Choose the content to read
- What causes refractive errors?
- How many eye surgery techniques are available to correct refractive errors?
- What is the procedure for SMILE Pro?
- Post SMILE Pro Aftercare Instructions
- What is the advantage of SMILE Pro?
- What is the difference between ReLEx SMILE and SMILE Pro?
- What is the success rate of ReLEx SMILE and SMILE Pro?
- LASIK Eye Surgeries and SMILE Pro at MedPark Hospital?
LASIK
LASIK is a refractive surgical procedure designed to permanently correct vision issues, including nearsightedness, farsightedness, or astigmatism. The surgery involves using Femtosecond Laser to open the outer corneal flap and an Excimer Laser to reshape the curvature of the inner cornea to ensure the light focuses precisely on the retina, allowing individuals to see objects more clearly; the position of objects is correct even in low-light conditions, worry-free about vision limitations. Lasik eye surgery makes life easier, enables you the freedom to do whatever you want, and allows you to live life to the fullest.
What causes refractive errors?
Refractive errors are caused by an excessive or insufficient curvature of the cornea, preventing the proper bending of light to match the size and length of the eyeball. This leads to the focal point of light not coinciding with the retina, resulting in blurred vision.
How many types of refractive errors?
There are 4 types of refractive errors, outlines as follows:
- Myopia (nearsightedness) is a condition in which light is focused in front of the macula, or before reaching the retina. This can be due to a curved cornea or an elongated eye socket. This causes individuals with myopia to see nearly objects clearly but experience blurry vision when looking at objects in a long distance.
- Farsightedness (hyperopia) is a condition in which light focuses behind the macula or beyond the retina. This condition may result from a less curved cornea (flat cornea), or a shorter eye socket, leading to unclear vision for objects near and far.
- Astigmatism is a condition in which an individual has double vision instead of single vision due to an imperfectly round cornea creating two focal points of light hitting the retina unevenly in the same plane. This uneven focus results in blurred vision at all distances.
- Presbyopia is an age-related condition causing near vision to blur or double when looking at close objects. It occurs due to the loss of flexibility in the eye lens, preventing it from changing shape to focus on close-range objects. Presbyopia is common in individuals over the age of 40.
How many eye surgery techniques are available to correct refractive errors?
There are several surgical techniques available to correct refractive surgery, including PRK, LASIK (Blade LASIK), Femto LASIK, ReLEx SMILE, or the latest advancement in refractive eye surgery, SMILE Pro. Typically, the ophthalmologist will recommend the most suitable surgical techniques based on each individual needs and considerations. Refractive surgical techniques to correct refractive errors are as follows:
PRK
PRK (Photorefractive keratectomy) is the pioneering laser technique for correcting refractive errors. The procedure involves removing the outermost layer of the cornea (Epithelium), either using an excimer laser or a diluted alcohol solution. Then, adjust the corneal curvature with an excimer laser to achieve standard, normal vision.
Following surgery, the ophthalmologist will protect the cornea with prescription-free contact lenses for approximately 5-7 days to reduce irritation while allowing the body to regrow the epithelial membrane, completely covering the cornea before removing the contact lens. PRK is a vision correction treatment that is appropriate for those whose ophthalmologist has determined that they are not suitable for Lasik eye surgery due to a thin cornea or dry eyes. The benefit of using PRK to correct refractive errors is that no laser is used to open the corneal flap. Thus, the cornea retains its natural strength.
Femto LASIK
Femto LASIK, or bladeless LASIK, is a surgical technique for correcting refractive errors that involves using a femtosecond laser to separate layers and open the corneal flap, then using an excimer laser to reshape the corneal flap precisely, point by point, to adjust the curvature of the cornea to achieve normal vision standards. The corneal flap is then delicately repositioned.
