SMILE : A New Way to See

Patrick Lam |

Corrective laser eye surgery is becoming a highly popular procedure for lasting distance vision correction. Patients with certain health concerns may be ineligible for LASIK (Laser-Assisted In-Situ Keratomilieusis) which is the most well-known option. Such individuals may frown, but with new advancements they can SMILE instead. SMILE (SMall Incision Lenticular Extraction)  is a brand new alternative method of laser eye surgery that differs from LASIK in that patients tend to recover faster and the procedure itself is more comfortable.1

Creation of the lenticule in the SMILE procedure.1 

 

In the SMILE procedure, the patient’s eye fixates on a point. The eye is held steady to minimize movement during the procedure. A laser separates a thin strip in the middle of the cornea, which is the front surface of the eye. This strip is called the lenticule. The removal of this lenticule reshapes the eye and corrects your vision.1 

In the LASIK procedure, the patient similarly fixates on a point, and a flap is generated on the cornea.2 This flap is folded away, and the surface of the eye is reshaped using a laser.2 When this is done, the prescription is corrected for, and the flap is folded back on and held in place naturally.2 Click here can see an one-minute demonstration of the surgery.

The differences between LASIK vs SMILE.3

 

A notable difference between the procedures is the lack of the flap in the SMILE procedure. This flap is created in the LASIK procedure, and can lead to issues such as dry eye and discomfort. So there are certain benefits of SMILE over LASIK.1 Some studies have shown that SMILE has faster recovery times and is considered less painful than LASIK.1, 5 SMILE has also been shown to preserve the strength of the eye more than in LASIK.1 This difference is thought to be a result of how the laser is used between procedures.1 While dry eye is commonly seen in patients within one year of LASIK operation, it is less common amongst SMILE patients. 1, 4

It should also be stressed that no surgery is perfect. Although SMILE has some benefits over LASIK, there are still some drawbacks. SMILE is not as effective for patients with mild to  moderate astigmatism; in these cases, LASIK leads to better vision.5 Despite the notable differences between these types of laser eye surgery, most cases have shown that both LASIK and SMILE are equally as effective, safe, and predictable.1, 5

Only your optometrist will know about the health risks and which procedure is best for you. Therefore it is even more important to get your eyes regularly checked with your optometrist. If you have any concerns or questions about your eyes or about these corrective procedures, you can schedule your regular eye exam at Chan Optometry and we will be glad to help you.

 

 

ABOUT THE AUTHOR

Patrick Lam is a summer student working at Chan Optometry as an intern.  He is an optometry student studying at the University of Waterloo.  Upon graduating in 2021  he wishes to start his career in the Greater Toronto Area. He previously finished his undergraduate degree at the University of Waterloo for his Bachelor of Science.

 

REFERENCES

1. Miruna, N., Andrei, F., Vasile, F. M., & Eugen, R. (2016). Smile–the next generation of laser vision correction. Romanian journal of ophthalmology, 60(1), 6.

2. Mori, Y., Miyata, K., Ono, T., Yagi, Y., Kamiya, K., & Amano, S. (2017). Comparison of laser in situ ketatomileusis and photorefractive keratectomy for myopia using a mixed-effects model. PloS one, 12(3), e0174810.

3. Picture from website: http://www.centreforsight.net/blog/smile-versus-lasik/

4. Shtein, R. M. (2011). Post-LASIK dry eye. Expert review of ophthalmology, 6(5), 575-582.

5. Shen, Z., Zhu, Y., Song, X., Yan, J., & Yao, K. (2016). Dry eye after small incision lenticule extraction (SMILE) versus femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia: a meta-analysis. PloS one, 11(12), e0168081.

6. del Barrio, J. L. A., Vargas, V., Al-Shymali, O., & Alió, J. L. (2017). Small incision lenticule extraction (SMILE) in the correction of myopic astigmatism: outcomes and limitations-an update. Eye and Vision, 4(1), 26.

 

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