ReLExSmall incision lenticule extraction (SMILE), second generation of ReLEx Femtosecond lenticule extraction (FLEx), is a form of laser based refractive eye surgery developed by Carl Zeiss Meditec used to correct myopia, and cure astigmatism. Although similar to LASIK laser surgery, the intrastromal procedure uses a single femtosecond laser referenced to the corneal surface to cleave a thin lenticule from the corneal stroma for manual extraction.[1]
The lenticule to be extracted is accurately cut to the correction prescription required by the patient using a photodisruption laser-tissue interaction.[2] The method of extraction was via a LASIK-type flap in ReLEx FLEx, but in SMILE a flapless technique makes a small tunnel incision in the corneal periphery, that does not (mostly) destroy Bowman's layer.[3] Currently in the US the procedure is only approved for nearsightedness, but is used for hypermetropia too in other countries.[4]
After the femtosecond laser has separated the lenticule, a blunt spatula is inserted through the incision between the lenticule and the stroma and carefully rotated to ensure that the lenticule is completely detached prior to removal by forceps. The procedure has been described as safe and predictable in treating myopia and astigmatism.[5] Some theoretical advantages are that the technique is minimally invasive compared with other flap based treatments and no collateral damage occurs to surrounding tissue due to the high speed of the femtosecond laser. There are limited studies on corneal wound healing and inflammatory response after this treatment has been carried out. There is a suggestion that the expression of fibronectin which is associated with wound healing is less in this method compared with femtosecond-LASIK.[2] Because SMILE treatment is relatively new compared with other laser correction treatments, result studies are limited, but postoperative five year (SMILE) outcomes indicate that the results have been stable after 5 years of follow-up.[6] In some cases post operative tear secretion and dry eye syndrome have been observed along with similar post operative complications seen in LASIK surgery.[1][4]
As lenticule extraction techniques evolve, there is a possibility that extracted lenticules can be cryogenically preserved either for future donation,[7] or re-implantation.[1] Proof of concept has been carried out on primates where lenticules were extracted from monkeys and allogenically transplanted into other monkeys with positive results.[8]
Referencesedit
^ abcIvarsen, Anders; Hjortdal, Jesper (2014). "New Developments in the Lenticule Extraction Procedure". European Ophthalmic Review. 08 (1): 31. doi:10.17925/EOR.2014.08.01.31. ISSN 1756-1795.
^ abWalter Sekundo (2015-08-03). Small Incision Lenticule Extraction (SMILE): Principles, Techniques, Complication Management, and Future Concepts. Springer. p. 15. ISBN978-3-319-18530-9.
^Liu R, Zhao J, Xu Y, Li M, Niu L, Liu H, Sun L, Chu R, Zhou X (2015). "Femtosecond Laser-Assisted Corneal Small Incision Allogenic Intrastromal Lenticule Implantation in Monkeys: A Pilot Study". Invest. Ophthalmol. Vis. Sci. 56 (6): 3715–20. doi:10.1167/iovs.14-15296. PMID 26047173.
