The world of laser corrective eye surgery has taken another step forward. In the fall of 2016, the FDA approved the ReLEx SMILE (Refractive Lenticule Extraction, Small Incision Lenticule Extraction) technique for myopia (near-sightedness) using the Zeiss Visumax femtosecond laser.
First generation laser surgery was called PRK (photorefractive keratectomy) and is still in use today, comprising 10-20% of laser corrective eye surgery in the United States. In this technique, the surface covering of the cornea (epithelium) is removed and the laser is applied directly to the surface of the cornea. This is a very safe technique but requires longer healing. Patients wear a bandage contact lens for 5-6 days and nights and then go through a 3-4 week visual recovery. This technique is still preferred in cases of thin corneas, irregular corneas, and some higher prescriptions.
Second generation laser surgery is called LASIK (laser in situ keratomiluesis). This is the most common form of laser vision correction. It involves using two steps to correct vision. First, a cornea flap is made at the surface of the cornea using a laser (all laser LASIK, intraLASIK) or a microkeratome (razor blade). Second, the flap is rotated back and the second laser (excimer laser) is then used on the exposed undersurface. Finally, the flap is rotated back down into position. This allows for dramatic, rapid visual recovery.
SMILE is a novel technique where just one laser is required, the Zeiss Visumax. Based on the prescription of the patient the laser will create a microscopic “lenticule” (disc of tissue) inside the intact cornea. The lenticule is extracted through a small opening. Advantages include not being performed at the surface, allowing for a quick recovery, and not being performed under a flap. This potentially will reduce dry eye symptoms which can be seen with some LASIK patients. Those who may have not been LASIK or PRK candidates in the past could potentially benefit from this new technique.
Hoopes Vision was the first center in Utah to have performed the SMILE technique. In preparation for this exciting surgical procedure the surgeons at Hoopes Vision have already performed hundreds of LASIK flap surgeries with the Zeiss Visumax. Hoopes Vision has used femtosecond laser technology for the past 14 years and performs more femtosecond laser surgery than all other Utah surgical practices.
Step 1: Lenticule creation
A microscopic “lenticule” (disc of tissue) is created inside the intact cornea.
Step 2: Lenticule removal
The lenticule is extracted through a small opening.
Step 3: Vision correction complete
Removing the lenticule changes the shape of the cornea, thereby achieving a refractive correction.