Vol. 7, Issue 2, Part A (2025)

Purpose: To evaluate and compare the tear film stability and visual outcomes in patients with low to moderate myopia undergoing Femto-LASIK and SMILE refractive surgeries.
Methods: This prospective comparative study was conducted at the cornea department of M.M. Joshi Eye Institute, Hubli. This study was designed to evaluate and compare the tear film stability and corneal outcomes of two refractive surgeries—FEMTO-LASIK and SMILE. A total of 120 patients above 18 years of age were included, with 60 patients undergoing SMILE surgery and 60 patients undergoing FEMTO-LASIK. All patients provided informed consent. And were Preoperatively assessed for visual acuity (UCVA), contrast sensitivity & tear film stability. Postoperative evaluations at one week & one month assessed changes in visual acuity, contrast sensitivity & dry eye symptoms. 
Result: Both SMILE and Femto-LASIK surgeries produced excellent visual and refractive outcomes. However, Smile patients demonstrated significantly better tear production, suggesting a lower risk of dry eye symptoms. Other parameters like visual acuity, contrast sensitivity, were comparable between groups. Visual Acuity: Significant improvement for SMILE at 1 month (p=0.048).Contrast Sensitivity: Minor significant drop for SMILE at 1 week (p=0.013); Femto improved at 1 month (p=0.011).Schirmer’s Test: Significant decrease in both groups at 1 week and still significant at 1 month (p<0.001).NIBUT test: Significantly better tear film stability in SMILE vs. FEMTO at 1-week post-surgery (p<0.001).SMILE maintains slightly better NIBUT values at 1 month. 
Conclusion: while both SMILE and FEMTO-LASIK effectively correct low to moderate myopia, SMILE offers improved contrast sensitivity, & greater tear film stability, leading to enhanced comfort and visual quality. Therefore, SMILE is a better option in surgical techniques.”