September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Small incision lenticule extraction (SMILE) vs LASIK: an ex vivo biomechanical evaluation of low and high myopic corrections
Author Affiliations & Notes
  • Briana C. Gapsis
    Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, United States
  • Adam Ahlquist
    Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, United States
  • Henry Perry
    Department of Ophthalmology, Nassau University Medical Center, East Meadow, New York, United States
    Ophthalmic Consultants of Long Island, East Meadow, New York, United States
  • George Asimellis
    Laservision.gr Clinical & Research Eye Institute, Athens, Greece
  • A. John Kanellopoulos
    Laservision.gr Clinical & Research Eye Institute, Athens, Greece
    Department of Ophthalmology, New York University Medical School, New York, New York, United States
  • Footnotes
    Commercial Relationships   Briana Gapsis, None; Adam Ahlquist, None; Henry Perry, Alcon (C), Allergan (C), Blephex (C), Omidria (C), Ophthalmic Consultants of Long Island (E); George Asimellis, None; A. Kanellopoulos, Alcon/WaveLight (C), Allergan (C), Avedo (C), i-Optics (C), ISP Surgical (C), Keramed (C)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2395. doi:
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      Briana C. Gapsis, Adam Ahlquist, Henry Perry, George Asimellis, A. John Kanellopoulos; Small incision lenticule extraction (SMILE) vs LASIK: an ex vivo biomechanical evaluation of low and high myopic corrections. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2395.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : The small-incision lenticule extraction (SMILE) procedure and laser in situ keratomileusis (LASIK) are both safe, effective, and predictable surgical techniques for the correction of myopia. SMILE presents an alternative to LASIK, which currently may be considered the most established form of laser vision correction. The purpose of this study is to evaluate corneal biomechanical changes associated with low and high myopic correction performed with small incision lenticule extraction (SMILE, employing the Visumax laser, Carl Zeiss Meditec, Jena Germany) compared to Femtosecond-laser assisted LASIK (FS200 & EX500 lasers, Alcon Surgical, Ft. Worth, TX)

Methods : Thirty human donor corneas were subjected to myopic SMILE or LASIK. These corneas were randomly allocated to one of four investigative groups (n=5 each), subjected to the following treatments: group-A -3.00 diopters (D) SMILE; group-B -8.00D SMILE; group-C -3.00D LASIK; group-D -8.00D LASIK. Additionally, two control groups (n=5 each) were formed, one for each procedure: group-E SMILE and group-F LASIK. The corneas in these control groups were subjected to the corresponding femtosecond-laser lamellar cuts but not to tissue removal. Biomechanical evaluation of tensile strength was conducted by biaxial force application. Primary outcome measures were stress at 10% and 15% strain, and Young’s modulus at 10% and 15% strain.

Results : In SMILE, the average relative difference (Δ) of the four metrics evaluated was -35.6% between the -3.00D correction and control and -50.2% between the -8.00D correction and control. In LASIK, average Δ was -21.2% between the -3.00D correction and control, and -50.4% between the -8.00D correction and control. When evaluating the same degree of myopic correction, SMILE, compared to LASIK, appears to result in greater biomechanical reduction for the -3.00D correction (-25.9%) while the difference at -8.00D correction is not statistically significant.

Conclusions : Biomechanical tensile strength is reduced with increasing amounts of myopia corrected in both procedures. LASIK results in less strength reduction in smaller myopes while, in higher myopes, SMILE and LASIK appear to result in similar corneal tensile strength reduction.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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