ReLEx SMILE is the short form for ReLEx (Refractive Lenticule Extraction Small Incision Lenticule Extraction).

ReLEx SMILE is a cutting-edge femtosecond technology used to generate a thin circular disc of tissue removed through a tiny incision in the cornea. The SMILE incision is less than 4 mm long.

Because of thin corneas, high prescriptions, dry eyes, and other factors, some individuals are not suitable for LASIK surgery. Eye doctors have traditionally employed Photorefractive Keratectomy (PRK) and Advanced Surface Ablation (ASA) for these eyes, which is a significant operation but takes longer to heal.

ReLEx SMILE is a suitable option for the safety profile that PRK gives for some eyes, yet with the same speedy recovery as LASIK.

Is ReLEx SMILE suitable for me?

ReLEx SMILE surgery is not suitable for everyone, especially if you fall under the following criteria:

• People under 18 years old, as the eye prescription has not stabilized.

• People whose eye prescription falls considerably outside of the listed therapy ranges.

• People with an unstable eye prescription during the last 12 months.

• People with long-sightedness or high astigmatism.

• Pregnant and breastfeeding women.

• People with skinny or irregularly shaped corneas.

• People of any age with severe cases of dry eye syndrome.

Here's a simple table of comparison to find out if ReLEx SMILE is suitable for you, and what the difference is compared to PRK and LASIK:

Setting your expectations for a ReLEx SMILE surgery

ReLEx SMILE suitability test

Your ophthalmologist will check your eyes to determine whether or not you are a candidate for SMILE.

What he or she will do is as follows:

Put your vision to the test. It's to ensure that your vision hasn't shifted. It also indicates how farsighted you are and whether you can use SMILE to correct your vision.

Examine your eyes for any additional issues. Your ophthalmologist will ensure that you do not have any eye issues. It's because other issues may interfere with your operation, or SMILE may exacerbate those other issues.

Measure and map the surface of your cornea. Your ophthalmologist will check the thickness of your cornea and make precise measurements of the cornea's surface. Your eye surgeon uses these measurements to program the computer-based laser used during surgery.

Measure your pupil size.

How to prepare for ReLEx SMILE Surgery

Aside from following the checklist below, the most important thing you can do to prepare for your treatment is to relax as much as possible. Ask your ophthalmologist if you have any questions, doubts, or concerns about the treatment — no matter how trivial, you must be informed and satisfied with the entire ReLEX SMILE Surgery process from beginning to end.

Here's a checklist for you to go through to prepare for the surgery:

• Avoid wearing perfume or cologne and hair products like hair spray or mousse that contain alcohol.

• Remove all eye makeup at least 24 hours before surgery. Don't wear any makeup on your face on the day of your eye surgery.

• Choose a comfortable piece of clothing and avoid wearing anything that will cause lint, such as wool.

• Depending on your occupation, you may need to plan on missing work for up to two days after ReLEx SMILE. Please consult with an optometrist about your specific situation.

• Make transportation arrangements; you will almost certainly be unable to drive yourself home, and public transportation may be exhausting.

• Drinking any form of alcoholic drink should be avoided before and after your surgery because it dehydrates your eyes.

• Do not bring small children, infants, or pets to the clinic.

• You will have to sign an informed consent form and pay the balance of your treatment fee shortly before your procedure.

You and your ophthalmologist should discuss your SMILE expectations before surgery.

People who expect to achieve the perfect 20/20 vision through SMILE may be disappointed. SMILE enables people to do the majority of their daily chores without the use of corrective glasses. However, specific tasks, including reading or driving at night, may still require the use of spectacles.

What to expect during a ReLEx SMILE surgery

During surgery, the patient is given a drop of anesthesia and an antibiotic right before entering the operating room. The patient's bed glides underneath the laser machine, gently guiding the patient up to the docking station.