small, incision, lenticule, extraction, relex, smile, second, generation, relex, femtosecond, lenticule, extraction, flex, form, laser, based, refractive, surgery, developed, carl, zeiss, meditec, used, correct, myopia, cure, astigmatism, although, similar, la. ReLEx Small incision lenticule extraction SMILE second generation of ReLEx Femtosecond lenticule extraction FLEx is a form of laser based refractive eye surgery developed by Carl Zeiss Meditec used to correct myopia and cure astigmatism Although similar to LASIK laser surgery the intrastromal procedure uses a single femtosecond laser referenced to the corneal surface to cleave a thin lenticule from the corneal stroma for manual extraction 1 Small incision lenticule extractionSpecialtyOphthalmology edit on Wikidata The lenticule to be extracted is accurately cut to the correction prescription required by the patient using a photodisruption laser tissue interaction 2 The method of extraction was via a LASIK type flap in ReLEx FLEx but in SMILE a flapless technique makes a small tunnel incision in the corneal periphery that does not mostly destroy Bowman s layer 3 Currently in the US the procedure is only approved for nearsightedness but is used for hypermetropia too in other countries 4 After the femtosecond laser has separated the lenticule a blunt spatula is inserted through the incision between the lenticule and the stroma and carefully rotated to ensure that the lenticule is completely detached prior to removal by forceps The procedure has been described as safe and predictable in treating myopia and astigmatism 5 Some theoretical advantages are that the technique is minimally invasive compared with other flap based treatments and no collateral damage occurs to surrounding tissue due to the high speed of the femtosecond laser There are limited studies on corneal wound healing and inflammatory response after this treatment has been carried out There is a suggestion that the expression of fibronectin which is associated with wound healing is less in this method compared with femtosecond LASIK 2 Because SMILE treatment is relatively new compared with other laser correction treatments result studies are limited but postoperative five year SMILE outcomes indicate that the results have been stable after 5 years of follow up 6 In some cases post operative tear secretion and dry eye syndrome have been observed along with similar post operative complications seen in LASIK surgery 1 4 As lenticule extraction techniques evolve there is a possibility that extracted lenticules can be cryogenically preserved either for future donation 7 or re implantation 1 Proof of concept has been carried out on primates where lenticules were extracted from monkeys and allogenically transplanted into other monkeys with positive results 8 References edit a b c Ivarsen Anders Hjortdal Jesper 2014 New Developments in the Lenticule Extraction Procedure European Ophthalmic Review 08 1 31 doi 10 17925 EOR 2014 08 01 31 ISSN 1756 1795 a b Walter Sekundo 2015 08 03 Small Incision Lenticule Extraction SMILE Principles Techniques Complication Management and Future Concepts Springer p 15 ISBN 978 3 319 18530 9 Ang Marcus Chaurasia Shyam S Angunawela Romesh I Poh Rebekah Riau Andri Tan Donald Mehta Jodhbir S 2012 Femtosecond Lenticule Extraction FLEx Clinical Results Interface Evaluation and Intraocular Pressure Variation Investigative Ophthalmology amp Visual Science 53 3 1414 1421 doi 10 1167 iovs 11 8808 ISSN 1552 5783 PMID 22323464 a b SMILE small incision lenticle extraction Lasercare Eye Center Shah R Shah S Sengupta S 2011 Results of small incision lenticule extraction All in one femtosecond laser refractive surgery J Cataract Refract Surg 37 1 127 37 doi 10 1016 j jcrs 2010 07 033 PMID 21183108 S2CID 43781436 Blum Marcus Taubig Kathrin Gruhn Christin Sekundo Walter Kunert Kathleen S 2016 Five year results of Small Incision Lenticule Extraction ReLEx SMILE British Journal of Ophthalmology 100 9 1192 1195 doi 10 1136 bjophthalmol 2015 306822 ISSN 0007 1161 PMID 26746577 S2CID 23860546 Moshirfar M McCaughey MV Reinstein DZ Shah R Santiago Caban L Fenzl CR 2015 Small incision lenticule extraction J Cataract Refract Surg 41 3 652 65 doi 10 1016 j jcrs 2015 02 006 PMID 25804585 Liu R Zhao J Xu Y Li M Niu L Liu H Sun L Chu R Zhou X 2015 Femtosecond Laser Assisted Corneal Small Incision Allogenic Intrastromal Lenticule Implantation in Monkeys A Pilot Study Invest Ophthalmol Vis Sci 56 6 3715 20 doi 10 1167 iovs 14 15296 PMID 26047173 External links editZeiss Official Page https rexhamiltonmd com pdfs peer 20reviewed 20papers 20and 20review 20articles SMILE 20vs 20LASIK 20early 20US 20outcomes 20jcrs 202021 pdf Comparison of early visual outcomes afterlow energy SMILE high energy SMILE and LASIK for myopia and myopic astigmatism in the United States https rexhamiltonmd com wp content uploads 2019 07 0319CRST Zeiss hamilton Insert pdf Frequently Asked Questions About SmallIncision Lenticule Extraction SMILE Official Zeiss Publication nbsp This surgery article is a stub You can help Wikipedia by expanding it vte Retrieved from https en wikipedia org w index php title Small incision lenticule extraction amp oldid 1189882127, wikipedia, wiki, book, books, library,
