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Small Incision Lenticule Extraction

The Small Incision Lenticule Extraction, or so-called as SMILE, is a recent laser refractive surgery. This kind of surgery is used for the treatment of eye disorders such as myopia or nearsightedness which is a common eye disorder for people with eyeglasses. It is a simple refracted error from the eyes. This type of disorder is called initially as Femtosecond Lenticule Extraction or FLEx. This type of surgery does not only pinpoint on people with myopia, but also with people that have astigmatism. These both can be encountered by a person at the same time. This kind of surgery is quite similar to another surgery, LASIK or laser-assisted in situ keratomileusislaser surgery. With the same methods, the intrastromal process is different for it uses only a femtosecond laser that is pointed to the surface of the corneal and cleaves a thin lenticule on the part of the corneal stroma to perform manual extraction. Both are said to have excellent outcomes one the eye surgery.


The SMILE or the Small Incision Lenticule Extraction started from the creation of intrastromal lenticule method was an alternative from the other surgical laser treatment to LASIK that was called as Femtosecond Lenticule Extraction or much more categorized as FLEx last 2007. This kind of method in optical surgery was to treat patients with extreme myopia. On the upcoming year, there were improvements in the said technology such as it can scan modes and its energy parameters. It improved the visual recoveries and was noted with the same results from the LASIK laser surgery procedure. And that was the crowned event for the FLEx. Upon the implementation of this kind of optical surgery, a new procedure was born and named as the Small Incision Lenticule Extraction or called as the SMILE. This new invention involves 2 to 3mm incisions that are used to allow extraction for the whole corneal lenticule.

On the occurring years or this new technology, SMILE. It has been noted for achieving similar results from the past inventions, LASIK. Aside from that, SMILE created a more positive part in the world of optical surgery for its better benefits and a much faster recovery for the people who have undergone this process. Some of the advantages that the SMILE has is a faster recovery of reinnervation of corneal nerves, post-optical dry-eye, and an advantage in the potential biomechanical technology. There was a commencement that was created in September 2011 for the success of SMILE technology. From the achievement that the SMILE created, they have established various technologies in the area such as China, India, and Europe. There was a clinical trial that was made in the US that started in June 2012 then expanded by the US FDA after some initial signs of the success of this technology to varying patients.

Surgical Procedure of the SMILE Optical Surgery

During the proper surgery of the SMILE optical laser surgery treatment, there are some guidelines to follow to provide success in clients with disorders. Also, there are some rules for the clients to qualify in this kind of treatment. There is a machine that is used to look at their corneal stroma’s thickness and ensure that the post-operative thickness should not be too thing during the treatment.

At the treatment, extraction of the lenticule is necessary and is accurate to be cut in correction prescription that was part of patient’s requirement in using the photo disruption laser-tissue interaction. The process of this extraction can make with Lasik type of flap, but now on the modern era, there is one flapless technique that is used to create a tiny tunnel incision that points the patient’s corneal periphery. Presently, this is the only approved procedure to cure nearsightedness in the country of the US.

After the method of femtosecond laser in where it already separates the lenticule, there is a blunted spatula that is being inserted in the incision that is between the stroma and the lenticule. After it, it has been carefully rotated in ensuring that the separated lenticule has been wholly detached former to be removed by the forceps. This kind of procedure is said to be predicable and safe for treating both astigmatism and myopia with clients that are experiencing this kind of optical disorder. Some theoretical benefits are saying that this technique creates a minimal effect to being invasive compared to other treatments that use flap based cures. There are also no collateral damages that were noted during the treatment in the surrounding tissue that can occur due to its high speed by utilizing usage of femtosecond laser. In recent limited studies, they created a research hypothesized that this kind of method has head cornel wound and different inflammatory response of the eyes. ’It’s been said that the wound healing must be associated with the turn of phrase of fibronectin less compared with the method of femtosecond-LASIK treatment.

Since SMILE treatment cansomewhat be considered as new than other types of laser correction aids, the result in the study is limited. But throughout the continuing process and usage of the SMILE laser treatment, the results are now stable after a 5-year process of following up the treatment.

As the lenticule extraction technique continually evolve, it is said that it is possible that the extracted lenticules that was made during the process can be preserved cryogenically that can be used for future donations or re-implantations that can help others. A proof that the concept has been tested on primates or the original owner of the lenticule, these were tested to be extracted from primates, and allogenically has been transplanted to other monkeys and created a positive result. This method has not been tested in the humans itself, but as the technology is getting better and more advanced, it is likely that this method can be entirely operated and to be used in human beings for further results that will be studies over time. This can change the world of optical surgery.