Small Incision Lenticule Extraction (SMILE) is a minus eye surgery method using a laser. SMILE is done by reshaping the cornea using a laser, so that light can be refracted well into the retina.
In good vision, light will enter through the cornea and lens to refract to focus on the retina. But in patients with nearsightedness, the cornea is disturbed, so that refraction of light does not focus on the retina and causes blurred vision.
SMILE is done to improve vision in people with nearsightedness and reduce the use of glasses or contact lenses.
SMILE Indications
For patients with dense activity, the doctor will recommend SMILE rather than LASIK. This is because the SMILE procedure requires a smaller incision than LASIK surgery, so the patient does not need to worry that the corneas that have been slashed will escape from the eyeball.
In addition to the above reasons, the doctor will also recommend the SMILE procedure in the following conditions:
- Patients aged 22 years and over.
- The size of the glasses have not changed in the past 1 year.
- The overall good eye condition, especially in the cornea.
- Nearsightedness rates are between -1 to -8, with minimal astigmatism.
SMILE Warning
Patients are advised to consult a doctor before deciding to undergo SMILE surgery. The doctor will tell the patient what conditions can pose a risk to undergo this procedure.
The following conditions need to be careful before undergoing SMILE surgery:
- Age less than 18 years.
- Pregnant and nursing mothers.
- The size of the glasses are not stable in the past year.
- History of eye disease.
- Corneal Abrasion.
- The cornea is not thick enough.
- Glaucoma.
- Have had eye surgery.
- Cataract.
- Uncontrolled diabetes.
Preparation for SMILE Operation
Before undergoing the SMILE procedure, the doctor will ask the patient to undergo a number of examinations to ensure this procedure is right for the patient, such as:
- Examination of the patient's visual function. This is done to ensure the patient's visual condition does not change. This examination is at once to measure the level of nearsightedness of patients.
- Overall eye examination. The doctor will ensure there is no interference with the patient's eyes. This is done to avoid risks that arise during and after surgery.
- Pupil size check.
- Examination and measurement of corneal thickness in patients. Corneal measurement results will be used to align the laser during surgery.
After the patient is certain to undergo SMILE surgery, the doctor will notify the series of operations, as well as the benefits and risks that arise postoperatively. In some patients who undergo SMILE, their vision function will be better. However, patients are advised to keep wearing glasses when undergoing a number of activities, such as reading or driving at night.
SMILE Operating Procedure
The SMILE procedure generally takes 10-15 minutes. The following steps are performed by the doctor in the SMILE procedure:
- The laser is programmed to the right size, according to the size of the patient's cornea.
- The patient's eyes will be dripped with anesthetic to numb.
- After the anesthesia is working, the eye doctor will install a brace to prevent the patient from blinking.
- Suction rings are placed in the eyes to lift and flatten the cornea, and prevent the eyes from moving.
- The laser will make a disc shape (lenticule) under the surface of the eye, then a small incision in the cornea will be made.
- The doctor will remove the lenticule through an incision that has been made. This stage also reshapes the corneal surface.
- The procedure with the use of a laser will only last for 30 seconds.
After the SMILE Procedure
The doctor will advise the patient to invite someone to drive him home after surgery. The eye condition that has just been operated on makes it impossible to directly use it to drive alone.
Patients are advised to rest for up to one day after surgery. Don't forget to routinely use eye drops as prescribed by your doctor. This is important to help the recovery process.
Vision will blur after surgery, but will gradually improve with time. You can resume your activities 1-2 days after the operation, but try not to get your eyes exposed to water for several days.
Risk of SMILE Side Effects
As with other operations, although rare, SMILE can also cause side effects to watch out for, including:
- Infection.
- Inflammation in the area of the former operation.
- Glare vision when in a bright place.
Patients may also get results that are not as expected, for example vision is still a little blurry. However, this condition can be overcome by using glasses, contact lenses, or additional laser surgery.
Generally, a number of complications that arise after SMILE surgery can be treated. However, there are also other complications that are more severe and less common, namely:
- Vision becomes worse than before undergoing the SMILE procedure. The condition does not change even if the patient wears glasses or contact lenses.
- Blindness.
