Small incision lenticule extraction

Small Incision Lenticule Extraction (SMILE) is a minimally invasive laser eye surgery technique used for the correction of myopia (nearsightedness) and astigmatism. Developed as an alternative to traditional methods such as LASIK and PRK, SMILE offers a less invasive approach with a single laser used to perform the correction. This procedure has gained popularity due to its potential for fewer side effects and complications.

Overview

SMILE involves the use of a femtosecond laser to create a small, lens-shaped piece of tissue (lenticule) within the cornea. Once the lenticule is created, it is extracted through a small incision, also made by the laser, on the surface of the cornea. The removal of the lenticule changes the shape of the cornea, thereby correcting refractive errors such as myopia and astigmatism.

Procedure

The SMILE procedure is performed under local anesthesia and typically takes about 10 to 15 minutes for both eyes. The steps include:

1. A femtosecond laser creates a precise, disc-shaped lenticule within the cornea.
2. The same laser then makes a small, arc-shaped incision on the surface of the cornea.
3. The surgeon extracts the lenticule through this incision, which alters the cornea's shape and corrects the refractive error.

Advantages

SMILE surgery offers several advantages over traditional refractive surgery techniques, including:

• Minimally invasive with a small incision
• Reduced risk of dry eye syndrome, as fewer corneal nerves are affected
• Less corneal weakening, preserving biomechanical stability
• Quick recovery time

Risks and Complications

While SMILE is considered safe, as with any surgical procedure, there are potential risks and complications. These may include:

• Infection
• Residual refractive error, necessitating further correction
• Difficulties with the extraction of the lenticule
• Temporary visual disturbances

Candidates

Ideal candidates for SMILE are individuals with myopia, with or without astigmatism, who are seeking an alternative to glasses or contact lenses. Patients should have stable vision for at least a year prior to the surgery and should not have any corneal abnormalities or active eye diseases.

Comparison with LASIK and PRK

Compared to LASIK and PRK, SMILE offers a less invasive option with similar visual outcomes. Unlike LASIK, there is no flap creation, reducing the risk of flap-related complications. Compared to PRK, SMILE has a quicker recovery time and less post-operative discomfort.

Conclusion

Small Incision Lenticule Extraction (SMILE) represents a significant advancement in laser eye surgery, offering a minimally invasive option for correcting myopia and astigmatism. With its potential for fewer side effects and complications, SMILE is an attractive option for many patients seeking freedom from glasses or contact lenses.