慧眼眼科专科诊所

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A new frontier of laser refractive surgery -- the ReLex (Refractive Lenticular Extraction) Smile (small-incision lenticule extraction)



In a single step, the laser creates arefractive lenticule and a small incision of less than 4 mm in the intact cornea– virtually regardless of the ambient conditions or corneal structure




The lenticule is removed through thesmall incision. The disruption to the biomechanics of the cornea is minimal.No flap is cut.




The removal of the lenticule changes theform of the cornea, creating the required change to the refraction.


Vision correction surgery, also called refractive and laser eye surgery, is any surgical procedure used to correct vision problems.Over the past decades, refractive surgery has improved thequality of life in over 30 million patients with a > 95% patientsatisfaction rate and made it one of the most popular electivesurgery procedures in all of medicine. It is considered very safe with predictable results andhas been approved by the arm forces in many countries and even NASAastronaut candidates in the United States of America.After refractive and laser eye surgery, many patients report seeing better than they had at any other time in their lives.

Extensive research has provided invaluable refinements and advancementsof laser technology and diagnostic tools to develop safe andappropriate treatment options for patients with a myriad of refractivedisorders. Laser-assisted in situ keratomileusis (LASIK) is presently themost performed elective procedure in the modern world.

In recent years, tremendous advancements have been made in this field. A new procedure called ReLex Smile is now gaining popularity in the refractive arena worldwide and is potentially changing the practice of refractive surgery for the next decades.

Unlike conventional LASIK, Relex Smile procedure does not create flap and involves the use of only one laser (the femtosecond laser). Instead of vaporising cornea tissue to correct the underlying short-sightedness and astigmatism, ReLEx® Smile carves out a small piece of corneal tissue called a lenticulein the cornea and then the lenticule is removed through a small keyhole incision (about 2.5 to 4mm only). This single-step, all-in-one-laser operation only takes about 30 seconds to perform the correctionfor one eye and the entire procedure complete in about 15 minutes for both eyes.This laser is extremely fast and uses very low energy, the procedure is odourless and silent, so there is less discomfort for patients.

Patient also feels more comfortable because the suction on the eye during the treatment is gentler. There is no frightening ‘blackout’, no bleeding (no red eye) during the procedure or swelling of the eye after. Light blackout is a phenomenon in which the laser beam the patient is told to focus on during the procedure vanishes when the procedure begin. This temporary disappearance of the focal point can cause panic. Foreign body sensations and mild discomfort may be experienced by some patients after the procedure, but this usually lasts for just a few hours.

Due to the smaller wound by minimally invasive surgery, ReLEx® smile results in a much stronger eye and less immediate postoperative discomfort and tearing. The use of a small incision also means that fewer corneal nerves are severed during the procedure, which also means less dry eye. With no flap created, flap displacement or dislodgement is not an issue, and so the eye will be less susceptible to trauma. ReLEx® smile is a good option for those who are involved in contact sports.

Most patients will experience a dramatic improvement in their vision a day after the surgery
and then remain stable days after the surgery.

All excimer laser procedures are subject to inconsistency based on differences in corneal hydration, laser fluence projection, reflection losses, temperature and humidity in the laser room and other environmental factors that are hard to control. In the ReLEx SMILE procedure, the only variable affecting tissue removal is the accuracy of the femtosecond laser’s optomechanics, which are unaffected by environmental conditions. It is likely that with the ReLEx SMILE procedure there will be less need to develop personalized nomograms for different machines, locations, or surgeons.

If the present direction and volume of researchis any guide, a large proportion of tomorrow’s femtosecondtechnological advances and discoveries will be based on ourmastery of treating refractive errors without even touchingthe cornea. All treatment will be intrastromal andReLex Smile is currently the most advanced procedure available. 


ReLex Smile (Bladeless and Flapless)

Femtosecond Lasik (Bladeless)

 

 

No corneal flap is created during surgery. No flap related complications during or after surgery

 

Creates a corneal flap during surgery. There is risk of flap displacement, folds after surgery. This flap may be susceptible to trauma

Single-step, one laser procedure.
Takes about 15 minutes for both eyes

Two-step procedure involving two different lasers. Takes about 20 to 25 minutes for both eyes

Removes a small piece of corneal tissue by laser carving called a lenticule through a small keyhole incision

Vaporises a small amount of tissue beneath the surface of the cornea to reshape the eye

The procedure is odourless and silent and no frightening ‘blackout’

Excimer laser is noisy, the ablation gives burning smell and transient blackout causes panic to some patients

Smaller wound means a much stronger eye

Flap wound is many times larger

Smaller wound means less dry eye

Dry eye is common after the surgery

 

Choosing laser eye correction to fix your eyesight problems is not a decision you should take lightly. Keep in mind that laser vision correction is still a surgical procedure that carries surgical risk, although the risk involved is negligible and the success rate is very high. You are advised to have your eyes properly evaluate and examine by the eye surgeon prior to surgery. So be sure you discuss all options in detail with your eye surgeon or eye care provider before making any final choices.