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The VISUMAX ® 800 from ZEISS represents the latest generation of ZEISS femtosecond lasers and offers a shorter laser time compared to its predecessors, while tissue separation with SMILE ® Pro from ZEISS is easier than before.
What is SMILE® Pro?
SMILE (Small Incision Lenticule Extraction) is a minimally invasive procedure where a laser creates a lenticule (or disc shape) inside the cornea, which is removed through a tiny incision. This reshapes the cornea to optimise focus and sharpen vision.
The cornea is made up of five layers, but SMILE ® Pro surgery focuses on the central layer, known as the stroma. During surgery, a computer-guided laser creates a precise lens-shaped disc (known as a lenticule) in the stroma. The shape of the lenticule is customised to correct the specific shape of your cornea. The laser then makes a tiny keyhole incision, and the lenticule is removed. When the process is complete, the cornea is shaped to optimise focus and sharpen vision long term.
Comfort and Ease
The laser portion of the procedure is quick it’s all over in under 10 seconds. The technology is also designed to ensure it’s an extremely comfortable procedure. Although everyone is different, recovery is quick – most people will be feeling great the very next day.
Advantages of innovative technology that you benefit from immediately during your laser eye treatment
- Short treatment time of only 32 seconds per eye.
- Also suitable for patients with dry eyes.
- Keyhole technology (incision of 2 mm) and thus rapid healing.
- For myopia up to minus 10 diopters.
- For astigmatism.
- Suitable for patients with thin cornea, corneal stability is maintained.
- No corneal flap.
- Better corneal stability.
SMILE ® Pro Treatment Steps
How does it work?
Until now, refractive correction has usually involved the surgeon first cutting a flap, which was then folded back to remove corneal tissue point by point. SMILE Pro now enables laser vision correction without a corneal flap and thus minimally invasive.
1. Creation of the lenticle and the incision
The first step with the VisuMax is to create a refractive lenticule and a small incision of no more than two to three millimeters in the intact cornea, which can be done almost independently of the surrounding conditions and corneal condition.
2. Removal of the lenticle
In the second step, the lenticle is removed through the created incision. Since no flap is cut, this is only a minimal intervention in the biomechanics of the cornea.
3. Rehabilitation
Removal of the lenticle changes the cornea to achieve the desired refractive change.
1. Non-binding, personal consultation
During a non-binding, personal consultation, your doctor will first clarify with you whether your eyes are basically suitable for SMILE Pro treatment. For this purpose, all relevant eye parameters will be measured.
2. Comprehensive preliminary examination
Before the operation, a comprehensive medical examination will follow. Before this examination, you should in any case refrain from wearing contact lenses, as they also change the shape of the cornea in the long term. You should not wear soft contact lenses for at least one week before the examination. For hard contact lenses, the interval should be at least two weeks. Lenses should then also not be worn in the same time window before the operation.
On the day before the treatment as well as on the day of the treatment itself, you should refrain from using cosmetic products such as face creams, lotions, and also make-up and perfume. They can increase the risk of infection or contamination of the surgical field. You should clean your eye area particularly thoroughly on the morning of the treatment day.
3. The SMILE treatment
On the day of the operation, you should wear comfortable clothes if possible. You can eat and drink normally, but should not smoke. For reasons of hygiene, you should wash your face thoroughly once again and completely remove any make-up residue.
Then the actual procedure takes place, which is performed on an outpatient basis and takes only about 20 minutes for both eyes. First, the surgeon will greet you and once again match your personal data before your corneal surface is anesthetized with drops. To prevent blinking during the surgery, you will be fitted with what is called an eyelid opener. The other eye will be covered during the procedure.
Next comes the preparation of the lenticule in the cornea using the VisuMax femtosecond laser. A contact lens adapted to the shape of the cornea is used to fix the eye. You will see a bright spot during these steps, but hardly feel anything. Once the surgeon has prepared the lenticule, he or she uses the laser to cut a small opening of no more than four millimetres, through which he or she releases the lenticule and carefully pulls it out. The small incision closes by itself after the correction, so it does not need to be sutured. No separate postoperative precautions are required. You will probably be amazed – as well as most other patients – at how quickly the procedure is over and that you hardly felt a thing. An eye bandage is not necessary, but sunglasses are recommended. No driving is allowed immediately after the treatment.
4. After the SMILE treatment
After the procedure, you should not rub your eyes. You will also receive antibiotic eye drops, which must be instilled into the eye five times a day for a week, as well as artificial tears – as needed. Normally, you can return to work after two to three days. You should also wait about three days before engaging in sporting activities. Swimming and sauna visits, on the other hand, should be avoided for about two weeks to reduce the risk of infection.
Medical checks take place after one day, one week and one month. Driving is allowed again only after medical permission, which can usually be given at the weekly check-up.
