One of the newest techniques in refractive surgery is the Small Incision Lenticule Extraction (SMILE) which utilizes a femtosecond laser to create an instra-stromal lenticule that is then removed through a small corneal incision. Significant dry eye disease (DED) symptoms following LASIK is well documented; and in the Ophthalmology 2014 Nov 22 Epub ahead of print, Denoyer et al investigate “Dry Eye Disease after Refractive Surgery: Comparative Outcomes of Small Incision Lenticule Extraction versus LASIK”.
Thirty patients scheduled for bilateral myopic SMILE and 30 age-, sex-, and refraction-matched patients scheduled for bilateral myopic LASIK were enrolled and followed for 6 months. All patients underwent a complete evaluation at 1 and 6 months including Ocular Surface Disease Index [OSDI]), tear film breakup time [TBUT], Schirmer I test, corneal staining and tear osmolarity measurements, together with an overall severity score. Function and morphology of the corneal innervation were evaluated by corneal esthesiometry and subbasal nerve imaging using in vivo confocal microscopy (IVCM). The main outcome was dry eye disease and corneal nerve innervation. They concluded 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. They also found quality of life, TBUT and osmolarity were significantly impaired in the LASIK group compared to the SMILE group.
Read the abstract here