SMILE stands for Small Incision Lenticule Extraction. Also known as ReLEx SMILE, It is a form of laser vision correction which is minimally invasive and does not require the creation of a corneal flap. With SMILE surgery, a laser is used to shape a thin piece of corneal tissue (lenticule) within the layers of the cornea. This lenticule is then removed via a small incision.
What is ReLEx SMILE and how does it work?
What are the benefits of ReLEx SMILE?
Benefits of SMILE surgery include:
- Freedom from glasses and contact lenses
- No risk of flap related complications e.g. Flap dislocation, flap striae
- Quick recovery with minimal downtime (1-2 days)
- Minimal pain and discomfort during the recovery period
- Minimal disruption to work schedule
- Short period of post-SMILE surgery eye drops needed (typically 1 week)
- Fewer dry eye symptoms
Who is a good candidate for ReLEx SMILE?
A thorough assessment should be done before proceeding with any laser vision correction. In general, a suitable candidate for SMILE surgery includes patients who:
- More than 18 years old
- Healthy corneas
- Stable vision and refractive errors
- Keen to be free of glasses or contact lenses
- Keen to avoid the discomfort related to post PRK surgery recovery
- Keen for a laser vision correction procedure with minimal downtime
What can you expect with ReLEx SMILE?
SMILE surgery is quick, taking about 10-15 minutes for both eyes. Recovery is generally comfortable with minimal discomfort. Antibiotic and steroid eye drops are given after SMILE surgery for about a week to prevent infection and minimise inflammation. Many patients are able to return back to normal activities in 1-2 days.
LASIK VS SMILE
LASIK stands for Laser-Assisted In Situ Keratomileusis and it is a bladeless procedure that involves creation of a corneal flap followed by correction of the refractive error with an excimer laser. LASIK is able to treat astigmatism, myopia (short-sightedness) and hyperopia (long-sightedness). LASIK is not only for the young; it is also a great choice for vision correction for those with presbyopia (lau hua yan).
SMILE stands for Small Incision Lenticule Extraction and it is also a bladeless procedure that does not involve creation of a corneal flap. Instead, a femto-second laser is used to create a corneal lenticule within the layers of the cornea followed by the subsequent dissection and removal through a small wound. SMILE is able to treat astigmatism and myopia (short-sightedness). SMILE potentially causes less dry eye since the wound is smaller and has inherent benefits of not having potential flap related complications such as flap striae and flap dislodgement. It is a more expensive procedure than LASIK at about $5000. Should there be any residual degree left, SMILE surgery cannot be repeated but rather the use of PRK or LASIK will be needed to do the enhancement needed.
Why Dr Val Phua at Eagle Eye Centre?
- Dr Val Phua is a Singapore Medical Council (SMC) accredited eye specialist, a consultant ophthalmologist and cataract and refractive surgery specialist with Eagle Eye Centre
- He has received numerous recommendations and referrals from satisfied patients
- He provides personalised care throughout the treatment journey
- He is supported by more than 90 staff at Eagle Eye Centre to ensure a seamless experience to achieve your vision goals
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FAQs – SMILE
What is SMILE?
SMILE stands for Small Incision Lenticule Extraction. It is a form of laser vision correction which is minimally invasive and does not require the creation of a corneal flap. With SMILE surgery, a laser is used to shape a thin piece of corneal tissue (lenticule) within the layers of the cornea. This lenticule is then removed via a small incision.
Who is a good candidate for SMILE?
A thorough assessment should be done before proceeding with any laser vision correction. In general, a suitable candidate for SMILE surgery includes patients who:
- More than 18 years old
- Healthy corneas
- Stable vision and refractive errors
- Keen to be free of glasses or contact lenses
- Keen to avoid the discomfort related to post PRK surgery recovery
- Keen for a laser vision correction procedure with minimal downtime
What are the risks of SMILE?
Risks of SMILE surgery include:
- Suction loss during surgery (may need to convert to LASIK)
- Glare and halos
- Dry eyes
- Vision fluctuation
- Under or over-correction
- Corneal ectasia
Is SMILE surgery painful?
