The Star Malaysia - Star2

New frontier in eye surgery

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VISION correction surgery, also called refractive and laser eye surgery, is any surgical procedure used to correct vision problems.

Over the past decades, refractive surgery has improved the quality of life in over 30 million patients with an over 95% patient satisfacti­on rate and made it one of the most popular elective surgery procedures in all of medicine.

It is considered safe with predictabl­e results and has been approved by the armed forces in many countries and even NASA astronaut candidates in the United States. After refractive and laser eye surgery, many patients report seeing better than they had at any other time in their lives.

Extensive research has provided invaluable refinement­s and advancemen­ts of laser technology and diagnostic tools to develop safe and appropriat­e treatment options for patients with a myriad of refractive disorders. Laser-assisted in situ keratomile­usis (LASIK) is presently the most performed elective procedure in the modern world.

In recent years, tremendous advancemen­ts have been made in this field. A new procedure called ReLEx Smile is now gaining popularity in the refractive arena worldwide and is potentiall­y changing the practice of refractive surgery for the next decades.

Unlike convention­al LASIK, ReLEx Smile procedure does not create flap and involves the use of only one laser (the femtosecon­d laser).

Instead of vapourisin­g cornea tissue to correct the underlying short-sightednes­s and astigmatis­m, ReLEx Smile carves out a small piece of corneal tissue called a lenticule in the cornea and then the lenticule is removed through a small keyhole incision (about 2.5mm to 4mm only).

This single-step, all-in-one laser operation only takes about 30 seconds to perform the correction for one eye and the entire procedure complete in about 15 minutes for both eyes. This laser is fast and uses low energy. The procedure is odourless and silent, so there is less discomfort for patients.

Patient also feels more comfortabl­e because the suction on the eye during the treatment is gentler. There is no frightenin­g “blackout”, no bleeding (no red eye) during the procedure or swelling of the eye after.

Light blackout is a phenomenon in which the laser beam the patient is told to focus on during the procedure vanishes when the procedure begins.

This temporary disappeara­nce of the focal point can cause panic. Foreign body sensations and mild discomfort may be experience­d by some patients after the procedure, but this usually lasts for just a few hours.

Due to the smaller wound by minimally invasive surgery, ReLEx smile results in a much stronger eye and less immediate post-operative discomfort and tearing. The use of a small incision also means that fewer corneal nerves are severed during the procedure, which also means less dry eye. With no flap created, flap displaceme­nt or dislodgeme­nt is not an issue, and so the eye will be less susceptibl­e to trauma. ReLEx smile is a good option for those who are involved in contact sports.

Most patients will experience a dramatic improvemen­t in their vision a day after the surgery and then remain stable days after the surgery.

All excimer laser procedures are subject to inconsiste­ncy based on difference­s in corneal hydration, laser fluence projection, reflection losses, temperatur­e and humidity in the laser room and other environmen­tal factors that are hard to control.

In the ReLEx SMILE procedure, the only variable affecting tissue removal is the accuracy of the femtosecon­d laser’s optomechan­ics, which are unaffected by environmen­tal conditions.

It is likely that with the ReLEx Smile procedure, there will be less need to develop personalis­ed nomograms for different machines, locations or surgeons.

If the present direction and volume of research is any guide, a large proportion of tomorrow’s femtosecon­d technologi­cal advances and discoverie­s will be based on the mastery of treating refractive errors without even touching the cornea.

All treatment will be intrastrom­al and ReLEx Smile is currently the most advanced procedure available.

Choosing laser eye correction to fix your eyesight problems is not a decision you should take lightly.

Keep in mind that laser vision correction is still a surgical procedure that carries surgical risk, although the risk involved is negligible and the success rate is very high.

You are advised to have your eyes properly evaluated and examined by the eye surgeon prior to surgery.

Be sure you discuss all options in detail with your eye surgeon or eye care provider before making any final choices.

This article is contribute­d by KPJ Pusat Pakar Mata Centre For Sight. Look out for the advertisem­ent in this StarSpecia­l.

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 ??  ?? ReLex Smile: In a single step, the laser creates a refractive lenticule and a small incision of less than 4mm in the intact cornea – virtually regardless of the ambient conditions or corneal structure.
ReLex Smile: In a single step, the laser creates a refractive lenticule and a small incision of less than 4mm in the intact cornea – virtually regardless of the ambient conditions or corneal structure.
 ??  ?? The lenticule is removed through the small incision. The disruption to the biomechani­cs of the cornea is minimal. No flap is cut.
The lenticule is removed through the small incision. The disruption to the biomechani­cs of the cornea is minimal. No flap is cut.

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