Laser eye surgery is one of the most common procedures in modern laser surgery. The LASIK procedure is usually used. However, the ReLEx smile method is safer and is mainly used for short-sightedness (myopia) or astigmatism . The ReLEx smile method has been officially permitted in Germany since 2011 and is a genuine alternative to Femto-LASIK.
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Article overview
- What is behind ReLEx smile?
- How does the smile laser method work?
- What is the difference between ReLEx smile and Femto-LASIK?
- What requirements must be met?
- What are the advantages and disadvantages of the ReLEx smile procedure?
- What are the risks of the smile method?
- What does smile laser surgery cost?
ReLEx Smile - Further information
What is behind ReLEx smile?
The smile technique is a keyhole surgical method that corrects short-sightedness of -2 to -10 diopters and astigmatism of up to 5 diopters.
Laser eye surgery using smile surgery is now regarded as the safest and gentlest procedure in laser eye treatment.
"ReLEx" stands for Refractive Lenticule Extraction and means that doctors remove a refractive lens (lenticule) from within the intact cornea.
"Smile" (Small Incision Lenticule Extraction) means that the surgeon removes the lenticule minimally invasively through a two millimeter opening.
This procedure was developed by Prof. Dr. Marcus Blum and Prof. Dr. Walter Sekundo, who worked closely with Carl Zeiss Meditec AG.
How does the smile laser method work?
In the Smile method, the surgeon first cuts a thin lens (lenticule) into the cornea. He removes this via a minimally invasive access (cap).
With this technique, the cornea retains its natural structure and the production of the tear film remains virtually unaffected.
This procedure is also suitable for patients with very dry eyes. These are not suitable for the LASIK technique.
Treatment with the smile laser takes place on an outpatient basis and under local anesthesia. It only takes a few minutes and is completely painless.
In the first few hours after the procedure, the eye may water and itch. The patient's vision is initially blurred. Just one day later, patients can see almost normally. Final stability occurs after four to six weeks.
What is the difference between ReLEx smile and Femto-LASIK?
Femto-LASIK uses the excimer laser. The surgeon cuts open the uppermost layer of the cornea like a round flap and folds it to the side.
This flap entails various risks and side effects:
- Dry eyes
- Incorrect incisions
- A foreign body sensation
- A flap tear-off, where the flap no longer grows on
In the Smile procedure, the femtosecond laser enables precise, three-dimensional incisions to be made within the cornea. It detaches a precisely calculated corneal flap, which the surgeon removes via a tiny incision.
A flap is a circular, wafer-thin layer of the outer cornea @ RFBSIP /AdobeStock
What requirements must be met?
To be able to undergo ReLEx-smile surgery, the patient must meet the following criteria:
- Short-sightedness of -2 to -10 diopters
- Corneal curvature of no more than 5 diopters
- Cornea not too thin
- No significant changes in defective vision within the last year
- There must be no pregnancy
The minimum age for the procedure is 18 years. ReLEx smile cannot be used for cataracts.
What are the advantages and disadvantages of the ReLEx smile procedure?
The biggest advantage of ReLEx smile is that this method does not require a flap and is therefore extremely low-risk. Rehabilitation is very quick. Patients can return to their daily routine shortly after the operation:
- Showering and light sporting activities are possible just 30 minutes after the procedure.
- Endurance sports are possible again without restrictions after two weeks.
- Swimming or sauna after three to four weeks
In summary, the advantages are as follows:
- Very gentle method, as the incision is only around 2 mm long
- No flap (85 percent less incision area, no flap-related risks such as epithelial cell ingrowth or flap tearing)
- Tear flow remains intact, therefore also suitable for very dry eyes
- painless
- Silent and odorless procedure
ReLEx smile is currently one of the safest methods of laser eye surgery. So far, no serious complications or permanent disadvantages have been reported.
However, the procedure is still very new, so there are no long-term studies yet.
The biggest problem with ReLEx smile is that it can only be used for short-sightedness and astigmatism . Patients with long-sightedness have to switch to another procedure. This method is not suitable for patients with a visual defect of less than -2 diopters. The lenticule to be extracted is too thin and can tear during extraction.
What are the risks of the smile method?
Although ReLEx smile is considered to be very gentle, like all medical procedures it is associated with certain risks. For example, there is a minimal risk of over- and undercorrection or regression of the surgical success. Follow-up treatment with the same procedure is not possible and would have to be carried out using the conventional LASIK technique (with flap).
Subsequent complications are possible:
- Minor signs of abrasion and tearing in the incision area
- Foreign body sensation (subsides shortly after the operation)
- Poorer vision at night and during twilight (temporary) in very short-sighted people
Complications that would result from the removal of a flap (e.g. sensitivity disorders and pain) are largely eliminated.
What does smile laser surgery cost?
Compared to simple LASIK, the Smile procedure is currently still very expensive. While LASIK treatments cost 1,000 euros, patients pay 2,000 euros per eye for an operation with ReLEx smile.
This means that this technique is too expensive for patients with limited financial resources.
However, it is possible to deduct the cost of the procedure from income tax. This indirectly reduces the overall costs, albeit with a delay. If you have private supplementary eyeglass insurance, you should find out whether it will reimburse the costs of the smile operation.