SMILE surgery itself is painless due to the numbing eye drops given before surgery begins. After SMILE surgery, there may be some discomfort immediately after the procedure, this largely resolves by the following day.
What will I see during the procedure?
During SMILE surgery, you will be given a target blinking green light to focus on. Focusing on this target light keeps your eyes perfectly aligned for the femto-second laser to accurately shape out the lenticule to be extracted. During the lenticule creation, this target green light will disappear about halfway through. You should continue to keep calm and keep your eyes straight as the laser completes the lenticule creation.
What precautions do I need to take after SMILE Surgery?
After SMILE surgery, it is important to avoid eye rubbing and to keep the prescribed eye drops going as planned. Goggles are given and should be used at night to prevent eye rubbing during sleeping hours.
Can SMILE surgery treat presbyopia (lao hua yen)?
There is a role for SMILE surgery in treating presbyopia and achieving glasses freedom. This is in the form of monovision where one eye is corrected for distance vision and the other eye corrected for near vision. Patients may simulate this with a trial of contact lenses before undergoing SMILE surgery
Can I undergo an enhancement after SMILE surgery?
In some cases, mild residual refractive errors may be present after SMILE surgery or may come back with time. These residual errors can be corrected with the PRK or LASIK procedures.
How long will SMILE surgery last?
In SMILE surgery, a laser is used to create a lenticule to be removed, reshaping the cornea and correcting any refractive error present. This correction is permanent. However as a person ages, there may be some changes to the eyeball that comes along with it. Some patients may find that the myopia or astigmatism “comes back” and may require an enhancement to re-correct this residual degree.
What are the benefits of SMILE?
Benefits of SMILE surgery include:
- Freedom from glasses and contact lenses
- No risk of flap related complications e.g. Flap dislocation, flap striae
- Quick recovery with minimal downtime (1-2 days)
- Minimal pain and discomfort during the recovery period
- Minimal disruption to work schedule
- Short period of post-SMILE surgery eye drops needed (typically 1 week)
- Fewer dry eye symptoms
What can you expect with SMILE?
SMILE surgery is quick, taking about 10-15 minutes for both eyes. Recovery is generally comfortable with minimal discomfort. Antibiotic and steroid eye drops are given after SMILE surgery for about a week to prevent infection and minimise inflammation. Many patients are able to return back to normal activities in 1-2 days.
When can i go back to work? How much leave do i need to take?
Recovery from SMILE surgery is quick with minimal downtime with many returning to work in 1-2 days. It is important not to rub your eyes during this early recovery period. A medical certificate is issued cover any absence from work after SMILE surgery.
When can i go back to exercising?
During each follow up consultation after SMILE surgery, the recovery process is assessed and advise given on when returning to exercising is suitable. Most patients are able to return to running, jogging and gyming within a week. Swimming should be avoided during the early recovery period.
What are the chances of being glasses free after SMILE surgery?
Significant improvement of vision is expected after SMILE surgery compared to the previous unaided vision without glasses or contact lenses. About 99% will no longer need glasses or contact lenses to meet legal requirements for driving.
What if I move or blink during SMILE surgery?
During SMILE surgery, the eye is held in position by a vacuum before the laser is applied. Gentle blinking during SMILE surgery is acceptable as long as there is no effort to tightly squeeze the eyelids closed.
Can SMILE surgery treat astigmatism?
SMILE surgery is able to treat myopia (short-sightedness) and astigmatism.
Can SMILE surgery treat hyperopia (long-sightedness)?
SMILE surgery is not used to treat hyperopia (long-sightedness)
What happens during an assessment for suitability for SMILE?
During an assessment, a detailed history will be taken from you and specialised test to gather data on suitability will be done. This includes checking your visual acuity, refraction, cycloplegic refraction, corneal thickness, corneal topography, pupillometry, eye anterior segment examination, dilated fundus examination. Based on the assessment results, Dr Val Phua will then have a detailed discussion on the various options for laser vision correction and recommend a suitable treatment to meet your vision goals.
