SMILE
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What is SMILE?
Understanding About
SMILE (Small Incision Lenticule Extraction) is a laser refractive surgery technique used to correct myopia and myopic astigmatism. Unlike LASIK (Laser-Assisted In Situ Keratomileusis) and FLEx (Femtosecond Lenticule Extraction), SMILE does not involve creating a corneal flap. Instead, it makes a small peripheral corneal incision through which a refractive lenticule is extracted.
This technique aims to improve corneal biomechanical stability by minimizing disruption to the peripheral collagen networks in the anterior stroma. Additionally, SMILE is thought to reduce injury to the subbasal nerve plexus and avoid flap-related complications.
Since its introduction in 2008, SMILE has gained popularity among ocular surgeons and has the potential to become a standard procedure for correcting visual refractive errors.
Symptoms
Treatments
Precautions
Symptoms
Treatments
- Patient positioning is crucial.
- Initial docking ensures proper alignment.
- Suction stabilizes the eye.
- Femtosecond laser creates incisions for lenticule formation and extraction.
- Lenticule extraction involves separating and extracting using forceps.
- Techniques include push-up, ASOCT, and “lenticuloschisis.”
- Options for retained lenticule: FLEx, surface ablation, or PTK.
- Postoperative medications: steroids, fluoroquinolone, lubricating drops for 1-2 weeks.
- Close follow-up by an ophthalmologist is recommended.
Precautions
Precautions for SMILE
- Ensure thorough patient counseling about potential complications.
- Surgeons must be highly trained to reduce intraoperative risks.
- Maintain proper patient positioning to minimize movement.
- Monitor and manage suction loss, opaque bubble layer (OBL), and black spots during lenticule creation.
- Perform skilled lenticule dissection and extraction to prevent complications.
- Manage postoperative issues like dry eye, corneal abrasions, and infectious keratitis.
- Conduct close follow-up to promptly address any emerging complications.
- Consider alternative treatments or retreatment options for unsatisfactory outcomes.
Types of SMILE
Different Types of
Before the Surgery
During the Surgery
After the Surgery
Before the Surgery
- Provide comprehensive counseling about potential risks and outcomes.
- Ensure the patient’s posture is comfortable with uncrossed legs and a relaxed neck.
- Advise shallow breathing to minimize head movement.
- Orient the head properly for accurate docking.
- Instruct the patient to remain calm, focus on fixation, and avoid eye squeezing.
- Verify proper docking with a curved contact glass before proceeding.
- Direct the patient to fixate on a green blinking light for alignment.
- Initiate and maintain suction throughout the surgery.
- Discuss postoperative medications and follow-up appointments.
- Ensure the patient comprehends and adheres to preoperative and postoperative instructions.
During the Surgery
- Ensure patient comfort and avoid neck twisting.
- Advise shallow breathing to minimize head movement.
- Orient the head correctly for docking and centration.
- Emphasize patient cooperation for successful surgery.
- Verify proper docking with a contact glass.
- Instruct fixation on a green light for centration.
- Maintain suction throughout.
- Allow the laser to create the lenticule.
- Use manual tools for lenticule extraction, ensuring proper tissue identification..
- Be prepared to address complications promptly.
After the Surgery
- Ensure the patient understands and signs the consent form.
- Monitor the patient during the procedure, emphasizing the need for stillness and minimizing anxiety.
- Postoperatively, monitor the patient for a few hours before discharge.
- Emphasize post-operative instructions, including avoiding scratching the eyes, wearing eye covering during sleep, and wearing eyeglasses when outdoors for the first week.
- Schedule follow-up appointments with the ophthalmologist as recommended.
Our Doctors
Dr. Kasu Prasad Reddy
M.B, D.O, MRCOphthCheif Cataract & Refractive Surgeon
Somajiguda
,
Telangana
Dr. P. Muralidhar Rao
MBBS, M.S, FIVRSr. Vitreo Retinal Surgeon
Somajiguda
,
Telangana
Dr. Anitha C Kamarthy
MBBS, M.SSr. Cataract & Glaucoma Surgeon
Somajiguda
,
Telangana
Dr. B M Anil Kumar
MBBS, D.O, FLVPEI, MBASr. Glaucoma Consultant
Somajiguda
,
Telangana
Dr. Vamshidhar
MBBS, DNB, FICO ( UK)Sr. Cataract & Refractive Surgeon
Somajiguda
,
Telangana
SMILE FAQS
FAQS
How many days leave do I need from work?
Will I be awake during the procedure?
Is it a permanent treatment?
Can both eyes be treated in the same sitting?
How much time does the procedure take?
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