ReLEx SMILE (more commonly known as just SMILE) is a fairly recently developed outpatient laser surgical procedure used to treat the following:
In SMILE, a small piece of tissue from within the cornea is removed to alter the shape of the cornea to improve the way light rays are focused on the retina.
SMILE is performed to decrease your reliance on glasses and contact lenses. In most cases, spectacle and contact lens independence is achieved. If you are beyond 45 years of age and require glasses for reading (a condition called presbyopia), you will probably still need your reading glasses after SMILE.
Here is what to expect:
You will be awake during the surgery and no sedation is necessary.
A video showing how SMILE eye surgery is performed. A femtosecond laser is used to create precise surgical planes within the cornea. The surgeon then removes a small piece of tissue called the “lenticule” from within the cornea, and this corrects the short-sightedness and / or astigmatism.
Generally, in order to undergo SMILE, you should:
Most importantly, you must have realistic expectations about the outcome of the procedure, and be willing to accept the potential risks associated with it. Fortunately, SMILE is very safe, and the results excellent.
Here are important points to note:
Overall, the surgery and post-surgery recovery, like LASIK, is a pleasant experience for most patients.
Most patients are able to return to work a day or two later.
Stabilization of vision varies. For some patients, it may take several weeks or a few months.
Like any other surgery, SMILE has side effects that you need to know about and carefully consider before deciding on having the surgery. Fortunately, SMILE is a very safe procedure and most of the side effects are mild and temporary. These include dry eye, fluctuating vision, hazy vision, haloes and glare in a dim environment and light sensitivity. Over- and under-correction may also occur, and a “top up laser” procedure called “enhancement” may be required in some cases. Serious side effects that can result in loss of vision are extremely rare, and these include severe inflammation, infection and corneal ectasia (weakening and thinning of the cornea).
SMILE is technically more difficult to perform than LASIK eye surgery, and occasionally problems with the creation and removal of the cornea lenticule can occur during surgery. If this occurs, the doctor may choose not to complete the SMILE treatment. This is uncommon, but it is very important to choose an experienced SMILE surgeon to perform the procedure, as adequate handling of such problems during surgery comes with experience.
Imagine not having to fumble for your glasses to check the time when you open your eyes the first thing in the morning. Imagine not needing your glasses and contact lenses to read, drive, use the computer, swim or scuba dive. SMILE can give you this life-changing experience.
However, it is important for you to have realistic expectations when considering SMILE for yourself. Stabilization of vision takes a few weeks or a few months, and varies from patient to patient. SMILE allows most patients to perform most of their everyday tasks without glasses or contact lenses, but in some cases, these corrective aids may still be required.
SMILE cannot correct presbyopia, the age-related loss of near vision due to a loss of the auto focusing power of the eye. With or without SMILE, most patients will require glasses for reading after the age of 45. Some people choose a vision correction method called monovision, which leaves one eye slightly short-sighted to allow for close work, while the other eye is adjusted for distance vision. Monovison works well for many patients, and your eye doctor will help you decide if you are suitable for this.
Both LASIK and SMILE are safe and excellent laser vision correction procedures. Each procedure has its inherent advantages. Visual recovery and stabilization from LASIK is generally faster, but SMILE, being a “flap-free” procedure may be more suitable for patients involved in high impact sports and other vocations.
Dr Cordelia Chan has had many years of experience performing both LASIK and SMILE in thousands of patients, and based on your profile and needs, she will be able to best advise you on which procedure is better.