SMILE: New 3D Minimally Invasive Surgery for Myopia Makes Statewide Debut
By MING WANG, MD, PHD
On April 21, 2017, the first SMILE procedure in the state was performed in Nashville at Wang Vision 3D Cataract & LASIK Center. The new procedure to treat myopia represents one of the most major advancements in laser vision correction technology in the last 20 years.
Myopia is a common eye condition in which close objects can be seen clearly but distant objects are blurry without correction. LASIK and PRK (photoreactive keratectomy) have been the mainstay treatments for myopia for over two decades. In late 2016, the U.S. Food and Drug Administration approved the VisuMax Femtosecond Laser for the SMILE procedure for -1.00 to -8.00 D myopia with up to 0.50D astigmatism.
SMILE stands for SMall Incision Lenticule Extraction. During the SMILE procedure a femtosecond laser, with precise short pulses, is used to make a small incision in the cornea to create a disc-shaped piece of tissue. This tissue is then removed by the surgeon though the tiny opening which causes the corneal shape to change, permanently changing the prescription.
SMILE has several unique advantages over LASIK. The surgery is minimally invasive, as the surgeon needs only to create a small, precise opening to correct vision. The traditional flap used for LASIK is not needed. The laser incision is smaller than 6 millimeters for SMILE, compared to approximately 20 millimeters for LASIK. This helps the cornea to retain more of its natural strength and reduces the risk of rare flap complications that can arise with LASIK. Dry eye after SMILE is also reduced compared with LASIK, as nerves responsible for tear production in the cornea remain more intact in SMILE.
SMILE has a proven track record of success. It has been used internationally since 2011 and over 750,000 procedures have been performed worldwide with 328 participants treated in the U.S. FDA clinical study of safety and effectiveness of the device. From the clinical study, 99.7 percent of patients were able to see without glasses or contact lenses at the level required for legal driving, and the majority of the patients were able to see 20/20 or better without glasses or contacts.
The procedure itself is very fast, taking only minutes per eye, with only about 30 seconds of laser treatment. The treatment itself is typically free of discomfort and is performed in a single-step process with one laser. Vision generally recovers quickly and most patients can resume many normal activities the day after the surgery.
While SMILE provides some great advantages over previous laser surgery options, not all patients are candidates. Currently, the procedure has not been approved to treat large amounts of astigmatism and cannot treat farsightedness. LASIK is still a great option for a majority of the patients seeking laser vision correction.
Dr. Ming Wang, a Harvard (MD, magna cum laude) & MIT (PhD) graduate, is the CEO of Aier-USA, director of Wang Vision 3D Cataract & LASIK Center, and one of the few laser eye surgeons in the world today who holds a doctorate degree in laser physics. He has performed more than 55,000 procedures, including over 4,000 on doctors. For more information, go online to wangcataractLASIK.com or email email@example.com.