Acta Scientific Ophthalmology (ISSN: 2582-3191)

Review Article Volume 3 Issue 8

LASIK X SMILE: Option in Refractive Surgery Correction

Flavio Sartori Junior1* and Joao Alberto Holanda de Freitas2

1Ophthalmologist, Physician in the Clinical Staff of the Hospital Centro Medico de Campinas and the Centro de Cirurgia Refrativa Campinas, Brazil
2Ophthalmologist, Faculty of Medicine of the Federal University of Ceará, specialist by the Brazilian Council of Ophthalmology (CBO), Brazil

*Corresponding Author: Flavio Sartori Junior, Ophthalmologist, Physician in the Clinical Staff of the Hospital Centro Medico de Campinas and the Centro de Cirurgia Refrativa Campinas, Brazil.

Received: July 07,2020; Published: July 28, 2020



Introduction: In Brazil, between 11 and 36% of people have myopia, which is one of the most frequent refractive errors that affects vision from afar, occurring due to the visual image not being focused directly on the retina, but ahead of it. Astigmatism, in addition to being a common optical problem, is associated, in most cases, with other refractive problems, such as myopia or hyperopia. Ophthalmology stands out for being the first specialty in medicine to use laser for therapeutic purposes, as well as for its accelerated and constant development. Corneal refractive surgery, also called subtraction surgery, was the first procedure adopted using the laser, being currently the most used surgery to correct refractive errors.

Objectives: The general objective of this article is to discuss the importance of using the laser in ophthalmology, since the control of the making of the cut with the laser reduces the risk of complications that can occur when creating the flap, such as lamella perforation (buttom hole), irregular cut and incomplete cut. The specific objective is to compare the SMILE (Small Incision Lenticule Extraction) and LASIK (Laser In-Situ Keratomileusis) techniques, for the purpose of verifying which method is the most efficient for correcting refractive errors.

Conclusion: When compared to other surgical techniques, SMILE is considered more efficient, since the incision is up to 80% smaller, which reduces the risk of dry eye by 99%.

