Upgraded Version SMILE®pro
The Zeiss VisuMax 800 SMILE®pro femtosecond laser system is used for corneal refractive surgery, specifically SMILE (Small Incision Lenticule Extraction) for myopia correction. It utilizes femtosecond laser technology to create extremely small laser bubbles within the cornea, allowing for precise cutting of the middle layer of the cornea to achieve the desired refractive effect.
Features of SMILE®pro
Faster laser time
The laser repetition rate has been increased from 500 kHz (kilohertz) in SMILE to 2 MHz (megahertz), driven by an improved scanning system. This significant advancement has reduced the single-eye laser time from approximately 25 seconds in SMILE to just 10 seconds. Consequently, the overall time spent fixating on a single point during the procedure is greatly reduced, alleviating patients’ psychological burden.
OcuLign ® Pattern rotation for cyclotorsion alignment
Astigmatism is a type of directional visual problem characterized by its axis. Prior to undergoing laser surgery, it is crucial to determine the precise location of the astigmatic axis since the position of the eye undergoes physiological rotation when the patient lies down.
ZEISS VISUMAX 800 features the intuitive OcuLign® pattern rotation. The sophisticated yet easy-to-use system automatically re-calculates the treatment pattern and helps to counter cyclotorsion that may occur.
CentraLign ® Assistant system computer-controlled function for easy centration
Everyone’s eyes have a “visual axis deviation angle,” which refers to the degree of deviation of the visual axis relative to the center of the pupil. During laser surgery, it is necessary to adjust the laser center based on the center of the pupil in order to align it with the visual axis.
The CentraLign® assistant system is a computer-controlled function for easy centration. It uses pupil center and vertex position, giving you full control of centration already during the docking phase. There is no need to shift the cutting pattern after docking.
SMILE®pro Vision Procedure
Laser refractive surgery is a procedure that can correct visual problems such as myopia, hyperopia, and astigmatism by altering the shape of the cornea. By modifying the cornea’s curvature, the surgery aims to adjust the refraction of light, enabling it to accurately focus on the retina.
During SMILE, the femtosecond laser platform cuts a refractive lenticule within the cornea. The cut lenticule is then removed through a small incision at the corneal periphery. This changes the overall corneal curvature and thus achieves the refractive correction effect.
SMILE is a ‘flapless’ procedure. When compared with LASIK where a corneal flap is created, the wound area in SMILE can be significantly reduced by more than 80%, resulting in a more desirable wound healing effect. SMILE is an odorless procedure when compared with LASIK since it does not involve vaporization of corneal tissue. Therefore, patients would have a more pleasant experience during SMILE.
Step 1: Laser directly creating the ‘refractive lenticule’ within the cornea
Step2: the lenticule is removed via a 2-4 mm small incision
Step 3: Cornea curvature changed to the desired shape after removing the lenticule
Features of SMILE®pro
More satisfactory results for correction of myopia under 10 dioptres, and able to correct astigmatism under 5 dioptres.
The entire procedure takes only about 5-10 minutes
Minimally invasive procedure with only a small incision (2-4mm)
There is no smell of burning during the correction process.
There is no need to switch instruments during the procedure.
The small incision minimizes surgical trauma to the corneal nerves, thus reduces postoperative dry eyes and minimizes the risk of infection
No vaporization of corneal tissue during the procedure
Comparing different vision correction surgeries
After undergoing the preoperative eye examination, the doctor will determine the suitable surgical options for you. You can also discuss with the doctor to make a decision together.
| SMILE PRO | SMILE | LASIK | ICL | |
| Degree of correction |
Up to -10.00 diopters of myopia Up to -5.00 diopters of astigmatism |
Up to -15.00 diopters of myopia Up to +6.00 diopters of hyperopia Up to +6.00 diopters of astigmatism |
Up to -18.00 diopters of myopia Up to +10.00 diopters of hyperopia Up to +6.00 diopters of astigmatism | |
| Technique | Cornea cutting; no need for cornea flap creation | Creation of corneal flap, followed by laser reshaping of the corneal inner layer beneath the flap | Implantation of ICL lens between the eye's natural crystalline lens and iris | |
| Surgical duration | 5 minutes per eye | 10 minutes per eye | 10-15 minutes per eye | |
| Laser procedure time | 10 seconds per eye | 25 seconds per eye |
I. Corneal flap creation: approximately 10 seconds II. Corneal reshaping (depending on the degree): 10-30 seconds | NA |
| Size of incision | 2-4mm | Approximately 20mm | Approximately 3mm | |
| Postoperative dry eye condition | Slight | Mild | Slight | |
| Natural cornea healing time | Several days | Several weeks | Several days | |
| Chance of cornea flap displacement | None, no need for cornea flap creation | Yes | None, no need for cornea flap creation | |
| Odor produced during the surgical procedure | None | Slight burning odor | None | |
Corneal Collagen Cross-Linking (determined by Doctor)
Corneal Collagen Cross-Linking (CXL) is a surgical technique used to enhance corneal strength in the treatment of corneal deformities and weakening conditions, primarily for the management of keratoconus.