The femtosecond laser - technical facts
A femto-laser is an infrared light laser that treats tissue such as the cornea not only very precisely, but also with much less heat than other lasers. This proves to be a decisive advantage, especially in eye surgery. The femtosecond laser works on the basis of ultra-short light pulses. These last only fractions of a billionth of a second; their spot size is only 1/100 mm.
The VisuMax femtosecond laser
A specially developed laser system, the VisuMax femtosecond laser from Carl Zeiss, is used for SMILE treatment. This laser has already proven itself in Femto-LASIK procedures with its sophisticated technology, precision and reliability. Through further development, it is now possible for the first time to prepare a lenticule within the intact cornea with millimeter precision, so that larger incisions and a flap can be dispensed with. In this way, the surrounding corneal tissue is spared as much as possible and the visual defect can be corrected in a targeted manner.
In addition to its high precision, a particular advantage of femtosecond technology is that it is highly reproducible and accurately predictable even when high corrections are involved.
In order to avoid unnecessary compression of the cornea, a contact lens is used that is adapted to the individual corneal anatomy and allows a precisely fitting treatment. This also avoids short-term visual loss, which can be caused by excessive intraocular pressure.
In addition to state-of-the-art laser technology, a functionally sophisticated and ergonomically shaped patient couch has also been developed for ReLEx treatments, allowing for maximum comfort and the most relaxed position possible during the procedure. During the operation, the patient’s position is continuously monitored and can be automatically readjusted if necessary.
At LEC London, we help patients with a number of visual impairments, including presbyopia, myopia, and cataracts. Our team has performed the most SMILE Pro laser eye surgeries across Europe and are experts in the field of refractive surgery.
We offer a full range of treatments at our London clinic, based in the prestigious Knightsbridge neighbourhood. Book your SMILE Pro appointment today to save £1,500 on surgery for both eye
SMILE® Pro FAQs
Is SMILE Pro treatment safer than LASIK?
The corneal opening with the SMILE Pro method is significantly smaller (2 mm) than with LASIK (20 mm). The cornea remains stable and the tear flow remains intact.
No flap complications
Although flap complications are very rare with a LASIK incision, they are completely eliminated with SMILE Pro treatment due to the keyhole technology.
SMILE Pro even for dry eyes
With the SMILE Pro procedure, the surgeons work with the so-called keyhole technology. The cornea remains stable and the tear flow is hardly disturbed compared to LASIK.
Corneal stability is preserved
For the SMILE Pro laser procedure, only a tiny opening in the uppermost corneal layer of about 2 mm is necessary (keyhole technology). In comparison, with conventional LASIK, a flap of about 20 mm is prepared.
100% Femtosecond technology
The SMILE Pro procedure uses solely a femtosecond laser (VisuMax from Zeiss). Femtosecond technology is considered worldwide to be the most modern, safest and most precise method for the correction of refractive errors.
Also suitable for patients who have not previously been able to have their eyes lasered
The SMILE Pro procedure is even suitable for patients with higher refractive errors, thinner corneas or dry eyes. Thus, myopic patients up to -10 diopters can be treated with the SMILE Pro procedure. With Femto-LASIK, treatment was only recommended up to a maximum of -8 diopters. A thinner cornea (min. 480 micrometers) is also not a problem, because the cornea remains fully intact with the SMILE Pro procedure and the tissue removal is not as deep. Since, in contrast to Femto-LASIK, the nerves in the uppermost layer of the cornea, which are necessary for the regulation of the tear film, are largely preserved, the risk of dry eyes after the operation is also reduced. Another advantage: Pain or a strong foreign body sensation on the cornea is hardly to be expected with SMILE, since the laser treatment takes place inside the cornea.
Is there an age limit for laser eye surgery?
A minimum age of 18 years is required for laser eye treatment.
How long should my values be stable for laser treatment?
Your values should be stable for about one year before treatment. If in doubt, come to us and we will check your visual acuity conscientiously.
Can one see sharply immediately after the treatment?
As a rule, the day after the procedure you can already see 80-90% of what you could see before with your visual aids and within 3 days you will have full visual acuity.
What about complications?
EuroEyes pays the utmost attention to maintaining high standards of quality and hygiene, as a result, the rate of complications during laser vision correction is extremely low. Real complications are extremely rare. In order to achieve an optimal healing process, it is very important that patients conscientiously keep their follow-up appointments. It is also essential to follow the drop schedule and the instructions given to the patient by the staff for the time after the treatment. The side effects that can occur during laser vision correction are usually short-term and harmless and treatable until full recovery.
When can I put on make-up, go swimming or take a sauna again?
After about two weeks, endurance sports are possible again without restrictions. Eye make-up, swimming or sauna are recommended in moderation, after about three to four weeks.