Five-Year Results of Refractive Lenticule Extraction ReLEx SMILE compared to Femto-LASIK

Vienna 2018

Presentation by Dr. Detlev Breyer on the Five Year Results of ReLEx SMILE compared to Femto-LASIK. – Vienna 2018.

Presenter / Co-Authors: Detlev Breyer (1,4), Hakan Kaymak (1,4), Karsten Klabe (1,4), Philipp Hagen (1,4), Timon Ax (1,4), Florian Kretz (2,4), Gerd Auffarth (3,4)

(1) Breyer, Kaymak & Klabe Augenchirurgie, (2) Dr. Gerl & Kollegen Ahaus-Raesfeld-Rheine, (3) Universitaets-Augenklinik Heidelberg, (4) International Vision Correction Research Center Network (

The aim of this retrospective quality management investigation was to answer the question whether 5 years after surgery the visual outcomes for ReLEx smile are as safe, predictable and efficient 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 982 eyes in the ReLEx smile group and 366 eyes operated with Femto-LASIK in the control group are evaluated. In all cases target refraction was emmetropia. Follow up was performed between 6 months and 5 years after treatment. For clinical evaluation visual acuity at far, subjective refraction and wave front analysis (KR-1W, Topcon) were compared. Additionally patient questionnaires were evaluated for dry eye symptoms, comfort and recovery time.

Concerning safety, predictability and efficiency we could not detect significant differences between both methods. 1 year after ReLEx SMILE and LASIK, the mean monocular UDVA was (-0.01+-0.11)logMAR and (0.02+-0.12)logMAR, respectively. These means remained stable within the 5 year follow up, with (0.01+-0.12)logMAR and (0.05+-0.13)logMAR being the 5-year values. With respect to aberrometry, there were significantly lower total higher order aberrations in the ReLEx SMILE group.

Five years after surgery, ReLEx SMILE and Femto-LASIK show equally good results in terms of safety, predictability and efficacy. However, no dry eyes were observed in the ReLEx SMILE group compared to the Femto-LASIK group. Therefore, we clearly favor the ReLEx SMILE technique in patients who ask for painless refractive correction.