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Sunday February 9, 2014 MYT 12:00:00 AM
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1. In a single step, the laser creates a refractive lenticule and a small incision of less than 4 mm in the intact cornea.
ReLEx SMILE is a new, ‘flap-less’ form of laser eye surgery that can be used to treat short-sightedness, often even for those with very high prescriptions, drier eyes, contact lens intolerance and thinner corneas.
VISION correction surgery, also called refractive and laser eye surgery, is any surgical procedure used to correct vision problems.
Over the past few decades, refractive surgery has improved the quality of life of over 30 million patients, with a more than 95% patient satisfaction rate.
This has made it one of the most popular elective surgical procedures in all medicine.
It is considered very safe, with predictable results. After refractive and laser eye surgery, many patients report seeing better than they had at any other time in their lives.
Extensive research has provided invaluable refinements and advancements of laser technology and diagnostic tools to develop safe and appropriate treatment options for patients with a myriad of refractive disorders.
Laser-assisted in situ keratomileusis (LASIK) is presently the most performed elective procedure in the modern world.
In recent years, tremendous advancements have been made in this field. A new procedure called ReLEx (Refractive Lenticule Extraction) SMILE (SMall Incision Lenticule Extraction) is now gaining popularity in the refractive arena worldwide, and is potentially changing the practice of refractive surgery for the next decade.
Unlike conventional LASIK, the ReLEx SMILE procedure does not create a flap and involves the use of only one laser (the femtosecond laser).
Instead of vaporising cornea tissue to correct the underlying short-sightedness and astigmatism, ReLEx SMILE carves out a small piece of corneal tissue called a lenticule in the cornea.
Then the lenticule is removed through a small keyhole incision (about 2.5 to 4mm).
This single-step, all-in-one-laser operation only takes about 30 seconds to perform on one eye, and the entire procedure can be completed in about 15 minutes for both eyes.
This laser is extremely fast and uses very low energy.
The procedure is odourless and silent, so there is less discomfort for patients.
The patient also feels more comfortable because the suction on the eye during the treatment is gentler. There is no frightening “blackout”, no bleeding (no red eye) during the procedure, or swelling of the eye after the procedure.
Light blackout is a phenomenon in which the laser beam the patient is told to focus on during the procedure vanishes when the procedure begins. This temporary disappearance of the focal point can cause panic.
Foreign body sensations and mild discomfort may be experienced by some patients after the procedure, but this usually lasts for just a few hours.
Due to the smaller wound, there’s less immediate postoperative discomfort and tearing.
The use of a small incision also means that fewer corneal nerves are severed during the procedure, which also means less dry eyes.
Flap displacement or dislodgement is not an issue as no flap is being created.
Most patients will experience a dramatic improvement in their vision a day after the surgery, remaining stable days after the surgery.
All excimer laser procedures are subject to inconsistency based on differences in corneal hydration, laser fluence projection, reflection losses, temperature and humidity in the laser room, and other environmental factors that are hard to control.
In the ReLEx SMILE procedure, the only variable affecting tissue removal is the accuracy of the femtosecond laser’s optomechanics, which are unaffected by environmental conditions. It is likely that with the procedure, there will be less need to develop personalised nomograms for different machines, locations or surgeons.
If the present direction and volume of research is any guide, a large proportion of tomorrow’s femtosecond technological advances and discoveries will be based on our mastery of treating refractive errors without even touching the cornea. All treatments will be intrastromal, and ReLEx SMILE is the most current procedure available.
Choosing laser eye correction to fix your eyesight problems is not a decision you should take lightly. Keep in mind that laser vision correction is still a surgical procedure that carries a risk, although the risk involved is very small and the success rate is very high.
You are advised to have your eyes properly evaluated and examined by the eye surgeon prior to surgery. Be sure you discuss all options and potential risks in detail with your eye surgeon or eye care provider before making any final choices.
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