The laser stays in place for about 30 seconds, which is all it takes to generate the planes within the cornea. It's mild. It's as though someone is softly kissing your eye. There is no discomfort, and the patient can keep his or her eyesight during the process.

There are numerous intriguing visual impacts, which eye surgeons usually explain to the patient as they go through the treatment. The laser releases the eye after 30 seconds and gently moves the patient back. Then, it will release the lenticule, the lens that we've formed within the corneal stroma, and slip it out via the small keyhole incision.

The entire ReLEx SMILE surgery usually takes around 5 minutes, with most of that time spent directing the slow-moving bed. So it's just softly maneuvering the bed and talking to the patient the entire time, 30 seconds of laser, and then careful manipulation to pull the lens out, and the treatment is over.

What to expect after a ReLEx SMILE surgery

ReLEx SMILE surgery recovery can usually take days or weeks to settle, and the total healing duration for the cornea after ReLEx SMILE is estimated to be 3 to 6 months. That is when you may resume all of your pre-surgery activities without concern.

The recovery timetable will vary depending on each individual's ability to heal.

Plan for relaxing activities, and avoid activities that will strain your eyes, like reading, watching television, or using the Internet. After the procedure, we recommend having a lengthy nap.

Although SMILE eye surgery needs a little downtime, you should plan on taking things gently for the following several days as your cornea recovers.

1. Avoid any water activities such as swimming in pools or bathing in hot tubs after the surgery.

2. Keep any kind of water out of your eyes even when showering, just until your eyes completely heal.

3. For at least 2 to 3 days, keep your workout modest and low-impact.

4. Don't wear makeup, as brushes and applicators can include microbes that can cause serious eye infections.

5. Continue to use all prescribed medications and eye drops.

   1. During the weeks after your SMILE eye surgery, you must continue all of your prescribed eye drops and medicines unless otherwise directed by your eye surgeon. Even if the adverse effects start to fade, you should still follow all aftercare recommendations. While recovering after SMILE eye surgery, do not use any other drops, pain killers, or non-approved drugs.

6. Wear safety glasses.

   1. Wear the provided eye shield when sleeping for the first three nights following SMILE eye surgery. When you walk outside, you should wear polarized sunglasses to protect your eyes from damaging UV rays.

7. Avoid areas where there is smoke or dust in the air.

   1. In the weeks following your SMILE operation, you should avoid environments with airborne particles such as sand, smoke, or dust. Minor irritants like these might cause eye damage or substantial discomfort while you recuperate.

A follow-up visit with your eye surgeon the day after your surgery should be necessary.

What are the side effects of ReLEx SMILE?

The side effects of SMILE laser eye surgery are brief, usually lasting no more than 3-6 months.

Unlike other laser eye operations, SMILE eye surgery decreases the chance of developing chronic dry eye or corneal flap displacement. One of the significant benefits of SMILE is the speedier recovery from irritation and dryness compared to LASIK. Regular follow-up checkups, as well as administering the medication and lubricating eye drops as directed, are critical to ensuring a quick and smooth recovery.

These are the temporary side effects of ReLEx SMILE that may occur throughout the healing process:

• Irregular vision

• Lights with haloes or glares

• A lack of moisture in the eye

• Sensitivity to light

• Long-term increased sensitivity to light and glare

• Temporary overcorrection

• Burning, itching, and foreign body feel owing to dry eyes

• Impairment of both eyes' cooperation

• Glares

• Haloes

• Dry eyes

• Mild fluctuation of vision

• Infections and complications – sporadic with today's laser technology

• Some temporary dryness can occur.

• There is still a fair chance of under-correction overall.

  • Although in general, SMILE patients usually require far fewer touch-ups than other laser vision correction patients.

• Minor risk of infection (as with all laser vision correction procedures)

  • There is a minimal danger that it may aggravate some unidentified structural weakness, in which case there will be a need to follow up with strengthening therapy. This danger looks to be substantially lower than with LASIK because SMILE surgery keeps the structural integrity of the hard layer upfront, which LASIK does not.

