Dry Eyes After SMILE

Abstract

Dry eyes is one of most common complications following laser vision correction. Small incision lenticule extraction (SMILE) is a flapless procedure with a smaller corneal incision, less corneal nerves are transected during, making it theoretically less prone to dry eyes. Both SMILE and femtosecond-laser assisted in situ keratomileusis (FS-LASIK) induce a transient worsening in dry eye parameters, but there are evidence showing SMILE holds promises to have fewer negative impacts on the ocular surface parameters and allow an earlier recovery. SMILE-treated eyes may also have shown less corneal denervation and better corneal sensitivity compared to FS-LASIK eyes. This review summarizes the mechanisms of dry eyes after laser vision correction, the short term (≤6 months) and long term (>6 months) results in changes to dry eyes signs and symptoms and corneal sensitivity of SMILE as compared to FS-LASIK. Limitation of the studies and reasons accounting for their discrepancies will be discussed. Future randomized controlled trials with standardized postoperative regime are needed for better evaluation of dry eyes after SMILE.