Since its approval for use in Australia in 2015, SMILE laser eye surgery has been found to be able to deliver excellent vision correction outcomes for patients. Learn more about what to expect as you recover from SMILE laser eye surgery.
What is SMILE Eye Surgery?
SMILE stands for small incision lenticule extraction. It’s a form of refractive surgery that uses a laser to modify the corneal tissue at the front surface of the eye. By doing this, the passage of light rays can be corrected to come to a clear point on the retina, providing you with clear vision. This means you are no longer dependent on glasses or contact lenses to see clearly.
Other refractive surgery techniques that can be classified as laser vision correction include LASIK and PRK.
At the moment, SMILE laser eye surgery is suitable only for myopia (short-sightedness) and myopic astigmatism. Patients with long-sightedness (hyperopia) are more likely to benefit from a different refractive surgery technique, such as LASIK or PRK.
How the SMILE Procedure Works?
SMILE laser eye surgery is performed under a topical anesthetic in the operating theatre.
A tool known as a femtosecond laser is used to separate a disc-shaped piece of tissue from the inner layers of your cornea.
This sliver of tissue, known as the lenticule, is calculated in thickness and shape based on the measurements of your eye and the prescription taken at your initial consultation.
Once formed with the femtosecond laser, your eye surgeon then extracts the lenticule from the cornea through a keyhole incision around 2-3mm long. This small incision and the surrounding tissues then naturally seal back together during the healing process.
The Benefits of SMILE Laser Eye Surgery
One of the main benefits of SMILE eye surgery is that it’s considered to be minimally invasive. Unlike other laser vision correction procedures such as LASIK and PRK, the SMILE procedure doesn’t require disturbance of the outer layers of the cornea to reshape the deeper tissues.
The minimally invasive nature of SMILE eye surgery is thought to lead to the improved biomechanical stability of the cornea compared to that found in PRK and LASIK patients, as these techniques of laser eye surgery are more invasive.
As the stability and strength of the cornea are better retained after SMILE eye surgery, refractive surgeons may also consider treating higher degrees of short-sightedness into the double digits in patients with thinner corneas. The higher the prescription, the more tissue from the cornea needs to be removed, which puts limits on treating high myopia for other methods of laser eye surgery, such as LASIK.
During SMILE eye surgery, fewer corneal nerves are disrupted. This can have benefits for reducing the risk of post-operative dry eyes, which is commonly encountered by patients having LASIK.
Additionally, as SMILE eye surgery is what’s called a flapless procedure (in contrast to LASIK, which requires the formation of a flap of superficial corneal tissue), patients undergoing SMILE eye surgery are able to avoid all flap-related complications, such as inflammation, infection, or dislocation.
Recovery from SMILE Refractive Surgery
Recovery and healing from SMILE eye surgery are considered to be quite rapid, and most patients resume activities within just a few days.
Your first follow-up appointment will be the day after your SMILE eye surgery procedure. At this examination, your eye specialist will check your vision and overall eye health and ensure everything is healing as anticipated.
Immediately After SMILE Eye Surgery
Immediately after your surgical procedure, your eye may feel a bit gritty and sore. You may have some tearing and a burning sensation for a few hours.
Visual Recovery
Visual recovery after SMILE eye surgery tends to be slightly slower compared to LASIK, but still, most patients notice clear vision within one to two days.
Like LASIK, full visual recovery after SMILE tends to occur around three months post-operation though you will enjoy clear and functional vision much earlier than this.
Returning to Work
Your return to work depends on your occupation and your typical tasks, which your eye surgeon will discuss with you ahead of time.
If you are in a sedentary office-based role, you may return as soon as the day after your first follow-up appointment. If your occupation puts you at risk of eye injury or catching something in the eye, your eye specialist will advise you to take a longer period of leave. This is still a much faster recovery compared to a patient undergoing PRK who will need to take at least a few weeks off work.
Returning to Driving
Once your eye doctor has assessed your vision to ensure it meets the local driving standards, you may return to driving. However, be aware that you may experience some light sensitivity in the few weeks following your SMILE surgical procedure, so be prepared with sunglasses.
Returning to Physical Activity
Given the minimally invasive nature of SMILE eye surgery, patients can often return to light physical activities such as pilates, jogging, and light resistance training within a few days.
More strenuous activities such as bike riding, swimming, and cardio exercise should take a rest for at least a week.
You will need to rest from higher-risk activities such as contact sports for at least a few weeks to avoid the risk of trauma as the eye heals.
Tips for Your Recovery Time After SMILE Eye Surgery
Your eye doctor will give you some instructions on how to make your healing process as uneventful as possible. General post-operative guidelines include:
- Use your eye drops. You will have prescription eye drops, such as antibiotics and anti-inflammatory medications, but your eye doctor will also recommend frequent use of lubricating eye drops to improve comfort.
- Avoid rubbing your eyes.
- Don’t wear makeup for the first day after surgery.
If anything doesn’t feel right with your eyes or vision, contact Dr Anton van Heerden on (03) 9000 0389 immediately.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Refractive lenticule extraction small incision lenticule extraction: A new refractive surgery paradigm.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778540/
Small Incision Lenticule Extraction (SMILE): It’s what’s new in laser vision correction.
https://www.health.harvard.edu/blog/small-incision-lenticule-extraction-smile-its-whats-new-in-laser-vision-correction-2020051419765#:~:text=Patients%20typically%20experience%2048%20to,fifth%20day%20after%20the%20procedure.
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