Unlike traditional LASIK, which uses a mechanical microkeratome blade, Femto LASIK utilizes a Femtosecond laser, which can emit ultra-short laser pulses at a high speed of 1 femtosecond (1 quadrillionth of a second). This laser technology is adept at separating corneal layers, lifting the corneal flap, and accurately determining the depth of the corneal layer without causing damage to surrounding tissues. This gentler approach is more considerate of the eyes' condition, resulting in a shorter recovery period and a quicker return to high-quality vision.
ReLEx SMILE
ReLEx SMILE (Refractive Lenticule Extraction) (SMILE: Small Incision Lenticule Extraction) is a vision correction surgical technology that uses small incisions to extract the lenticules without opening the corneal flap. ReLEx SMILE is derived from LASIK and Femto LASIK, using a femtosecond laser to separate the corneal layers into a lens-shaped disc known as a "Lenticule.". The ophthalmologist then pulls out the lenticule through a tiny side incision to adjust the curvature of the cornea to normal vision standards without requiring raising a corneal flap. Therefore, the small incision can heal without stitches after surgery.
ReLEx SMILE addresses the concerns associated with corneal flap elevation in traditional LASIK procedures, aiming to reduce the risk of infection. This technique offers a minimally invasive approach to corneal surgery while striving to preserve as much of the natural curvature of the cornea as possible.
SMILE Pro
SMILE Pro is the most advanced refractive surgery technology available. Utilizing the Visumax 800 machine, this advanced procedure involves carving out a lens-shaped disc, or "Lenticule," from the central corneal layer. Notably, the laser procedure is remarkably swift, taking only 8–10 seconds per eye, three times faster than the original ReLEx SMILE. The ophthalmologist then extracts the lenticule through a 2–4-millimeter side incision, effectively adjusting the shape and curvature of the cornea without raising a corneal flap to meet corrective refraction requirements.
SMILE Pro is a minimally invasive surgery, reducing complications and procedural times while leaving only a small incision that heals quickly, with restored vision as soon as the next day. Notably, SMILE Pro contributes to maintaining the strength of the cornea more effectively than conventional LASIK and is widely earning widespread recognition for its high safety profile within the ophthalmology community.
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What is a SMILE Pro procedure?
Pre SMILE Pro Procedures
Refrain from wearing contact lenses
- The ophthalmologist will ask those who wear hard contact lenses or semi-hard contact lenses to refrain from wearing them for at least 21 days before the eye examination and surgery. During this period, prospective patients can opt to wear eyeglasses instead.
- In addition, the ophthalmologist will ask those who wear soft contact lenses to refrain from wearing them for at least 7 days prior to the day of the eye examination and surgery. During this period, the prospective patients can wear eyeglasses instead.
Stop using certain medications
- The ophthalmologist will ask those who take isotretinoin-based acne medications, such as Roaccutane or Acnotin, to stop taking them for at least 1 month before surgery because this class of drugs can cause side effects on the conjunctiva of the eyes and contribute to driver-than-usual corneal surfaces.
- Those with an underlying disease or taking certain medications to treat chronic diseases, including diabetes, lipid-lowering, blood pressure, thyroid, or sleeping pills, should notify the ophthalmologist at the first visit or before an eye assessment day. However, they are not required to discontinue taking medication prior to the day of surgery.
Eye Examination
- The ophthalmologist will schedule a comprehensive eye check to diagnose the eye condition, which will include an Automated Refractometer for visual inspection and measurement, Manifest Refraction and Cycloplegic Refraction, and utilizing a Slit-lamp Examination to assess overall eye health and other specialized examinations. If the patient's eyes are in good condition, the ophthalmologist will schedule SMILE Pro surgery on the requested date and time.
- If the eye examination reveals that the eyes are in poor condition, such as with dry eyes, eye inflammation, or eye infection, a team of specialized ophthalmologists will treat the symptoms before considering SMILE Pro eye surgery.
- If the test results indicate that SMILE Pro cannot be performed, the ophthalmologist will recommend an alternative vision correction option suitable for the individual, such as PRK or ICL lens implant surgery.
Avoid wearing makeup
- Refrain from wearing makeup or using skincare products containing perfume ingredients or alcohol 1 day before surgery and on the day of surgery since unclean cosmetic debris can cause eye infections after surgery.
