What Is SMILE?
Small Incision Lenticule Extraction (SMILE) is the most recently developed type of minimally invasive laser eye procedure which can correct various vision impairments.
How does SMILE work?
SMILE uses femtosecond laser to reshape the cornea. The laser's high peak intensity over a very short pulse duration (within a few femtoseconds of time) allows it to create micro-precision single holes (bubbles) that form together cuts or planes in the corneal tissue without affecting the surrounding tissue.
It takes an average of 23 seconds for the laser to create a small lens-shaped piece of corneal tissue (called the lenticule) inside the cornea. The surgeon then removes the lenticule through a small incision outer part of the eye. This reshapes the cornea and corrects the refractive error.
The femtosecond laser produces a thin layer just beneath the surface of the eye, and at the same time creates a small opening. It’s an almost silent, noiseless, odourless procedure and the patient can remain in the same position from start to finish.
What are the benefits of SMILE?
Femtosecond lasers are designed to harmlessly pass through the upper layers of the cornea, to create the lenticule only at a specific sublayer inside the cornea, which means:
- With an incision smaller than 4mm on the eye surface, SMILE supports a minimally invasive procedure.
- The outer layer of the cornea doesn’t have to be removed.
- Corneal nerves stimulating the tear glands are less affected and are still able to help keep the eye lubricated. Side effects, such as dry eye syndrome, are very less after SMILE.
- The corneal stability is increased, because the entire upper layers of the cornea are virtually unaffected.
What are the similarities Between LASIK & SMILE?
There are many similarities between LASIK and SMILE. They are:
- Both procedures have similar qualifications for patients, like you must be at least 18 years old, and have otherwise healthy eyes and must not have underlying conditions that impact your ability to heal, like autoimmune conditions or diabetes. You must also not be pregnant or breastfeeding
- Both procedures take about 10 to 15 minutes
- Both procedures require only a day of rest and healing
- The steps of the procedures are similar. The Doctor will map and reshape your cornea using a guided laser
- Both procedures lead to at least 6/9 vision for most patients and 6/6 vision in many. The long-term results are consistent and predictable.
Ultimately, both SMILE and LASIK are affordable procedures to improve refractive errors, with certain limitations on who is a good candidate for each option
What are the advantages of SMILE over LASIK?
- LASIK is not a good choice for people who have thin corneas. SMILE can still benefit nearsighted people who have thin corneas
- Concerning higher myopia (more than 6D), surgeons have found SMILE superior to LASIK in predictability and safety
- LASIK requires a flap to be cut in the cornea, so the excimer laser reaches the inside of this part of your eye. SMILE reshapes the top of the cornea to flatten it without creating a flap. Hence flap related complications are lesser in SMILE.
- While SMILE, the night vision is better than in those undergoing standard LASIK
What are the advantages of LASIK over SMILE?
- LASIK, and other types of refractive surgery like photorefractive keratectomy (PRK), can treat higher-order aberrations (HOAs) that impact night vision, while SMILE cannot treat these issues.
- LASIK treats all refractive errors. SMILE treats myopia with or without astigmatism, but not farsightedness or astigmatism by itself.
- LASIK has been around for about 20 years, and there are few new developments with the procedure. SMILE is new in INDIA and there are exciting developments, according to eye surgeons. It is still evolving and getting more refined.
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