Should we be SMILEing?!

Posted by: West Georgia Eye Care Center in Frontpage Article on February 22, 2019

SMILE…

LASIK remains the most popular refractive surgery currently performed in and outside of the U.S.A., but a newer procedure called SMILE has hit the U.S. market.   Small incision lenticule extraction (SMILE) is another all-laser refractive surgery procedure first approved in the U.S.A. in 2016, and which is now being billed by some as a better option than LASIK.  SMILE is very similar to ALK, a non-laser procedure which used to be performed in the US for refractive correction, except that SMILE uses a more precise LASER with smaller surface incision to remove corneal tissue.

iLASIK…

SMILE is also similar to iLASIK in that the same femtosecond laser is used to create corneal incisions, but SMILE is touted as being ‘minimally invasive’ as the external(outer) corneal incision is smaller than the LASIK flap incision. In SMILE corneal tissue (a lenticule) is removed in one piece rather than tissue being ablated by the iLASIK excimer laser.

SMILE is currently approved for nearsightedness and low to moderate astigmatism; however, is not available for higher amounts of astigmatism or farsightedness, which can be corrected with LASIK. In addition, if a patient needs an enhancement after SMILE (for incomplete correction) another laser procedure such as PRK may need to be performed.

DRY EYE…

A possible benefit of SMILE may be a lower risk of dry eye; however, dry eye can still occur after any refractive laser procedure. Some studies contend that corneal biomechanics may be stronger after SMILE; however, there remains uncertainty as to the validity of these claims.

Importantly, SMILE is a relatively new procedure, meaning that there have been no really long-term studies of safety and efficacy. Thus potential complications, including the true incidence of dry eye, ectasia (corneal thinning disorder), the outcomes of subsequent other eye surgery(such as for cataracts), are not fully known; as well, there is uncertainty regarding the effects of incomplete lenticule removal. LASIK and PRK on the other hand have a long-proven track record.

Proven…

Until more data is available, WGECC will continue to offer iFS LASIK, with its proven track record, larger range of available treatments, and excellent safety profile. Stay tuned though!