Since 1991, eye surgeons offered a one-size-fits-all procedure called LASIK. Every day, thousands of people had LASIK because that was the staple of the laser eye surgery world – and it’s still great.
One day about ten years ago (2011), a brilliant team of German scientists revolutionized laser eye surgery. They introduced a less-invasive and flapless procedure and called it SMILE.
Because of that, millions of people who either couldn’t have LASIK or didn’t like the idea of a flap chose SMILE.
SMILE® stands for “small incision lenticule extraction” and combines the best of both worlds from PRK (photorefractive keratectomy) and LASIK (laser-assisted in situ keratomileusis) techniques.
SMILE is an excellent option for many patients with a refractive error who wish to reduce their dependence on glasses and contact lenses. Since its introduction, over 4 million eyes have seen the benefits of SMILE® laser surgery, allowing patients to continue their active lifestyles without impediment from their glasses or contacts with LASIK surgery.
Am I suitable for SMILE®?
Laser eye surgery in Melbourne is now available to more patients than ever before with the introduction of SMILE® technology at Eye Laser Specialists. Though the usual exclusion criteria do apply, refractive surgery is now more accessible with the added advantages of the SMILE® technique.
Before entering the SMILE® operating theatre, you will undergo a thorough clinical assessment with the ophthalmology team. This is to ascertain your suitability for the procedure and to take the appropriate measurements necessary to guide the laser in creating the precise lenticule.
SMILE® may be most suited to:
Patients with pre-existing dry eye
Other refractive surgery techniques can carry a big risk factor for the exacerbation of pre-existing dry eye or the new development of dry eye due to the nature of the surgery. Dry eye post-operatively from SMILE® is exceedingly rare due to the minimally invasive nature of this procedure, allowing better preservation of the corneal nerves. The incidence of dry eye in the general population increases with age, making SMILE® an excellent option for older generations.
Patients who play contact sports or work in environments with risk of trauma
SMILE® is a flapless procedure, eradicating all risks of flap-related complications. Patients can return to their hobbies and work without concern of mild trauma or dirty environments, causing a corneal flap to dislodge or move, or debris to get caught under the flap.
Patients who can’t afford a long recovery time
Many of us lead busy lives, and taking time off work can be difficult. Because SMILE® is such a minimally invasive procedure, most patients find they can drive and return to work within 2 to 3 days after surgery. Though vision may take a few weeks to stabilise, the majority of patients find they can see quite clearly the immediate day after surgery.
SMILE works by using a femtosecond laser to remove a small piece of corneal tissue called a lenticule through a keyhole incision. This reshapes the cornea and corrects your vision. The total time spent on the operating bed is about 10-20 minutes but the procedure itself, from the incision to the laser to the removal of the lenticule, takes only a few minutes per eye.
What are the advantages of SMILE laser eye surgery?
The benefits of SMILE® eye surgery are numerous, which is why this technique is considered a revolutionary refractive surgery procedure.
During LASIK eye surgery, a superficial flap of corneal tissue is created to allow the laser to access the underlying layers. Although uncommon, some complications can arise from the creation of this flap. SMILE® eliminates the need to form a flap and therefore eliminates all flap-related risks.
The term minimally invasive refers to the minimal amount of tissue affected during the surgery. As the superficial layers of the cornea are left intact, this contributes to improved biomechanical stability of this structure and promotes faster healing when compared to the LASIK procedure.
The fewer steps and movements in a surgical procedure, the better. SMILE only uses one laser for the entire technique, meaning we do not need to move the patient from one machine to another. This also reduces the incidence of technique-related complications.
Due to its minimally invasive nature and keyhole incision, the physical recovery after a SMILE® operation is very quick.
Lower risk of dry eye post-operatively
When compared to the LASIK procedure, SMILE® carries a much lower incidence of postoperative dry eye complications. This is due to fewer corneal nerves being affected during the SMILE® procedure, which is important for the healthy and normal production of tears.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Major risks which are very rare:
- Loss of BCVA
- Corneal ectasia
Minor risks include:
- Retained lenticule
- Suction loss
- Need for enhancement surgery
- Dry eye
We will always recommend SMILE surgery If patients are suitable to have either SMILE, LASIK or PRK as we know that the outcomes are excellent with less dry eye and less need for future enhancement treatments.
Step 1: Lenticule creation
We create a small piece of corneal tissue (lenticule) and a small incision inside the intact cornea
Step 2: Lenticule removal
We remove the lenticule through the incision
Step 3: Impairment is corrected
Removing the lenticule changes the shape of the cornea, achieving a vision correction
SMILE has excellent refractive results, less dry eye, better contrast and less induced aberrations than other refractive laser platforms.