Abstract

Small incision lenticule extraction (SMILE) is an all-femtosecond laser treatment for refractive errors. In contrast to previous flap-based treatment, a thin layer of anterior stroma is preserved during SMILE surgery. This has led to the suggestion that SMILE has a higher biomechanical stability than excimer laser based photoablative procedures. Although the potential biomechanical advantage needs to be clinically demonstrated, it has made SMILE particularly interesting in the context of high myopic corrections. At present, the Visumax femtosecond laser allows SMILE to be performed for up to -10 D of myopia. Clinical studies have shown the shown the safety and the visual and refractive outcomes after SMILE to be as good as after FS-LASIK.In the present chapter, the clinical outcome of SMILE for high myopia of more than -6 D is reviewed.

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