Femtosecond-laser-assisted Small Incision Lenticule Extraction to Treat Refractive Error: A Narrative Review.

With the approval of the Federal Drug Agency of the USA in 2018, femtosecond laser-assisted small incision lenticule extraction (SMILE) became an officially available option in several countries including Saudi Arabia to treat myopia and astigmatism. Intense marketing by industries has placed both clients and corneal surgeons into a dilemma of the plus and minuses of this option. Although several reviews compare SMILE to other conventional methods, especially laser in situ keratomileusis, this narrative review perhaps for the first time offers a detailed summary of this procedure and compares two sets of published literature, by authors from China and other countries. The efficacy and safety of SMILE seem to outnumber the complications and high cost of the investment. Its long-term usefulness for treating high myopia and hyperopia is still a matter of research.