• There is a risk that there will be some variation over time.

  • Again, the European data suggest less drift since SMILE leaves the complex layer entirely upfront. The other surgeries, on the other hand, fundamentally degrade the tough layer.

• Few epithelial cells (surface tissue) may be displaced. Hence, occasionally the eye surgeon might need to remove this cluster of epithelial cells known as a piece of clog. It usually does not reoccur within the first several months or so following the treatment.

If over or under-correction occurs in the range of +/-0.75 or more, you may have to undergo an enhancement 3 months after the procedure or when the refractive error has become stable. SMILE does not correct presbyopia, which requires reading glasses for people over 40 years of age.

How much does ReLEx SMILE surgery cost?

The average cost of ReLEx SMILE surgery range from $4600 - $5659 per eye. As with all medical procedures, you have your choice of public institutions and private clinics for your ReLEX SMILE procedure. Public institutions are generally, though not always, the cheaper options.

Check out the price comparison prepared for you (based on a few ReLEx SMILE clinics in Singapore).

• Atlas Eye Specialist Centre - $5,359

• LSC Eye Clinic - $5,659

• Clearvision Eye Clinic & LASIK Centre - $5,200

• W Eye Clinic - $5,337.16

• Asia Pacific Eye Centre - $4,805.37

• SNEC Laser Vision Centre - $4,600 – $5,000

Can I use Medisave or insurance to pay for ReLEx SMILE surgery?

ReLEx SMILE and other vision correction treatments are considered elective (non-essential) surgery, hence Medisave cannot be used to pay for them. It's because your eyes are not suffering from any sickness.

However, there are exceptions. You can use Medisave if:

• There is at least a 300 degrees difference between your left and right eyes.

• If you are confirmed to be sensitive to eyeglasses and contact lenses.

Medisave may get you up to $1,200 with ReLEx SMILE. Contact your eye clinic for further information.

Is ReLEx SMILE better than LASIK?

ReLEx SMILE utilizes a technologically advanced femtosecond laser to create a hole in your cornea. The surgeon reshapes the cornea by using a lenticule to improve one's eyesight. This treatment involves an 80% smaller side-cut and a 30% smaller cap cut compared to LASIK, and this means there is a higher chance of less side effects compared to LASIK.

SMILE also protects the biomechanical strength of the cornea after surgery to prevent dry eyes, which leads to a lower downtime than LASIK.

Is ReLEx SMILE permanent?

The effects of ReLEx SMILE surgery is usually permanent, but some people may see vision deteriorate to the original state, especially young people where myopia is not fully stable.

That's why ReLEx SMILE surgeons don't treat young people under the age of 20 or 21 who may have changing eye prescription.

As people reach middle age, what will happen eventually is that they may then need reading glasses. And as middle age progresses, the need for reading glasses may increase. But of course, if you've had SMILE, it doesn't preclude you from having a further procedure in middle age to address the reading glasses issue.

How long does ReLEx SMILE take to heal?

ReLEx SMILE surgery recovery time will typically take a few days to weeks. Within the first day, your vision should be restored 75% or so, and within the next few days, more vision and clarity will be restored.

The majority of people will need to wait 24 hours before seeing significantly better without the mild haziness.

Your eyes may need at least two to four weeks for the eyesight to fully settle.

You will be unable to drive for the first 24 hours after your ReLEx SMILE surgery. You must arrange for a friend or family member to drive you home following your procedure. Everyone's recovery period will be different. However, most patients will be able to drive the next day.

ReLEx SMILE surgery, the 3rd generation laser vision correction procedure

Many studies have shown that ReLEx SMILE surgery produces excellent results, with minimal downtime. Because it corrects complications associated with corneal flaps, this technique is highly safe and effective. Furthermore, studies showed that it had excellent predictability and stability for myopia correction. Consider going for a ReLEx SMILE suitability test to kickstart your journey!