Official ESCRS | European Society of Cataract & Refractive Surgeons


Five-year results of refractive lenticule extraction (ReLEx SMILE) compared to Femto-LASIK

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Session Details

Session Title: Moderated Poster Session: Refractive Surgery: Can Results Improve Even Further?

Venue: Poster Village: Pod 2

First Author: : D.Breyer GERMANY

Co Author(s): :    H. Kaymak   K. Klabe   P. Hagen   L. Beckers   F. Kretz   G. Auffarth        

Abstract Details


There are very few peer-reviewed publications reporting long-term clinical outcome after ReLEx SMILE. The aim of this retrospective analysis is to investigate whether 5 years after surgery the visual outcomes for ReLEx SMILE are as safe, predictable and stable as those after Femto-LASIK.


All ReLEx SMILE (VisuMax, CZM) and Femto-LASIK (Mel 80, CZM) surgeries were performed at the Breyer-Kaymak-Klabe Eyesurgery in Duesseldorf, Germany, which is part of the International Vision Correcton Research Center (


So far the results of 1192 eyes in the ReLEx SMILE group and 404 eyes operated with Femto-LASIK in the control group are evaluated. Follow up was performed between 6 months and 5 years after treatment. For clinical evaluation visual acuity at far, subjective refraction, and retreatment rates were compared. Additionally patient questionnaires were evaluated for dry eye symptoms, comfort and recovery time.


Concerning safety, predictability and stability we could not detect significant differences between both methods. Mean values for spherical equivalent did not show any clinically relevant regression. Regarding the subgroups with target refraction emmetropia, 6 months after ReLEx SMILE and Femto-LASIK, the mean monocular UDVA was (0.01+-0.12)logMAR and (0.04+-0.12)logMAR, respectively. These values remained stable within the 5 year follow up, with (0.03+-0.10)logMAR and (0.03+-0.10)logMAR being the 5-year values. Retreatment rates were comparable in both groups and of the order of 1%.


Five years after surgery, ReLEx SMILE and Femto-LASIK show equally good results in terms of safety, predictability, and stability. However, less dry eyes were observed in the ReLEx SMILE group compared to the Femto-LASIK group. Therefore, we favor the ReLEx SMILE technique in patients who ask for painless refractive correction without the risk of dry eye.

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