Keywords: Ophthalmology; Corneal Refractive Surgery; Laser; SMILE; LASIK



  1. Yamane R. Semiologia ocular, 3rd edition. Rio de Janeiro: Cultura Médica; (2009).
  2. Duarte A. “Alguns recursos ópticos a disposição do médico oftalmologista”. Arquivos Brasileiros de Oftalmologia 60 (1997)320-331.
  3. Bower KS., et al. “Overview of Refractive Surgery”. American Family Physician7 (2001): 1183-1191.
  4. Bechara SJ., et al. Cirurgia Refrativa. São Paulo: Artmed. (2009).
  5. Forseto AS., et al. “PRK versus LASIK para correção de miopia baixa e moderada”. Arquivos Brasileiros de Oftalmologia 4 (2006): 257-262.
  6. Mainan TH. “Stimulated Optical Radiation in Ruby”. Nature4736 (1960): 493-494.
  7. Moo-young GA. “Lasers in ophthalmology”. Western Journal of Medicine 6 (1985): 745-750.
  8. Aron-Rosa DS., et al. “Use of a pulsed picosecond Nd: YAG laser in 6,664 cases”. Journal of American Intra-Ocular Implant Society 1 (1984): 35-39.
  9. Soong HK and Malta JB. “Femtosecond lasers in ophthalmology”. American Journal of Ophthalmology2 (2009): 189-197e2.
  10. Salomao MQ and Wilson SE. “Femtosecond laser in laser in situ keratomileusis”. Journal of Cataract and Refractive Surgery 6 (2010): 1024-1032.
  11. Ambrosio R Jr and Wilson SE. “Complications of laser in situ keratomileusis: etiology, prevention, and treatment”. Journal of Refractive Surgery 3 (2001): 350-379.
  12. Salomão MQ., et al. “Dry eye associated with laser in situ keratomileusis: Mechanical microkeratome versus femtosecond laser”. Journal of Cataract and Refractive Surgery 10 (2009): 1756-1760.
  13. Ambrosio R., et al. “LASIK-associated dry eye and neurotrophic epitheliopathy: pathophysiology and strategies for prevention and treatment”. Journal of Refractive Surgery4 (2008): 396-407.
  14. Victor G., et al. “Primeiro censo brasileiro em cirurgia refrativa”. Arquivos Brasileiros de Oftalmologia6 (2005): 727-733.
  15. Heekeren HR., et al. “The neural systems that mediate human perceptual decision making”. Nature Reviews Neuroscience 9 (2008) 467-479. 
  16. Hess RF., et al. “Binocular vision in amblyopia: Structure, suppression and plasticity”. Ophthalmic and Physiological Optics 34 (2014): 146-162. 
  17. Moshirfar M., et al. “Visual outcomes after wave front guided photorefractive keratectomy and wave front guided laser in situ keratomileusis: Prospective comparison”. Journal of Cataract and Refractive Surgery 8 (2010): 1336-1343.
  18. Shortt AJ and Allan BD. “Photorefractive keratectomy (PRK) versus laser-assisted in-situ keratomileusis (LASIK) for myopia”. Cochrane Database System Review2 (2006): CD005135.
  19. Kuo IC. “Trends in refractive surgery at an academic center: 2007-2009”. BMC Ophthalmology 11 (2011): 11.
  20. Husk JS., et al. “Global processing of orientation in amblyopia”. Vision Research 82 (2013) 22-30. 
  21. Kiorpes L., et al. “Neuronal correlates of amblyopia in the visual cortex of macaque monkeys with experimental strabismus and anisometropia”. Journal of Neuroscience18 (1998): 6411-6424.
  22. Muckli L., et al. “Cerebral correlates of impaired grating perception in individual, psychophysically assessed human amblyopes”. Vision Research 46 (2006): 506-526.
  23. Sengpiel F., et al. “Strabismic suppression is mediated by inhibitory interactions in the primary visual cortex”. Cerebral Cortex 16 (2006): 1750-1758.
  24. Slotnick SD., et al. “Attentional inhibition of visual processing in human striate and extrastriate cortex”. Neuro Image 19 (2003): 1602-1611. 
  25. Zhang B., et al. “Rapid plasticity of binocular connections in developing monkey visual cortex (V1)”. Proceedings of the National Academy of Sciences, USA 102 (2005): 9026-9031.
  26. Pinero DP., et al. “Refractive and aberrometric outcomes of intracorneal ring segments for keratoconus: mechanical versus femtosecond-assisted procedures”. Ophthalmology9 (2009): 1675-1687.
  27. Kumar NL., et al. “IntraLase-enabled astigmatic keratotomy for post-keratoplasty astigmatism: on-axis vector analysis”. Ophthalmology6 (2010): 1228-35 e1.
  28. Soong HK., et al. “Femtosecond laser-assisted lamellar keratoplasty”. Arquivos Brasileiros de Oftalmologia4 (2008): 601-606.
  29. Buratto L and Bohm E. “The use of the femtosecond laser in penetrating keratoplasty”. American Journal of Ophthalmology 5 (2007): 737-742.
  30. Yoo SH and Hurmeric V. “Femtosecond laser-assisted keratoplasty”. American Journal of Ophthalmology2 (2011): 189-191.
  31. Sekundo W., et al. “Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study”. British Journal of Ophthalmology3 (2011): 335-339.
  32. Randleman JB., et al. “Depth-dependent Cohesive Tensile Strength in Human Donor Corneas: Implications for Refractive Surgery”. Journal of Refractive Surgery 24 (2008): 85-89.
  33. Reinstein DZ., et al. “Mathematical Model to Compare the Relative Tensile Strength of the Cornea After PRK, LASIK, and Small Incision Lenticule Extraction”. Journal of Refractive Surgery7 (2013): 454-460.
  34. Scarcelli G., et al. “Brillouin Optical Microscopy for Corneal Biomechanics”. Investigative Ophthalmology and Visual Science 53 (2012): 185-190.
  35. Bingjie Wang., et al. “Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia”. Journal of Ophthalmology (2015).


Citation: Flavio Sartori Junior and Joao Alberto Holanda de Freitas. “LASIK X SMILE: Option in Refractive Surgery Correction". Acta Scientific Paediatrics 3.8 (2020): 29-36.


Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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