What is Visumax ReLEx - SMILE?
The Visumax Femtosecod Laser System is the latest addition in the world of refractive surgery. This award winning technique has significantly changed the way we perform refractive surgery for spectacle removal.
It is the epitome of outstanding precision, speed and gentle treatment.
In other techniques for spectacle removing refractive surgery, a flap is first cut from the cornea with a microkeratome or femtolaser, and raised. During this step, suction has to be applied to fixate the eye, which may lead to raised intra-ocular pressure. Then, using excimer laser, the corneal tissue is ablated (vaporized) to the calculated extent after which the flap is repositioned. In the immediate post-operative period, eye rubbing etc may result in this flap being displaced.
On the other hand, the RELEX SMILE procedure is a single step, single laser procedure, performed on a single platform. It does not involve cutting of a flap, suction application, or ablation of corneal tissue. In SMILE, a small lenticule is cut precisely in the cornea by laser. This lenticule is gently and easily removed through a small 2mm. self-sealing incision. There is no pain. No flap is created, leading to less risk and complications. The predictable and swift procedure takes four minutes compared to 3 minutes by other methods. This FLAPLESS, BLADELESS,PAINLESS, KEYHOLE surgery is minimally invasive which offers quick recovery.
Visumax is the only machine which allows us to perform this revolutionary surgery. It is considered to be the most safe, rapid, precise, risk-free and painless surgery for spectacle removal.
Why SMILE ? What are the benefits of Smile?
- Visumax SMILE offers a 100% BLADELESS treatment, in which a small lenticule is created by laser and extracted in an intact cornea.
- This single step, single laser, all-Femto procedure is FLAPLESS. In LASIK, a flap is cut in the cornea either with a microkeratome or a bladeless femto second laser. This flap can be easily displaced by eye rubbing after surgery. In SMILE, unlike LASIK, no flap is cut in the cornea, and the small lenticule is removed through a KEYHOLE incision. The self sealing micro incision is only one tenth the size of the microkeratome or bladeless flap. Hence the cornea is much more stable after SMILE surgery.
- The strength of the cornea is further preserved as the side incision (2mm) is only 10% that of the LASIK flap (20mm).
- The lamellar incision area is one third that of Femto Lasik or microkeratome Lasik. Only 10% Laser energy is used. All these factors help to maintain the stability leading to improved corneal biomechanics.
- This surgery is much less invasive. In LASIK, after creating and raising a flap in the cornea, the tissue is ablated or vaporized, after which the flap is replaced over this ablated area. In SMILE, there is no vaporization of tissue, and no Flap related risks, making it a very SAFE, RELIABLE and PRECISE procedure.
- It is PAINLESS. In LASIK, a suction of 600mm of Hg is needed for one to two minutes in order to fixate the eye to make the flap. It is this suction which leads to high intraocular pressure, frightening black-out of vision at that time and pain. In SMILE, a contact lens is applied at low pressure and there is no pain & black out.
- The entire surgery is a SINGLE STEP, SINGLE LASER performed all on one Laser platform. Thus the surgery is SWIFT, SAFE and EFFECTIVE.
- DRYNESS of eyes, commonly seen after LASIK, is much less with SMILE as the size of the cut is smaller and less corneal nerves are injured.
- No redness of eyes is experienced in the postoperative period. Discomfort, tearing and swelling is also much less and lasts for only four to six hours as compared to twenty four hours with other procedures.
- Being a flapless, non-invasive procedure, the risks are considerably reduced. Complications of flap such as dislodgement, displacement, uneven thickness of flap, striae & free flap are avoided. The incidence of infections or interface deposits is almost nil.
- Robust Technology: In SMILE, the laser energy used is ten times lower than with Excimer laser, leading to increased stability and precision. The Excimer laser is dependent on atmospheric humidity, temperature and aromatics, whereas the Visumax Femtosecond is more robust.
- Patients experience overall better quality of vision with SMILE than with any other procedure.
- As it is flap-free and minimally invasive it is better for sports persons, especially those engaged in contact sports.
