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Spektrum der Augenheilkunde

, Volume 33, Issue 6, pp 147–154 | Cite as

„Small incision lenticule extraction“ (SMILE): eine Standortbestimmung

  • Nikolaus Luft
  • Jakob Siedlecki
  • Benedikt Schworm
  • Martin Dirisamer
  • Siegfried G. PriglingerEmail author
main topic
  • 12 Downloads

Zusammenfassung

Mit bis dato über 2 Mio. durchgeführten Eingriffen ist die „small incision lenticule extraction“ (SMILE) ein integraler Bestandteil des Armamentariums der modernen keratorefraktiven Chirurgie geworden. Diese gänzlich Femtosekundenlaser-basierte Technik ermöglicht eine Flap-freie minimal-invasive Korrektur von Myopie und myopem Astigmatismus mit ebenbürtiger Präzision und Sicherheit im Vergleich zur Femtosekunden-assistierten Laser-in-situ-Keratomileusis (fs-LASIK). Potenzielle Vorteile liegen in der geringen Kompromittierung der kornealen biomechanischen Stabilität und in der Reduktion postoperativer Beschwerden durch das trockene Auge. Als noch ungelöste technische Limitationen sind die manuelle Zyklotorsionskontrolle und die fehlende Möglichkeit einer exklusiv Femtosekundenlaser-basierten Nachkorrektur anzuführen. In der vorliegenden Arbeit wird auf den historischen Hintergrund und die Entwicklung der SMILE, aktuelle Empfehlungen zu chirurgischer Technik und Anwendungsspektrum, klinische Ergebnisse, Vor- und Nachteile gegenüber konkurrierenden keratorefraktiven Verfahren als auch auf zukünftige Entwicklungen eingegangen.

Schlüsselwörter

Keratorefraktive Chirurgie Femtosekundenlaser Minimal-invasiv Lentikel 

Small incision lenticule extraction (SMILE): an update

Summary

With more that 2 million procedures performed globally, small incision lenticule extraction (SMILE) has become an integral component of modern keratorefractive surgery. This all femtosecond laser-based technique enables flap-free and minimally invasive surgical correction of myopia and myopic astigmatism with on par safety and efficacy compared with femtosecond laser in situ keratomileusis (fs-LASIK). Less iatrogenic detriment to corneal biomechanical stability and reduced postoperative dry eye symptoms constitute potential advantages of SMILE compared to flap or surface ablation-based keratorefractive techniques. Residual technical limitations of SMILE include the lack of automated cyclotorsion control and the unavailability of exclusively femtosecond laser-based retreatment. The present review sheds light on the historical background of SMILE, summarizes present recommendations regarding the surgical technique and the treatment range and discusses advantages and drawbacks of SMILE as well as future refinements.

Keywords

Keratorefractive surgery Femtosecond laser Minimally invasive Lenticule 

Notes

Interessenkonflikt

N. Luft, J. Siedlecki, B. Schworm, M. Dirisamer und S.G. Priglinger geben an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag GmbH Austria, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Nikolaus Luft
    • 1
    • 2
  • Jakob Siedlecki
    • 1
    • 2
  • Benedikt Schworm
    • 1
    • 2
  • Martin Dirisamer
    • 1
    • 2
  • Siegfried G. Priglinger
    • 1
    • 2
    Email author
  1. 1.AugenklinikLudwig-Maximilians UniversitätMünchenDeutschland
  2. 2.SmileEyesLinzÖsterreich

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