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SMILE® laser eye surgery: One year on

Prof Gerard Sutton


Illustration of SMILE procedure

In late 2014, we introduced the newest form of laser vision correction, SMILE, to our practice as an additional refractive treatment option for our patients.

One year on, we now have a better perspective of outcomes and the true potential of the SMILE surgical vision correction procedure.

Why we introduced SMILE

Although SMILE had been around for some years, we only decided to introduce the procedure to our Chatswood clinic when the evidence-based medical studies showed that it was at least as good as LASIK and potentially had some advantages.

From my side, my technique and unit settings have undergone continual refinement over the last year. Along the way, the aim has been to produce an easier experience for both surgeon and patient with optimal visual and safety outcomes.

Now that we’ve reached the beginning of 2016, SMILE is a smooth procedure that is a joy to perform. From a practical point of view, this is reflected in faster recovery times for patients, which although not quite matching standard LASIK, are significantly improved.

Most recent updates to our vision correction technology

In 2016, we moved both our femtosecond (SMILE) laser and our excimer (LASIK) laser into a custom built operating theatre with an environmental control system that keeps both temperature and humidity at a very specific level. This has resulted in improved performances of both lasers.

From the beginning our refractive results were excellent, which confirmed that our decision to transition to the SMILE procedure was the correct one. Another pleasing observation with these developments is that the number of patients achieving post-operative uncorrected vision better than 20/20 has improved. This remains a significant positive step and we look forward to presenting the data for publication soon.

Although we felt SMILE had great potential, the proposed benefits of the procedure appeared to dominate the moderate-to-high ranges of myopia (short-sightedness). Initially I only used SMILE for significant short sightedness (-5D upwards to -10D) and results equalled and then appeared to quickly surpass outcomes achieved through the LASIK procedure.

SMILE vision correction today

Because of this initial experience, I now offer SMILE to patients with myopia as low as -3D. Both LASIK and ASLA remain excellent procedures and in January we installed a new excimer laser which can more accurately treat astigmatism. It has a 3D tracking mechanism to ensure accuracy of laser placement and does not rely on the patient to be stay still.

One year since the introduction of SMILE, it is performed in just over half of our patients, perfectly reflecting my confidence in the technique. I chose to introduce the SMILE procedure when the published safety and visual outcomes matched LASIK. In this past year the results have exceeded my expectations. Our patients have a lot to ‘smile’ about!

Professor Gerard Sutton is an internationally recognised expert in corneal conditions, cataract surgery and laser eye surgery. In addition to his ophthalmic practice, Prof Sutton is a researcher and lecturer at the University of Sydney. He practises at Vision Eye Institute Chatswood, Vision Eye Institute Bondi Junction and Vision Eye Institute Hurstville.

SMILE® is a registered trademark of Carl Zeiss Meditec

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