- It is important to understand that the safety and excellent results with SMILE are due to very experienced surgeons, detailed selection of cases and the most highly advanced engineering and technology. These do add up to higher treatment costs. However the results speak for themselves. When it comes to vision, there should be no compromise.
A Survey: Conducted from the results of Patients, operated for SMILE procedure.
Did you opt for ReLEx® smile because this method involves only minimum intrusion to the cornea?
Why did you not decide on an alternative treatment method (e. g. LASIK or PRK)?
Did the following treatment characteristics apply to your personal ReLEx® smile treatment?
Would you recommend ReLEx® smile to others?
Who can benefit from SMILE?
Those patients who are not suitable for Lasik can undergo SMILE. This will be particularly beneficial to those patients who were still debating whether to get refractive surgery done or not & were fearing about the outcomes or flap related complications in Lasik. Now can go for SMILE procedure
- SMILE can be performed on people with -0.75Dsph to -13.00 Dsph spectacle power or spheroequivalent and people with -0.50Dsph to -5.00Dsph cylindrical power.
- People with high powers achieve better quality of vision than with other procedures. They also have less chance of regression (number returning) as there is more corneal strength and stability.
- The procedure is preferred for those suffering from dry eyes.
- People engaged in contact and extreme sports; Army, Navy, Airforce or Police personnel; and frequent air travelers benefit immediately. They can even resume some level of activity on the next day as there are no chances of flap displacement.
Why SMILE at Diva Eye Institute?
- Diva Eye Institute is a comprehensive Eye care centre centrally situated in Ahmedabad, Gujarat We have been awarded NABH certification. This National Accreditation Board of Hospitals & Healthcare providers certification is awarded only after rigorous assessments for quality control, equipment maintenance, operative skills, patient satisfaction and safety among others.
We are the only NABH certified Eye Hospital in Western India.
- We have highly qualified surgeons who have been performing refractive surgery since twenty years.
- A sterling history of over eighty years of eye care in Gujarat. The third generation of ophthalmologists in whom it is ingrained to have integrity, honesty and to always keep the patient's interests first.
- At DIVA we provide all the alternative methods for spectacle removal. At our centre, we perform PRK, LASIK, LASEK, Bladeless LASIK, RELEX, SMILE, ICLs (Intra Ocular Contact Lenses), Phakik IOLs and Cataract surgery. The patient has all the alternatives of surgery and affordability. More importantly, treatment plans can be tailored to individual needs.
- At DIVA, we work as a comprehensive Eye Institute, not just a spectacle correction refractive centre. We provide complete eye care under one roof and offer surgery and treatments for Cataract, Glaucoma, Retina, Paediatric Ophthalmology, Corneal problems, Squint and Oculoplasty. Hence we can provide the best management for even complicated cases with other concurrent eye problems.
- We are flexible and can provide immediate appointments for surgery within three days.
- Ahmedabad is a cosmopolitan city with an international airport. The cost of stay and food is very reasonable compared with other metropolitan cities. DIVA is centrally situated with decent hotels within a radius of one kilometer. We also offer in-house accommodation. Airport pick-up, stay and even nearby tourism can be arranged. There are many heritage sites in and around Ahmedabad and plenty to do by way of shopping, dining and entertainment.
Cost of Procedures:
Our rates are the most competitive in India and a third of those in other countries.
|LASIK:||Rs.35,000 to 45,000|
|Bladeless LASIK:||Rs. 85,000|
|SMILE:||Rs. 1.25 to 1.50 lakhs|
When considering cost of eye surgery, it is important to understand quality. Many centres offer "bargain packages" for spectacle removal surgery. Cutting prices means cutting corners. These ads can be dangerous or misleading. Quality of surgery and best visual results all depend on well maintained machines, latest technology, rigorous quality control, safety protocols and surgical experience especially in case of complications. Bargain packages may not be following strict protocols, especially as regards to reusing disposables. They also may not specify extra or hidden costs. This is a machine-dependent surgery where, though poorly maintained older technology may be cheaper, it will not give the best results. All this must be considered during your decision making. In fact it is better to avoid the surgery altogether rather than go bargain-hunting!
Pre- SMILE Consultation:
At DIVA, a friendly staff and counselor will put you at ease. The pre-operative consultation will include:
- Counselling on how the procedure is performed and its benefits.
