A newer technique and surgery procedure, ReLEx SMILE has been developed for correction of refractive errors for better vision, with no need for creation of the flap, since that laser vision correction is performed with the Lasik. The procedure needs only a small incision at one side by an experienced and trained surgeon. The ReLEx SMILE eye surgery can leave the cornea anterior lamellae intact, by removing the refractive lenticule. This procedure needs no excimer laser for correction of vision. The ReLEx Small Incision Lenticule Extraction or SMILE is a new generation method of laser correction for vision, where the procedure is performed with a femtosecond laser. The procedure is performed by making two cuts at the layer of cornea, for separation of lenticule and removal of the same. This technology is made available only through Visumax machine by Carl Ziess, currently.

The technique of ReLEx SMILE Laser eye surgery stands as one of the most innovative approaches for correction of vision and it is purely blade free procedure and so pain free and flap free treatment. The procedure has shifted the correction of vision to the next level, as it offers best precision, comfort and maximum safety.

The surgery for ReLEx laser eye procedure is done by Carl Ziess with the Visumax machine and performed with two small side incisions over the cornea, measuring to the length lesser than 4 mm. here, vision correction is achieved by creating a disc shaped or lenticule shaped cornea tissue. Then a side incision is made to remove the lenticule. And finally, the lenticule that caused the changes in the cornea will be removed towards correction of the refractive error.


SMILE Technology – Advantages

  • More appropriate choice for more refractive error values for the patients
  • Being a flapless procedure, concerns of traumatic flap dislodgement or displacement eliminated
  • Very minimal procedure, hence minimized possibility of tissue ingrowth or infections
  • Because of small incision made, increased corneal nerves preserved from the procedure, resulting minimal discomfort of dry eye
  • Much better choice for higher refractive error values, for patients
  • Faster cornea healing, however, needs more time for visual recovery than the Lasik Surgery

Complications Possible

Similar to any other technology, the ReLEx SMILE technology also is not free from post operation complications. Some of the possible complications associated with this technology are the following.

  • During the lamellar cuts, there is a possibility of most being lot, because of the suction. In such cases, the procedure would just be aborted, so that the vision of the patient would not be disturbed, postponing the procedure to the later date. Another alternative is to switch to either PRK or Lasik.
  • Incomplete removal of lenticule is possible sometimes. The solution is the re-procedure and sometimes the surgeons recommend shifting to standard or conventional Lasik that may be difficult in some cases.
  • Possibility of not reaching the refraction targeted and may need enhancement procedure. The possible options can be ideally Thin Flap Lasik or sometimes PRK also. Thin Flap Lasik is better feasible, as long as,
  • There is an enough space is left for a new flap along with space for ablation, when the previous ReLEx SMILE procedure was performed with a cap that is thick enough.
  • Before new flap is made, the maximum epithelial thickness is confirmed, so that buttonhole is avoided.
  • The thickness of the residual stroma, present below the lenticule is beyond the safety limits of the standard Lasik, and it may not be necessary for the procedure of the primary ReLEx SMILE.

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ReLEx SMILE is the beginning of a new era in laser refractive eye surgery, on patient’s comfort grounds, as its significant advantage. An innovative treatment technique, ReLEx SMILE is designed and developed by Carl Zeiss, in Germany for treatment of precise and sensitive defects of vision. First time in the history of refractive laser eye surgery, correction is enabled to perform without flap cut. So far it is the first and only flapless, bladeless and minimally invasive 3D procedure.

What is SMILE?

SMILE (SMall Incision Lenticule Extraction) was introduced in t