KEY TAKE-AWAYS
- Alcon WaveLight® Topography-Guided LASIK and Zeiss small-incision lenticule extraction (SMILE^) treatments are fundamentally very different corneal refractive procedures.
- Topography-Guided LASIK allows for correction of corneal irregularities that cause HOA aberrations whereas SMILE cannot correct for this. Quantifying UCVA beyond the 20/20 level for these two procedures is critical.
- Where direct comparative studies exist for the two procedures, WaveLight® Topography-Guided LASIK outperformed SMILE.
- Comparisons of SMILE to WFO LASIK or to generalized FS-LASIK are not equivalent to comparisons of SMILE to Topography-Guided LASIK given that Topography-Guided LASIK is a highly customized and advanced procedure.
- While visual and refractive outcomes for low laser energy SMILE are similar to Wavefront Optimized LASIK, many direct comparative studies show that Topography-Guided LASIK outperforms Wavefront Optimized LASIK.
- When compared to LASIK, SMILE has not conclusively shown that the procedure has greater biomechanical stability nor that it results in reduced post-operative dry eye symptoms as a short-term consequence of higher nerve fiber preservation.