SMILE laser is the latest developed technique among corneal refractive surgical methods. SMILE laser, which has been widely used worldwide for approximately 20 years, is an abbreviation of “Small Incision Lenticule Extraction” and can be described as the extraction of a lenticule (a disc-shaped structure) through a small incision. SMILE laser, which was approved by the FDA (Food and Drug Administration) for myopia treatment in 2016, is now used in the treatment of all refractive errors such as hyperopia, myopia, and astigmatism with its updated technology.
SMILE laser is a femtosecond laser method. With this method, cuts are made inside the cornea using a laser, and a lenticule is created. By removing this lenticule, the refractive error is corrected.
Unlike excimer laser, there is no ablation or vaporization process, and no flap is created as in Femto LASIK. Therefore, dry eye disease, which can be seen after these surgeries, is less common. Since the cuts are made only in certain areas of the cornea and a small area of the lenticule is extracted, the nerves in the cornea are less damaged, and the nerves of these tissues are less affected.
This method, in which no flap is created like LASIK, is especially preferred for individuals who are active and participate in sports, as it reduces the risk of complications associated with flap displacement.
It can be applied to suitable candidates with refractive errors ranging from +5 to -10 spherical and 5 diopters of astigmatism. For this procedure, the patient must have completed their development and be over 18 years old.
What are the advantages of SMILE laser over other methods?
+ It is a bladeless surgery with a closed system, and no flap is created.
+ There is no risk of eye trauma or flap displacement after surgery.
+ The risk of dry eye is lower compared to other methods.
+ Since the corneal nerves are not fully cut, corneal sensitivity is better preserved compared to other methods.
+ Corneal biomechanics are less affected compared to other methods.
+ The post-operative recovery is fast and painless.
Who is eligible for SMILE laser?
Eyes that are over 18-20 years old and have not had a change in their refractive error in the last 6 months.
Eyes with a refractive error (eye prescription) in the range of +5 to -10 diopters spherical and 5 diopters of astigmatism.
Eyes with suitable corneal thickness and corneal topography (height map).
Who is not eligible for SMILE laser?
Like all refractive surgeries:
+ Patients with unrealistic expectations.
+ Individuals with compromised tissue healing or a risk of scar formation such as keloids.
+ Patients with uncontrolled diabetes or chronic conditions like glaucoma.
+ Pregnant or nursing mothers.
+ Individuals with cataracts.
How is the surgery performed? What are the stages?
Before the surgery, make sure to remove all eye makeup and take a shower, as you should avoid eye contact with water for the first 24 hours.
+ The first stage is the anesthesia of the eye with anesthetic eye drops. In this surgery, no local injections or other anesthesia procedures (sedation, general anesthesia) are used.
+ After disinfecting your eyes with a sterilizing agent, they are separated from the surroundings with a sterile drape, and a lid speculum is placed.
+ Your doctor brings the laser device head closer to your eye.
+ You will be asked to look at the green light in front of you.
+ Once the device makes contact with your eye, it is important not to move your eye for approximately 15-20 seconds, as this is when the laser cuts inside the cornea are made.
+ Then, the microscope light is used to remove the lenticule inside the cornea.
+ The surgery is finished by applying antibiotic eye drops.
+ All these stages take about 5-10 minutes.
What should be considered after the surgery?
+ It is beneficial to wear sunglasses when leaving the hospital since light and sunlight sensitivity can last for 4-5 hours.
+ There is no need to cover your eye or wear contact lenses.
+ It is necessary to apply the prescribed eye drops as instructed by your doctor.
+ You can wash your face and take a shower 24 hours after the surgery.