperopia by implantation of an allogeneic
lenticule obtained by SMILE from a myopic donor. Abstract
Journal of Refractive Surgery 2013 Nov, Pradhan KR, Reinstein DZ,
Carp GI, Archer TJ, Gobbe M, Gurung R
Reversible femtosecond laser-assisted myopia correction:
A non-human primate study of lenticule re-implantation
after refractive lenticule extraction. Full text
PLOS One 2013 Jun, Riau AK, Angunawela RI, Chaurasia SS,
Lee WS, Tan DT, Mehta JS
Cryopreservation of extracted corneal lenticule after
small incision lenticule extraction for potential use in
human subjects. Full text
Cornea 2014 Dec, Ganesh S, Brar S, Rao PA
Cornea lenticule viability and structural integrity after
refractive lenticule extraction (ReLEx) and cryopreservation.
Mohamed-Noriega K, Toh KP, Poh R, Balehosur D, Riau A,
Htoon HM, Peh GSI, Chaurasia SS, Tan D, Mehta JS Full text
SMILE and lenticule re-implantation
“Based on the initial clinical outcome it appears that SMILE Xtra may be a safe and feasible modality to prevent corneal ectasia in susceptible individuals.”Ganesh et al, Journal of Ophthalmology 2015 Jun
SMILE with collagen cross-linking
Femtosecond intrastromal lenticular implantation
combined with accelerated collagen cross-linking for the
treatment of keratoconus – initial clinical result in 6 eyes.
Cornea 2015 Oct, Ganesh S, Brar S Abstract
Clinical outcomes of Small Incision Lenticule Extraction
with accelerated Cross-Linking (ReLEx SMILE Xtra) in
patients with thin corneas and borderline topography.
Journal of Ophthalmology 2015 Jun, Ganesh S, Brar S Full text
SMILE with keratoplasty/ keratotomy
Small Incision Lenticule Extraction after Deep Anterior
Lamellar Keratoplasty. Abstract
Journal of Refractive Surgery 2015 Sep, Mastropasqua L,
Calienno R, Lanzini M, Nubile M
Full-thickness astigmatic keratotomy combined with
Small-Incision Lenticule Extraction to treat high-level
and mixed astigmatism. Abstract
Cornea 2015 Sep, Kim BK, Mun SJ, Lee DG, Kim JR, Kim HS, Chung YT
15
Future development
Improved lenticule shape for hyperopic femtosecond
lenticule extraction (ReLEx® FLEx): a pilot study. Abstract
Lasers in Medical Science 2016 May, Sekundo W, Reinstein DZ, Blum M
Femtosecond lenticule extraction (ReLEx®) for correction
of hyperopia - first results. Abstract
Graefe’s Archive for Clinical and Experimental Ophthalmology
2013 Jan, Blum M, Kunert KS, Voßmerbäumer U, Sekundo W
Hyperopia correction
“This pilot study confirms that the improved lenticule’s design with a large optical and transition zone can achieve good centration and acceptable results for spherical hyperopia using FLEx.” Sekundo et al, Lasers in Medical Science 2016 May
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Each Publication is based on the author´s own professional opinion or their study results.
It does not necessarily reflect Carl Zeiss Meditec AG’s opinion and may not be in line with the clinical
evaluation or intended purpose of our medical devices. Therefore, suitability of clinical application for each
recommendation should be carefully assessed by the concerned physician.