KEY TAKE-AWAYS:

Alcon WaveLight^® Topography-Guided LASIK and Zeiss small-incision lenticule extraction (SMILE^) treatments are fundamentally very different corneal refractive procedures.

Topography-Guided LASIK allows for correction of corneal irregularities that cause HOA aberrations whereas SMILE cannot correct for this. Quantifying UCVA beyond the 20/20 level for these two procedures is critical.

Where direct comparative studies exist for the two procedures, WaveLight^® Topography-Guided LASIK outperformed SMILE.

Comparisons of SMILE to WFO LASIK or to generalized FS-LASIK are not equivalent to comparisons of SMILE to Topography-Guided LASIK given that Topography-Guided LASIK is a highly customized and advanced procedure.

While visual and refractive outcomes for low laser energy SMILE are similar to Wavefront Optimized LASIK, many direct comparative studies show that Topography-Guided LASIK outperforms Wavefront Optimized LASIK.

When compared to LASIK, SMILE has not conclusively shown that the procedure has greater biomechanical stability nor that it results in reduced post-operative dry eye symptoms as a short-term consequence of higher nerve fiber preservation.