January 31, 2017
SMILE or Small Incision Lenticular Extraction is a procedure that entails using a femtosecond laser to create a lenticule of a defined thickness that can be removed through a small incision made in the cornea. It is sometimes hailed as the third generation of laser vision correction technology (After PRK and LASIK). The reasoning behind considering this technology stems from the fact that SMILE allows surgeons to be able to remove the desired amount of tissue to correct vision without having to either create a surface ablation in PRK or a flap-like in LASIK. This technology was recently approved in the United States and Canada.
In August of 2015, I had the pleasure of personally flying to Jena, Germany to further investigate this technology from the manufacturer and from various surgeons in Germany. I had spent a great deal of time researching this technology in anticipation that it may get approved in North America in the near future. After consulting with the manufacturer and surgeons using this technology, I was left with several conclusions:
The final question I asked SMILE surgeons was simple: Would you recommend SMILE if I was a mild myope? I was surprised by some SMILE surgeons recommending PRK to me over SMILE because they felt there was more predictability in outcomes!
In summary, I am excited by the fact that we have potentially a new technology for correcting vision as I do truly believe we have to continue refining and developing new ways to correct vision. But I felt that SMILE is currently at its first generation of laser correction with many issues that still need to be refined similar to when PRK and LASIK were first introduced. Currently, we are in the sixth generation of excimer technology and we continue to further perfect our vision outcomes with more refinement in excimer lasers. I do believe that SMILE will one day become a strong contender for correcting vision. My personal opinion is that it’s not as effective as what excimer technology can offer our patients and for that reason, we decided to hold off for now in bringing this technology.
Video: Schwind laser’s capability to deliver an incredibly smooth laser surface is demonstrated in this animated video. This allows for more precision in treating high-order aberrations as well.
At Clarity Laser Vision, we strive to bring the most advanced, and more importantly, proven technology to correct vision. I hope one day SMILE will prove its merit the same way PRK and LASIK did. When it does, I will be sure to introduce it to my patients to ensure we continue our mandate of bringing the best technology.