SMILE - Flapless Lasik Expert Roundtable

Though SMILE has some similarities to LASIK, they are still two different procedures and require different surgical techniques. LASIK surgery makes use of 2 lasers. A VisuMax femtosecond laser to create the LASIK flap and an excimer laser to reshape the cornea. Both procedures are used to correct nearsightedness and astigmatism
During SMILE eye surgery, Surgeons use the VisuMax femtosecond laser to create a contact lens shaped piece of material known as a lenticule within the cornea. The laser uses tiny laser pulses, applied at an astounding 500,000 pulses per second, to define a lens shaped piece of material (called a “lenticule”) in the center of the cornea (window on the front of the eye). These pulses form bubbles less than 1/100th the width of a human hair. The shape of the lenticule is precisely determined and customized to the patient’s nearsighted correction. The laser then creates a tiny connecting tunnel through which the surgeon removes the lenticule from the cornea. By removing the lenticule, the shape of the cornea changes and corrects the nearsightedness.
No flap (Flapless Lasik) is required with SMILE and the procedure is completed using only the VisuMax laser. As a result, there is minimal disruption to the surface of the eye and the healing time is very short. Because of the smaller size of the incision, patients experience less dryness after SMILE. The incision is smaller than the flap that’s created when performing LASIK allowing patients to return to normal activities like swim, workout, and wear makeup the very next day. Lasik patients have wait at least a month before they can participate in water sports or wear makeup.
The small incision additionally allows some extremely nearsighted patients to qualify for SMILE. Because of the severity of their nearsightedness, they may not have qualified previously for LASIK.
LASIK is well-known in the vision correction community, and it’s an amazing procedure for many patients.
A common side effect of LASIK, however, is the post-operative dry eye that can occur. In general, this lasts for about 6 to 12 months. Symptoms of dryness can be quite bothersome, particularly in patients who spend lots of time looking at screens for a profession or during their leisure time.
Because of the larger incision required for LASIK, many of the nerves that sense dryness are affected by the procedure and need to regenerate. During SMILE, a significantly smaller incision is used and only a small fraction of the nerves are affected. The result: patients who get SMILE experience fewer dry eye symptoms for a shorter time as compared to LASIK.