During SMILE Pro Procedures
Photo from: https://www.zeiss.com/
- Lenticule creation: The ophthalmologist utilizes a Femtosecond laser to precisely cut and separate the central corneal tissue layer into small circular, lens-shaped, or "Lenticules" within the cornea to correct refractive errors. This step is integral to correcting refracting errors using the SMILE Pro technique. The femtosecond laser operation lasts only 8–10 seconds, with a 2–4-millimeter side incision for lenticule removal.
Photo from: https://www.zeiss.com/
2. Lenticule removal: The ophthalmologist gently removes the lenticule through a small side incision on the peripheral corneal surface without raising the corneal flap.
Photo from: https://www.zeiss.com/
3. Refractive correction: After the lenticule extraction process, there will be reshaping of the cornea curvature, which gradually shifts light to focus on the retina. Consequently, individuals who were nearsighted or had astigmatism can now see clearly, akin to those with normal vision.
Post SMILE Pro Aftercare Instructions:
- Refrain from rubbing or squeezing your eyes for approximately one week.
- Avoid washing your face and prevent water from entering your eyes for 1 week to prevent infection.
- Refrain from using eye makeup for 2 weeks.
- Refrain from swimming and driving for at least one month.
- Instill medications on time and every time, as prescribed by the ophthalmologist.
- Wear eye protection while sleeping both day and night for at least 1 week to shield your eyes from dust and unintentional eye rubbing.
- Wear sunglasses during daylight hours to shield your eyes from bright sunlight and strong winds, which can cause dry eyes.
- Refrain from activities or exercises that induce sweat running into the eyes for at least one week.
- Refrain from activities that could cause an accidental impact on the eye area for at least 3 months.
- Refrain from prolonged staring activities, including extended screen time or reading, for approximately 2 weeks.
- Attending all scheduled appointments with the ophthalmologist at the hospital for continuous monitoring of symptoms and evaluation of treatment outcomes.
What is the advantage of SMILE Pro?
- Fast: SMILE Pro uses Femtosecond Laser technology with faster cut speeds, completing the procedure in only 8–10 seconds, making it three times faster than the original ReLEx SMILE.
- Precise: The Visumax 800 ensures precision by accurately determining the corneal curvature based on ophthalmologist calculations. The AI-assisted ophthalmic machine has a high-performance digital sensor system that assists in determining the center point of lenticule creation and alerts the ophthalmologist if the eyeball position deviates from the calculated position.
- Safe: SMILE Pro uses a femtosecond laser to open a corneal flap from the side without raising the corneal flap. Lower the risk of the eyeball retainer losing suction power due to eye movement, as well as infection complications from opening the corneal flap, etc.
- Flapless Innovation: SMILE Pro is a Femtosecond Laser eye surgery innovation that eliminates the need to raise the corneal flap. This flapless procedure helps maintain post-surgery corneal curvature, reduces complications associated with creating a corneal flap, minimizes symptoms related to corneal flap movement, and diminishes the natural in-growth of epithelial cells under the corneal flap.
- Very Small Incision: SMILE Pro corrects vision by adjusting the curvature of the cornea by removing corneal tissue, or lenticule, through a very small surgical incision of only 2-4 millimeters, which is 80% smaller than Femto LASIK, allows you to be pain-free during surgery, and hastens a quick recovery after surgery.
- Preservation of Corneal Integrity: SMILE Pro's minimally invasive technology lessens the impact on the upper corneal layer, preserving the natural curvature of the cornea (Corneal Biomechanics) to the maximum extent possible post-surgery.
- Reduce Side Effects: The small-incision approach of SMILE Pro minimizes cutting through nerves around the cornea, reducing the risk of side effects such as dry eyes, eye inflammation, blurred vision in low light, or seeing light spread in the dark.
- Minimal Downtime: Those who have had SMILE Pro typically use their clear vision the next day after the surgery.
