Laser Eye Surgery Treatments: SMILE / ReLEx SMILE
It can seem like there are countless Laser Eye Surgery procedures to choose from, particularly when you’re going from clinic to clinic to try and find the best fit for you. But the truth is, there are only really three main types of Laser Eye Surgery you need to know about: PRK/LASEK (the surface procedures), LASIK, and SMILE / ReLEx SMILE.
Other ‘treatments’ you might come across, such as UltraLASIK, Accu-wave LASIK, UltraLASIKplus, and Zyoptix, are simply brand names used by some clinics to differentiate between what is essentially the same treatment, just packaged slightly differently.
For example, some clinics might take LASIK and then offer an additional technology, such as wavefront measurement, as an optional extra. And voila – you have Wavefront LASIK. This technology helps to improve the treatment and its outcomes, which means some clinics see it as a chance to charge more. However, at London Vision Clinic, we believe all patients should have access to this technology, which is why we offer wavefront as standard.
So, if there are only three main types of Laser Eye Surgery treatments (excluding PRESBYOND® Laser Blended Vision), then what’s the difference between them?
Well, the first thing to know is that all Laser Eye Surgery treatments follow the same method. All treatments use laser technology to remove tissue from the stroma that makes up the body of the cornea – the clear window at the front of the eye.
Removing small areas of this tissue allows the surgeon to effectively reshape the cornea, hence adjusting the way it directs light into the eye, allowing it to be focussed more accurately on the retina. Refractive errors, including myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism, occur due to abnormalities in this function. Therefore, Laser Eye Surgery can be used to correct a wide range of prescriptions.
However, there are some important differences between the three main Laser Eye Surgery procedures: the method used to access the corneal tissue.
How Does ReLEx SMILE Laser Eye Surgery Work?
In order to correct your refractive error, the surgeon needs to be able to access the stroma beneath the surface layer of tissue (epithelium) of the cornea. The way in which this is achieved is the distinguishing factor between different Laser Eye Surgery treatments.
So, how does SMILE tackle this resilient barrier?
While PRK/LASEK involves the complete removal of the epithelium and LASIK creates a doorway to the tissue beneath, ReLEx SMILE offers the least invasive route. It involves creating a tiny tunnel from the surface of the eye, through the epithelium, and down to the tissue beneath. This is referred to as a “keyhole” laser treatment.
So, let’s take a closer look at how ReLEx SMILE works, and the pros and cons of this Laser Eye Surgery treatment.
A Revolution in Laser Eye Treatments
ReLEx (refractive lenticule extraction) SMILE (small incision lenticule extraction) is the latest innovation in Laser Eye Surgery treatments. Developed in collaboration with our own founder and expert surgeon, Professor Dan Reinstein, the procedure was officially introduced in 2011.
This keyhole procedure is made possible thanks to the state-of-the-art Carl Zeiss VisuMax laser. This best-in-class technology is currently the only femtosecond laser with the capabilities to perform SMILE. Moreover, it minimises intraocular pressure, making the procedure more comfortable for the patient.
With guidance from cutting-edge 3D placement, the laser places a series of pulses within the cornea, forming bubbles less than 1/1000th the width of a human hair, outlining the tissue that needs removing, and creating a tiny connecting tunnel through which it can be drawn out.
This entire process takes less than four minutes to perform. In this Video, you can watch a ReLEx SMILE procedure being performed in real time.
“Generally speaking, traditional Laser Eye Surgery can only correct prescriptions up to a maximum of between -8 and -10… With ReLEx Laser Eye Surgery treatment at London Vision Clinic, people with thin corneas and those with prescriptions of higher than -10 can be treated, because we do not make a flap from the corneal surface.” — Prof Dan Reinstein
The Pros of ReLEx SMILE
This makes the treatment not only a lot smoother, quicker, and more comfortable for the patient, but the healing time is even shorter than that of conventional LASIK, the temporary side effects are minimised, and it is suitable for even patients with very high prescriptions, drier eyes, and thinner corneas.
The minimally-invasive nature of SMILE treatment presents a number of benefits, including:
Faster Treatment and Recovery times
As mentioned above, the keyhole nature of SMILE means that it can be performed in a matter of minutes. Moreover, removing the need to create a flap or remove an area of epithelium, their is minimal disruption to the cornea. As a result, the incision in the cornea can begin to heal practically as soon as the procedure is complete.
This makes for extremely fast recovery times – even faster than those after LASIK! So, ReLEx SMILE is a great option for patients with a busy work schedule or an active lifestyle.
Improved Safety and Comfort
The technology and techniques used in ReLEx SMILE maximise patient comfort. The minimal disruption to the cornea not only reduces treatment and recovery times, but also minimises the duration of Laser Eye Surgery side effects such as dry eyes.
Expanded Suitability and Higher Prescriptions
The introduction of ReLEx SMILE also means that Laser Eye Surgery is now an option for many people who may once have been found unsuitable. For example, some people may be told they are unsuitable for LASIK as their corneas are not thick enough to accommodate a flap and the removal of corneal tissue. As SMILE requires only a tiny incision in the epithelium, it leaves the cornea intact, allowing for the treatment of higher and more complicated procedures, which typically require the removal or more tissue.
The Cons of ReLEx SMILE
While ReLEx SMILE offers a wide range of benefits and has further expanded the reach of Laser Eye Surgery, it does have limitations in some areas. For example:
Limited Prescriptions
As mentioned above, SMILE can make it possible to treat higher prescriptions than previously; however, the treatment is currently only considered suitable for myopia (short-sightedness) and astigmatism. Further development is underway with the hope of expanding to long-sighted prescriptions in the near future.
Limited Availability
ReLEx SMILE has been available at London Vision Clinic since 2011; however, not all clinics have access to the equipment or surgeon expertise required to perform this treatment, which means its availability is still relatively limited.
Choosing the Right Treatment
Choosing a Laser Eye Surgery treatment can seem like a daunting task. But when it comes down to it, there are really only three main procedures you need to be aware of. Moreover, if you opt for a high-quality clinic, you will he able to rely on experienced surgeons and clinic staff who are well equipped to advise you on the most suitable treatment for you and your eyes. After all every patient – and every eye – is different.
If you’d like to learn more about ReLEx SMILE, or any of our other Laser Eye Surgery treatments, get in touch with one of our friendly clinic coordinators – they’re always happy to help! Alternatively, Book a Consultation today to see if you could be suitable for Laser Eye Surgery.
