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    Low myopia correction: SMILE versus surface ablation

    Ongoing observational case series is comparing the two corrective techniques

    The use of small-incision lenticule extraction (SMILE) in low myopes is still controversial for two reasons: there might be greater cross-talk between the cap and the lenticule plane, and the challenging separation of a thin lenticule may lead to more complications. In Germany, SMILE is still not recommended for myopia correction <3 D. For this reason, my colleagues and I felt the need to compare the visual and refractive outcomes of SMILE and surface ablations (SAs).

    At the Center for Refractive Surgery Muenster, Germany, we are conducting an ongoing observational case series of our first 123 consecutive SMILE procedures and 29 consecutive SAs for low myopia. Our inclusion criteria for this study are identical to those of the only published study on SMILE for low myopia correction by Dr Dan Reinstein and colleagues, who conducted a retrospective analysis of 120 SMILE procedures for low myopia.1

    Their inclusion criteria were preoperative spherical equivalent refraction of up to -3.50 D, cylinder of up to 1.50 D and corrected distance visual acuity (CDVA) of 20/20 or better. They reported preoperative mean spherical equivalent refraction of -2.61 ± 0.54 D and mean cylinder of 0.55 ± 0.38 D.

    After one year, mean spherical equivalent refraction was -0.05 ± 0.36 D and mean cylinder was ± 0.50 D in 84% and ± 1.00 D in 99% of eyes. They reported that uncorrected distance visual acuity (UDVA) was 20/20 or better in 96% of eyes and 20/25 or better in 100% of eyes. Based on these results, they found SMILE for low myopia was found to be safe and effective with outcomes similar to LASIK.

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