Since LASIK is more than two decades old at this point and has several drawbacks despite its proven results, it should not be a surprise that people are always looking for a new alternative procedure. The new candidate is called SMILE surgery, which is short for Small-Incision Lenticule Extraction surgery, and it uses only a femtosecond laser to reshape the cornea.
This procedure hopes to remove flap complications associated with LASIK as well as the risk of dry eyes after the procedure, and maybe give a treatment alternative to many people who cannot benefit from LASIK.
In SMILE surgery, a small incision is made in the surface of the cornea using a femtosecond laser. The femtosecond laser is then used to cut out a lens-shaped section from the interior of the cornea. This section is then extracted using a small tool.
There have been a number of significant studies performed on this procedure. One of the earliest was performed in Germany and the results published in the Journal of Cataract and Refractive Surgery in 2008, using a slightly different version of the procedure called Femtosecond Lenticule Extraction (FLE, sometimes FLEX or reFLEX). This study treated ten myopic eyes, with 90% of them achieving +/- 1.00 D, approximately equivalent to 20/50 vision. The study showed no evidence of higher-order aberrations.
A more recent study published in the British Journal of Ophthalmology looked at 91 eyes of 48 patients. This multi-center 6-month prospective study showed even more positive results, with 95.6% of patients within 1.00 D, and 83.5% of eyes achieved an uncorrected visual acuity (vision without glasses or contacts) of 20/20 at 6 months, comparable to LASIK results. In the follow-up questionnaire, 93.3% of patients were satisfied and would undergo the procedure again.
The SMILE procedure is already being offered in Britain and India, and researchers are recruiting candidates for clinical trials here in the US. It’s hard to say just how long it will be before the procedure will be available.
To learn more about advanced vision correction alternatives, please contact a local ophthalmologist today.