- Checking of your current spectacle power
- Corneal Topography i.e. curvature mapping of the cornea
- Dilatation and comprehensive check-up of the retina
- One-on-one consultation with the chief surgeon
Please do not forget:
- Bring your reference number and old files if any, even from other eye hospitals
- Bring along your latest pair of spectacles
- If using contact lenses, then you must stop wearing gas permeable hard lenses for three weeks and soft lenses for one week before coming for consultation.
- The entire consultation and examination may take an hour. It is wise to bring someone to drive you back from the clinic as your eyes may be dilated and you will experience glare.
On the day of Surgery:
The whole process, from registration to discharge, will be completed in less than two hours.
Continue with all your other medications such as for Diabetes, Hypertension etc.
An attendant must accompany you.
All post-operative medications will be explained to you in detail by our staff. A file with the "do's and don'ts" will be provided and the contents explained to you.
Post Surgery Instructions:
- You will be prescribed three types of eye drops:
- Antibiotic eye drops - three times a day for fifteen days
- Anti-inflammatory eye drops - four times a day for fifteen days
- Tear Substitute eye drops - four times a day for two months
- Do not swim or participate in any water sports for two weeks. Exercises and other sports can be started after a week.
- You may have a bath below the neck on the next day. The face can be sponged. Hair can be shampooed after three days. Avoid getting water into the eyes for at least a week as the water in the water tank is not very clean.
- After instilling the eye drops, the eyes must be cleaned only with sterilized cotton. Only a third of the eye drops instilled go into the eye. The remaining two thirds come out and needs to be wiped only with sterile cotton.
- Your vision will improve from the next day and will continue to do so for a month. You will be able to pursue all routine activities from the next day.
This is a painless procedure, so the less tension and stress you have, the better the outcome. Leave all your worries at home before the procedure. Relax when you come in and SMILE when you leave the hospital after the procedure!
Fequently Asked Questions ?
Here only a minimum amount of corneal tissue is lasered to create a lenticule with Micron precesion which is extracted through a key hole incision of 2 to 4.00 mm compared to 20mm in Lasik procedures where a flap is made and then another Excimer laser does reshaping of cornea.
Flap related complications are most common in Lasik which are absent here. The cut being 80% smaller then Lasik gives it Stability and better corneal strength (Biomechanics). There are least chances of Infection also minimizing the chances of late corneal thinning.
- Painless (Less Foreign body sensation & watering)
- Flapless (In Lasik most complications are Flap related. Since in SMILE there is no Flap , so there are no flap related complications. Hence, No Blade, No Cut)
- Single step (In Lasik corneal flap made with Microkeratome or Laser and then Excimer Laser is used to reshape cornea and Patient has to shift from one machine to another).
- Less Dry Eye related problem - There are minimum nerves being cut in SMILE, thus we have few dry eye problems compared to LASIK the corneal heals faster.
- Strong Against Trauma - Can start playing sports or activities soon. As there is flap displacement is not there so you can start sports within 2 to 3 days after SMILE.
- As there is High Stability and Corneal Mechanic changes less, there are less chances of Regression i.e., number coming back.
- Highest Patient Satisfaction with accurate results.
- Stronger cornea
- Less Dry eyes
- Less nerves cut
- Single step
- Accurate and complications free
- Shorter recovery time
- Safest procedure for contact sports
Comparison between ReLEx SMILE, Femto Lasik and PRK/LASEK
|Treatment of myopia of 0.5 to -3 D|
|Treatment of myopia of -3 to -6 D|
|Treatment of myopia of > -6 D|
|Procedure without flap incision in cornea (Flapless)|
|Minimally invasive access 2mm|
|Treatment exclusively with femtosecond laser|
|Preservation of the corneal epithelium|
|Practically painless during the procedure|
|Practically painless after the procedure|
|Stabilization of visual acuity within 14 days|
|All femto Single Laser|
- No retreatments
- No dry eyes
- No night vision problems
1) Patient should be over 18 years of age (upto any age)
2) The number of glasses should be steady.
Hard lenses - 3 weeks before procedure & examination.