SMILE

The SMILE (SMall Incision Lenticule Extraction) is a new generation of laser vision correction surgery, based on technology that won the Nobel Prize in Physics for 2018. SMILE surgery boasts especially high levels of accuracy, efficiency and safety.

The uniqueness of this method is that barely any contact is made with the outer sensory-innervated section of the cornea, and after the procedure, the eye is “quiet”, without any redness or hemorrhage – and it appears as though the patient never underwent surgery. The SMILE method is based on the extraction of a thin inner layer from within the cornea.

In this technology, a sophisticated system precisely calculates the thickness and shape of the inner corneal layer that the laser beam is required to remove in a focused manner, with minimal impact on the outer section of the cornea.

In general, laser surgery is suitable for patients aged 18 and above who suffer from nearsightedness and/or astigmatism, with a stable prescription for the six months prior to the pre-surgery compatibility examination. SMILE surgery may be suitable for the following candidates:

• Those with nearsightedness up to minus 11 and astigmatism up to 3-4.
• People who suffer from corneal problems due to overuse of contact lenses.

How is suitability testing for a SMILE surgery conducted?

Comprehensive and meticulous suitability testing of the eyes is vital to the success of the operation, and it examines data such as corneal thickness, prescription (optical condition), corneal topography, intra-ocular pressure, eye conditions and physiological issues such as dryness of the eyes.
It is important to note that this test is conducted with dilated pupils, and examines the inner parts of the eye (the lens, the retina, the vitreous and the optic nerve).

The suitability test at the Dr. Levinger Eyes medical centers involves a comprehensive diagnosis of the eye, and takes about 3 hours, including wait times.

Approximately 75% of candidates are found suitable for laser vision correction surgery!

SMILE laser vision correction surgery is performed under local anaesthesia using anaesthetic eye drops and is pain-free.

What are the advantages of vision correction with SMILE?

• High level of safety.
• Precise results.
• Rapid and pain-free recovery.
• Quick return to routine.
• Very short procedure – only 3 to 4 minutes per eye.
• Optimal vision within several weeks.
• Stable and strong retina.
• May be suitable for soldiers in combat units and athletes.
• No hemorrhages following the surgery, to the point it appears that the patient had never undergone surgery.
• No concern of post-operative injury

How is surgery performed with the SMILE method?

1. A computerized treatment plan is built based on the suitability test, including a schematic simulation of incision patterns. The inner layer of the cornea that requires cutting is measured in accordance with the vision disorder – in conditions of nearsightedness, a disc-shape incision is made to flatten out the cornea.
2. An inner layer is formed in the cornea using a laser beam generated by a ZEISS VISUMAX 800 device, without causing any damage to the outer layer of the cornea. The beam speed is particularly high (incision in 9 seconds only!) and enables shortening the duration of the surgical procedure to only 3 minutes per eye.
3. Creating an opening for extracting the inner corneal layer – using a laser beam, the surgeon makes a small, 2-4 mm incision in the periphery of the cornea to allow access for extracting the inner corneal layer.
4. The inner corneal layer is extracted via the tiny incision using delicate tweezers.

What should be done before SMILE surgery?

Laser surgeries for eyeglasses removal are considered a short and safe procedure. However, the patient’s adherence to safety rules and the surgeon’s instructions is a necessary component in maintaining eye health before and after surgery and accelerating recovery.

• For contact lens wearers, do not wear soft lenses for at least 72 hours before surgery, hard lenses 10 days before surgery, and do not wear Ortho-K lenses 3 months before surgery.
• Do not wear makeup for about three days before surgery.

What should be done on the day of SMILE surgery?

• Do not use perfume or aftershave on the day of surgery.
• It is recommended to wash your hair before surgery, as afterward, it is forbidden to wash hair for 3-5 days, depending on the type of surgery.
• Before arriving for surgery, it is recommended to eat only a light meal (no need to fast).
• Bring the drops prescribed by the doctor during the compatibility examination: antibiotic drops to prevent infection, steroid drops to accelerate healing, artificial tears to protect against dry eyes, a medical patch, and protective glasses for the recovery period.
• Come to surgery with an escort who will receive an explanation about post-surgery care in the first hours.

What should be done a day after SMILE surgery?

• You should come for a follow-up the day after surgery. Until then, do not remove the eye shields.
• It is recommended to come for the follow-up with sunglasses.

Do’s and Don’ts for a week after SMILE surgery:

• Use drops as directed by the doctor. Before instilling drops, wash hands thoroughly and ensure that the bottle and fingers do not touch the eye.
• You must sleep with eye shields for 3 nights, as directed by the doctor.
• Do not wash hair for 3-5 days and do not wet the eyes with tap water for 5 days.
• Do not engage in strenuous physical activity for a week to prevent sweat from entering the eyes.
• Come for a second follow-up a week after surgery. After that, as needed and as directed by the doctor.

Do’s and Don’ts for two weeks after SMILE surgery:

• Do not apply makeup or rub your eyes.

Do’s and Don’ts for a month after SMILE surgery:

• Be sure to wear sunglasses.
• It is recommended to limit driving, especially at night.
• Do not swim in the sea, pool, or ritual bath (mikveh).
• Avoid direct trauma to the eyes.
• Be careful when in contact with small children and animals.