Conventional laser refractive surgeries can weaken the cornea. However, the enhanced versions (Xtra) of LASIK Xtra and SMILE Xtra surgeries are specifically designed for individuals with higher refractive errors and thinner corneas. These procedures utilize cross-linking techniques to strengthen the cornea’s collagen structure, thereby consolidating the refractive correction outcomes.
Corneal Collagen Cross-Linking (CXL) Procedure:
- Administer topical anesthesia eye drops.
- Apply a special solution of vitamin B2 (riboflavin) onto the cornea as a supplement.
- Expose the cornea to ultraviolet light to activate the vitamin B2.
- The procedure typically takes approximately 30 minutes to 1 hour.
Am I a Suitable Candidate for SMILE®pro
- At least 18 years old
- No health issues which affect your eyes, no special issues which may influence the healing of wound
- Having a stable contact lens or glasses prescription
To find out if SMILE®pro is suitable for you, you should have a comprehensive eye examination by our ophthalmologist. During the examination, we will give you more specific information and answer any questions you may have.
Prepare for SMILE®pro
- To schedule an eye examination prior to the surgery (approximately 2 hours), please click here.
- If the doctor determines that you are suitable for the procedure, you can then schedule a surgery appointment.
- Before the eye examination and SMILE®pro surgery, it is necessary to discontinue wearing contact lenses:
– Soft lens wearers should stop wearing them three to seven days prior.
– Rigid or gas-permeable lens wearers should stop wearing them one to two weeks prior.
FAQ's on SMILE surgery
Am I at risk of developing dry eyes after laser eye surgery?
In the vast majority of cases, post-operative dry eye only causes minimal discomfort (which can be relieved with the lubricating drops in your medication pack), and will resolve with time. Compared with LASIK, SMILE induces less dry eyes.
Can I receive other eye operations after SMILE? (Such as: cataract surgery)
Yes, you can. SMILE surgery will only change the shape of the cornea. Other tissues in the eye are not affected. Therefore, you can receive other eye operations after SMILE.
Can I wear cosmetic or colored contact lens after receiving SMILE surgery?
As the curvature of the cornea will be changed after SMILE, patients may experience some discomfort while wearing contact lenses. If you feel discomfort, you should avoid wearing them and consult your doctor. It is recommended to withhold contact lens wear during the first month after LASIK or SMILE surgery.
How long will the surgery last?
The time inside the operation theatre ranges from 15 minutes to 20 minutes, but if we include the preparation time before operation and the post-operative monitoring, the total time at our center will be around 2 hours. Most patients enjoy remarkable vision improvement within one to two days after refractive surgery. However, this recovery time varies from one patient to another. It is important to note that full visual recovery may sometimes take up to three to six months.
Difference between LASIK and SMILE?
LASIK surgery involves creation of a flap measuring around 20mm in circumference, and the corneal nerve may take some time to recover. Thus, dry eye syndrome is a common condition in the early post-operative period.
SMILE surgery is a flapless procedure and only a 2-4mm incision is required. Thus, it has a lower incidence of post-operative dry eye when compared with LASIK surgery, and faster wound recovery. It also eliminates the risk of flap-related complications.
SMILE surgery is not suitable for correction of hyperopia, myopia more than 10 diopters, or astigmatism more than 4 diopters.
Is it necessary to attend a hospital?
No. Modern refractive surgery is fast and safe; and no anesthesia (apart from anesthetic eyedrops) is required. Therefore, there is no need to be admitted to a hospital.
Does LASIK refractive surgery hurt?
Some of our patients may experience little but acceptable discomfort during the procedure. Right after the surgery, some patients may have a foreign body sensation, tearing, or light sensitivity.
How much time do I need to take off from work after the surgery?
It depends on your job nature. You are advised to rest for 1 to 2 days after the surgery. Many patients can go back to work in 2-3 days following LASIK or SMILE surgery. Air travel would not be affected after LASIK or SMILE.
Who is not suitable for laser eye surgery?
- The refractive error is not stable in the past year
- The cornea is too thin
- Suffering from keratoconus / forme fruste keratoconus
- Suffering from cataracts or glaucoma
- Immune system problems, such as rheumatoid arthritis, lupus etc.
- Pregnant or lactating woman
- Does LASIK or SMILE surgery reduce the risk of developi
Does LASIK or SMILE surgery reduce the risk of developing cataracts, retinal detachment and glaucoma at a later date?
In refractive surgery, we modify the corneal curvature in order to eliminate the need of spectacles. The underlying shape of other parts of the eye (eg retina) are not changed. Thus, the risk of developing other ocular conditions such as cataract remains the same. Patients with high myopia (more than 6 diopters) before refractive surgery are advised to undergo regular ophthalmic check-up since they are at risk of developing these conditions.
Free Seminar
Our center regularly hosts free seminars conducted by specialized ophthalmologists, explaining the principles, procedures, preparations, and precautions of eye surgery.
