title: [Limitations of SMILE (Small Incision Lenticule Extraction)].
abstract: BackgroundSMILE is a relatively new technique to correct moderate and high myopia. The limits of SMILE are yet unknown.MethodsLiterature research using PubMed until October 1, 2016.Results/DiscussionRecently presented axial 2D-strain-stress measurements indicate that the biomechanical impairment of the cornea after SMILE and LASIK is comparable. The difference in elastic moduli is statistically not different. The visual rehabilitation after SMILE takes significantly longer (weeks) compared to LASIK (days). The refractive success rate of SMILE is still not as good as that of LASIK (88 % vs. 95 % within ± 0.5 D) but SMILE has caught up during the past years. The problem of reoperations is not yet solved.ConclusionMore technical and clinical improvements are required to make SMILE comparable to LASIK regarding success rate and patient convenience. The biomechnical argument pro SMILE has turned out to be weak. To achieve the improvements a commercially competing femtosecond laser would be of advantage.
authors.affiliation: Augenarzt, Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Schweiz.
authors.forename: T
authors.initials: T
authors.lastname: Seiler
authors.affiliation: Augenarzt, Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Schweiz.
authors.forename: T
authors.initials: T
authors.lastname: Koller
authors.affiliation: Augenarzt, Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Schweiz.
authors.forename: V V
authors.initials: VV
authors.lastname: Wittwer
mesh_terms: D003315:Cornea / Q000473:pathology / Q000503:physiopathology*; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D048988:Corneal Surgery, Laser / Q000009:adverse effects / Q000379:methods*; D055119:Elastic Modulus; D019317:Evidence-Based Medicine; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D009216:Myopia / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D013812:Therapeutics; D016896:Treatment Outcome; D014792:Visual Acuity