Modern laser vision correction has come a long way in the past 30 years since LASIK first became approved. At the Clear Vision Center, we've invested in your vision by offering only the most modern and advanced, all-laser vision correction options, including the SMILE procedure from Zeiss. SMILE stands for Small Incision Lenticule Extraction, which is a laser-only vision correction procedure that is FDA approved for mild-to-moderate myopia (nearsightedness) and astigmatism. SMILE is a one-step procedure and requires the use of a special laser, the Zeiss Visumax femtosecond laser. This laser gently and painlessly creates a thin layer of cornea tissue called a lenticule, which is carefully removed by the surgeon through a tiny opening which you will not feel. The entire procedure takes approximately 5-10 minutes per eye. Unlike LASIK, there is no flap created, which means increased safety with high-impact activities and careers, and less risk of dry eye after the procedure. In addition, the SMILE procedure is comfortable and fast, ensuring you'll have the most rapid recovery possible.
LASIK uses two lasers to correct your vision. The femtosecond laser creates a corneal flap, which is then lifted by the surgeon to perform the vision correction itself with the excimer laser. The flap is then carefully placed back and self-heals. With SMILE, the entire procedure is done with one laser, the Visumax. This carefully docks to your eye and creates a carefully measured disc of tissue called the lenticule, which when removed from the cornea by the surgeon results in the vision being corrected. The main difference with SMILE is that the procedure is shorter, and the eye is typically more comfortable immediately afterwards. Long-term results comparing SMILE to LASIK have shown comparable vision results and risks. The main differences would be lower risk of flap complications with SMILE (as there is no flap) and less dry eye symptoms in the first 6 months following surgery given the smaller incision. It is important to note than any eye procedure may have side effects or complications, and these risks should be discussed with your surgeon at your consultation.
Your vision correction journey with SMILE will begin with a screening and detailed examination of your ocular health, including 3D scans of the cornea to get a picture of your eye's unique "fingerprint". Unlike most other laser centers, at the Clear Vision Center this evaluation includes a personal consultation and examination by your actual surgeon. This personalized evaluation ensures that your surgeon confirms you are a candidate for SMILE, that it is the best option for you, and how to optimize the procedure to match your visual goals. On your procedure day, you'll arrive at our on-site Laser Vision Suite, and will be given the option to take a relaxing medication (Valium) 30 minutes prior to your procedure. While waiting, you'll relax in one of our comfortable massaging recliner chairs. When it's your time, we'll guide you into the procedure room where Dr Vrabec and staff will ensure you are 100% comfortable before proceeding. After placing numbing eye drops, Dr Vrabec will carefully place a special contact lens that securely connects you to the Visumax laser, and then quickly and painlessly activate the laser to create the SMILE lenticule in around 30 seconds. After the lenticule is created by the laser, he will carefully remove the lenticule from the cornea in a painless 5-10 minute procedure. Once complete, we repeat the procedure in the left eye and the vision correction is complete! If you want a safe, minimally invasive way to correct your vision with fast recovery, then SMILE may be the right vision correction solution for you!
Every potential candidate for laser vision correction such as SMILE undergoes a meticulous screening process where we assess various factors including the shape of the eye, your current glasses prescription, and other factors such as your personality, profession and vision goals. The best candidates for SMILE are between 20-49 with mild-to-moderate degrees of myopia +/- astigmatism. If you are over 49, are hyperopic (farsighted) or have conditions such as keratoconus, autoimmune disease, or severe dry eye syndrome, then Dr Vrabec may recommend an alternative vision-correcting procedure such as the EVO ICL or refractive lens exchange (RLE). Our standard process is to recommend to each unique patient the procedure that fits them best, and not to match the same procedure to every patient. This custom, personalized approach ensures you receive the best recommendation and treatment possible for you and your most valued assets: your eyes!
This is a very common question, and one that we take very seriously as potential "guardians" of your vision. SMILE has been FDA approved since 2016 for the correction of myopia and 2018 for astigmatism, and over 7,000,000 SMILE procedures have been safely performed worldwide. As with any surgical procedure, it does carry some risks (discussed below). Overall, SMILE has greater than 99% safety and efficacy, and has a similar safety profile to the more well-known procedure LASIK. While complications can occur with any procedure, the vast majority of these can be avoided through the use of meticulous screening (making sure you are a candidate), having a skilled and experienced surgeon, and using modern technology. At the Clear Vision Center, we go beyond the standard-of-care with our screening process to ensure that only the best candidates qualify for SMILE. While we would love if everyone wanting vision correction could qualify for vision correction with LASIK or SMILE, the truth is that some patients have corneas that are too thin, systemic illness, or personality traits that make LASIK or SMILE inadvisable (although they may qualify for a different vision correction procedure).
If you have additional concerns about risks, we will take the extra time to counsel you at your screening visit. We fully understand that making the decision to correct your vision is a big one, and will make sure you have all the necessary information to make an informed decision.
As with any procedure, there are some common side effects and a risk of surgical complications. Common side effects immediately after surgery are dryness of the eyes, light sensitivity, blurred vision, fluctuating vision, glare, halos, and ocular redness. Most patients will use frequent artificial tears immediately after SMILE surgery for a few weeks to help the eye restore its baseline level of dryness and vision. It is also possible to have a mild vision under-correction or vision over-correction, which may require an eventual enhancement procedure with PRK or LASIK. The lenticule created during procedure may also break apart during removal, requiring an additional procedure to remove the remnants if they affect your vision. Other potential risks may include prolonged eye inflammation, swelling, or infection, however these cases are extremely rare and are equal to or lower than the risks of wearing contact lenses.
During your initial consultation, we will be able to determine if you are a the best candidate for SMILE or one of our other vision correction procedures such as LASIK or the EVO ICL. While SMILE 99% safe and effective in the properly selected patient, some patients are not a candidate for the procedure due to thin corneas, your prescriptions, or systemic conditions. Alternative laser vision procedures such as photorefractive keratectomy (PRK) or LASIK are alternative laser procedures that have similar excellent results, and may be recommended if you are far-sighted or have prescriptions outside the range of SMILE. In addition, there are safe and effective lens-based vision correction procedures such as the EVO ICL or refractive lens exchange (RLE) which avoid treating the cornea altogether to achieve similar, and in some cases superior visual results for high myopia and/or presbyopia.
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