What is the difference between ReLEx SMILE and SMILE Pro?
The difference between ReLEx SMILE and SMILE Pro is the VisuMax 800 speedy advanced Femtosecond laser and streamlined, integrated workflow. While ReLEx SMILE uses a laser cutting speed of 25–27 seconds, SMILE Pro uses a faster cutting speed of only 8–10 seconds, shortening surgery time, reducing excessive impact on the eyes, and providing the patient with the most comfort.
Who can benefit from SMILE Pro?
- Those with good overall eye health have a healthy cornea and no corneal disease.
- Those with myopia less than 1000 diopters (-10.00 diopters) and astigmatism less than 500 diopters (-5.00 diopters), or nearsightedness combined with astigmatism.
- Those between the ages of 20 and 50 with stable vision or a small change in vision value of less than 50 in a year
Who is not suitable for SMILE Pro?
- Those who have corneal diseases, corneal scars, keratoconus, corneal abrasions, severe dry eyes, eye inflammation, or photophobia.
- Those with other eye diseases such as severe glaucoma, cataracts, macular degeneration, amblyopia, or eye infections.
- Those with chronic diseases such as autoimmune diseases, diabetes with poor sugar control, ocular herpes, or shingles.
- Those who have unstable vision or a significant change in vision value of more than 50 in a year.
- Pregnant woman or a breastfeeding mother.
- Those who were born farsighted or have presbyopia due to age (the ophthalmologist will consider alternative treatment options).
What is the success rate of ReLEx SMILE and SMILE Pro?
According to a study of individuals treated with ReLEx SMILE and SMILE Pro, the success rates were:
- Visual Acuity at Six Months: 99% of individuals achieved 20/40 vision six months after the surgery.
- Improved Vision Level at 20/20: 88% of those who had the surgery and participated in regular health checkups every six months experienced an improved vision level of 20/20, the same level as individuals with normal vision.
These findings suggest a high success rate in terms of visual acuity improvement following ReLEx SMILE and SMILE Pro procedures. However, individual results may vary, and potential candidates need to discuss their specific case with an ophthalmologist during a comprehensive eye examination and consultation.
What is the recovery time of SMILE Pro?
Typically, those receiving SMILE Pro treatment can have clear vision the next day after the ophthalmologist removes the eye patch to assess symptoms and evaluate treatment outcomes. Nonetheless, there may be some cloudiness in the eyes. However, the vision will gradually improve, and you will be able to see things more clearly within 2-4 weeks.
The patient should instill the drops as prescribed by the ophthalmologist, avoid getting water in their eyes, and strictly follow the ophthalmologist’s post-surgery instructions.
Are SMILE Pro and other LASIK eye surgeries safe?
From a medical standpoint, SMILE Pro, ReLEx SMILE, Femto LASIK, and PRK are considered safe treatments for refractive errors, each with satisfactory treatment outcomes, particularly noteworthy for ReLEx SMILE and SMILE Pro, which utilize a surgical technique that avoids raising the corneal flap, which significantly reduces the risk of complications after treatment.
LASIK Eye Surgeries and SMILE Pro at MedPark Hospital?
Eye Center at MedPark Hospital, Bangkok, Thailand, is led by a team of expert ophthalmologists with extensive experience and proficiency in every facet of LASIK eye surgery. A team of ophthalmologists is ready to provide exclusive care at every step of the treatment journey, from pre-treatment assessment to post-surgery follow-up, for the following treatments: PRK, Femto LASIK, and the latest technology, SMILE Pro, to correct all types of refractive errors, including nearsightedness, astigmatism, and congenital farsightedness or presbyopia, using innovative AI-assisted surgical technology and high-performance diagnostic and treatment equipment.
MedPark’s ophthalmologist team uses a minimally invasive approach, which results in less pain and a faster recovery, yielding quick and precise surgery, lowering the risk of complications, shortening the recovery period, correcting refractive errors effectively, allowing the patients to achieve clear normal vision, and enabling individuals to live their lives freely.
