C54677: Managing myopia with a SMILE

Surgical correction of refractive errors is popular and the excimer laser and the later addition of the femtosecond laser have revolutionised corneal refractive surgery. Progressive flattening of the cornea, diurnal fluctuations in vision post-operatively and the invention of laser-based techniques (PRK, LASEK and LASIK) were some of the reasons radial keratotomy (RK) is largely obsolete. Many other corneal refractive procedures have been attempted, such as thermal collagen shrinkage and epikeratoplasty, and these have largely been abandoned. Other techniques such as arcuate keratotomy and corneal inlays are still used.

More recently femtosecond lenticule extraction (FLEx) of intracorneal tissue, using only a femtosecond laser, has become possible. A stromal lenticule was created in conjunction with a lamellar flap. This was the precursor to the small incision lenticule extraction (SMILE) procedure for treating myopia and astigmatism. This article provides an introduction to SMILE.