Comparing the outcomes of SMILE and LASIK
A French study, carried out in collaboration between the Quinze-Vingts National Hospital and the University of Paris, examined the dry eye outcomes of refractive surgery, comparing the LASIK and SMILE (Small Incision Lenticule Extraction) techniques.
The aim of the study was first of all to examine the occurrence of dry eye, by means of a comprehensive post-operative check-up at 1 month and 6 months, using the OSDI (Ocular Surface Disease Index) qualitative test, clinical examinations (T-BUT, Schirmer I test, corneal staining) and tear osmolarity measurements, together with an overall assessment of the degree of dry eye severity.
In parallel, corneal innervation was tested with corneal extesiometry and sub-basal neurological imaging using In Vivo Confocal Microscopy (IVCM).
With both techniques, there was a high incidence of mild to moderate dry eye in the immediate postoperative period. However, after 6 months the incidence remained much higher in patients treated with LASIK than in those treated with SMILE, leading to a more frequent use of tear substitutes in the former group in the longer term. Corneal sensitivity was also better preserved with SMILE, already one month after surgery.
In conclusion, the SMILE technique was found to have significantly less impact on the ocular surface and corneal innervation than LASIK.
This less invasiveness results in a lower incidence of dry eye and the subsequent deterioration of quality of life after refractive surgery.
See the article published in No. 122 Ophthalmology.
Dr. Carmelo Chines
Direttore responsabile
English 
Italian