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SMILE laser vision correction replaces LASIK? / ReLEx SMILE - A State of Sight #108

ReLEx SMILE is a modern laser vision correction procedure that has the potential to replace LASIK as the laser eye surgery of choice. The name of the procedure stands for SMall Incision Lenticule Extraction, which is a form of Refractive Lenticule Extraction.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about this exciting treatment.




Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain SMILE laser vision correction because this is a new procedure and some people wonder if it will replace LASIK as the number one laser vision correction procedure of choice.
 
SMILE stands for SMall Incision Lenticule Extraction. In order to understand this better, first let’s think about how LASIK is performed. SMILE uses the same femtosecond laser that is used for the first step of LASIK.
 
This first step is creating the flap in the cornea (the clear shield covering the front of the eye). The femtosecond laser makes an incision in the cornea so we can lift the flap. The second step in LASIK uses the excimer laser to flatten the cornea for nearsighted people, changing the shape. This includes the power needed in glasses or contacts onto the eye.
 
With SMILE, the femtosecond laser is used to make two separate incisions in the cornea. These are similar to the flap incisions in LASIK, but one is near the front of the cornea and another is a deeper in a different direction.
 
Once these two incisions are made, then the central part of the cornea is removed that is between the incisions. This effectively lets the cornea flatten and change shape, causing a result that is similar to LASIK. The new cornea then includes the power needed for vision correction on the eye.
 
We wonder if this is a safer or better procedure than LASIK. The piece of cornea can be removed from a small incision, so there is less damage to the nerves in the cornea. This may lead to less dry eyes after surgery. We also wonder if it could give better vision than LASIK. LASIK has been a very safe and successful procedure, so SMILE will have to prove successful as well in order to be better than LASIK. I think with more studies, time will tell.
 
At this point, SMILE is not FDA approved in the United States. We’re waiting for studies and research to see if will be FDA approved. As of this point in the spring of 2015, the speculation I’ve heard is that it may be spring of 2017 before it’s available here. This has been performed throughout the world beginning in 2008 and there have been about 100,000 people (200,000 eyes) that have received this treatment. The results that I have seen appear pretty promising.

If you have any questions about this new technology or this new procedure, please post and we will be happy to answer them. We hope to see you again soon next time on A State of Sight.