Research shows that laser SMILE eye surgery produces nearly identical visual acuity as LASIK for correction of myopia, without requiring LASIK-style corneal flaps. SMILE (Small Incision Lenticule Extraction) Small Incision Lenticule Extraction) is a type of laser eye surgery intended to correct astigmatism, usually at higher degrees of impairment, in order to improve overall visual acuity of a patient. Recently, the range of options for laser vision correction procedures has expanded, as the FDA has approved the use of small incision lenticule extraction, also known as SMILE eye surgery.
During the procedure, a small flap of corneal tissue is created by the laser, which allows that same laser to alter your cornea. With LASIK, the surgeon uses a femtosecond laser to create a tiny corneal tissue flap, which is then folded back in place.
The new procedure uses a femtosecond laser to carve out tiny, lens-shaped tissues on the eyes, making a microscopic cut in the surface of the cornea. During the Smile Refractory Surgery, the Visumax femtosecond laser is used to produce pulses that will contour and create the contours of a thin, lens-shaped slice of corneal tissue called the lenticule. By avoiding the flap-making process, SMILE is able to create the lens-shaped piece of corneal tissue (a lenticule) using just a femtosecond laser, resulting in a minimum amount of exposure and limited damage to structural components of the eye. During the SMILE eye procedure, Dr. Belmont uses a VisuMax femtosecond laser to create a contact-lens-shaped piece of material known as the lenticule inside of your cornea.
During the SMILE procedure, the patient is raised up onto the contact lenses of the femtosecond laser, and suction ports are turned on to hold the patients eyes fixed into proper positions as the lenticule is created.
SMILE eye surgery creates a thin layer of contact lens-like material directly below the eye surface, then a small hole is cut through this layer to remove it (the E in SMILE), rapidly correcting your vision. While SMILE eye surgery does indeed involve moving tissues and making a laser incision, it fixes problems at a smaller scale than most alternative methods, with no compromise to your results. Comparable to both LASIK and refractive surgery, it is a laser-based surgery that helps to correct a particular vision issue related to the cornea, such as myopia. SMILE eye surgery takes just minutes to fix the issue (comparable to the healing time of LASIK and refractive surgery), and requires only a tiny, exact hole in the cornea for the adjustment.
Patients can expect to heal rapidly from SMILE Laser Eye Surgery, and they will feel less discomfort than methods like LASIK because there is no flap created around the cornea. Even more impressive, most people are able to resume normal activities a day after their SMILE laser eye surgery eye surgery procedure, and post-operative dry eyes and discomfort are far less common compared with other refractive procedures, such as LASIK and PRK.
The most common side effect reported by patients who undergo all types of laser surgery is dry eyes, and patients who undergo SMILE are no different. In fact, patients undergoing SMILE surgery tend to describe problems with blurred vision and light sensitivity more frequently at one month after the procedure compared with LASIK. In fact, 3 percent of patients with SMILE have had a visual enhancing procedure in the two years following the original procedure, and the majority are for inadequate correction.
During the 2016 FDA clinical trials, fewer patients achieved 20/20 vision following SMILE surgery compared with those who had undergone LASIK. Studies show that SMILE eye surgery can correct higher amounts of nearsightedness than LASIK surgery, and the risks for requiring a booster procedure to reach a perfect correction are lower.
While it is still in the early stages of being accepted by surgeons, SMILE has been noted to produce similar results as LASIK, with a few potential advantages, such as faster recovery from post-operative dry eyes, re-neuronduction of the corneal nerves, and potential biomechanical advantages. SMILE is a relatively new alternative to the well-established procedure, LASIK (laser assisted in situ keratomileusis). LASIK (laser-assisted in situ keratomileusis) is distinguished from SMILE by using two different lasers for more accurate results. One of the easiest ways to understand Small Incision Lenticule Extraction Laser Vision Correction (SMILE) is by comparing it with Keratomileusis (LASIK) or refractive surgery.
While SMILE and LASIK produce similar results in people who have myopia or astigmatism, SMILEs main advantage is due to being a flapless laser procedure. The new procedure beats out LASIK surgery in all but one aspect, with the exception of the procedure being available to nearsighted individuals only. LASIK patients are able to start seeing the difference almost immediately following their procedure, while a new procedure takes approximately one to two days to kick-in.
LASIK was one of the first laser-guided operations that altered the shape of the cornea, and LASIK works on all types of refractive errors. Originally, these procedures involved razor-thin incisions made with very small scalpels to alter the shape of the cornea or lenses; however, most current versions include programmed lasers for much of the procedure.
Following implementation of intrastromal lenticule techniques, a procedure called small-incision lens extraction (SMILE) was developed, which involves a small 2-3mm incision used to enable the entire corneal lenticule to be extracted without requiring the creation of a flap. The layers of intrastromal lenticule are contoured, and lenticules are either removed from the cornea using a pair of microretinal forceps, or they may be extracted directly from the pocket using a recent version of a lenticule stripper, one of the many instruments developed for the SMILE procedure specifically. The surgeon then extracts the minuscule, via an incision, and the cornea is altered, resulting in corrected nearsightedness.