Dr. Andrew Logan explains SMILE® laser eye surgery at Wellington Eye Centre

The Wellington Eye Centre is proud to be the first to perform SMILE® laser vision correction surgery in New Zealand.

SMILE stands for SMall Incision Lenticule Extraction. This new technique, only able to be performed with the VisuMax® femtosecond laser made by Carl Zeiss Meditec, has fast visual recovery like LASIK, but has a number of advantages compared to LASIK for the correction of short sight and short sight combined with astigmatism.

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Advantages of SMILE

No corneal flap so there are no concerns about flap related complications.
Less effect on corneal strength and stability compared to LASIK.
Less damage to corneal nerves so better preservation of corneal sensation.
Less dry eye issues compared to LASIK.
Better predictability compared to LASIK , especially for bigger corrections.
Better stability of correction compared to LASIK , especially for bigger corrections.
Fast and pain-free recovery of vision like there is with LASIK.
Because only one laser is used, the procedure is quicker & simpler than LASIK.
No burning smell and a totally silent procedure.

Frequently asked Questions

How does SMILE work?

SMILE uses one laser machine (the VisuMax femtosecond laser) to correct short sight. The laser cuts a lens shaped piece of tissue in the middle of the cornea, and then makes a small 2mm to 3mm keyhole incision to one side. Using a pair of delicate forceps, the lens shaped piece of corneal tissue is removed through the keyhole incision. This result in flattening of the cornea to correct the short sight and completes the procedure.

How are LASIK and PRK different from SMILE?

Both LASIK and PRK use a laser called an excimer laser to flatten the cornea to correct short sight - this occurs by a process called photoablation where the laser removes minute layers of corneal tissue by breaking the bonds between carbon atoms in the cornea. In the case of PRK this is performed on the surface of the cornea. The cornea then has to heal - this takes 3-4 days. During the healing period vision is quite blurred and the eye will feel moderately uncomfortable. With LASIK surgery, a femtosecond laser is used to cut a thin flap of corneal tissue. This flap is lifted out of the way, and the excimer laser is used to perform the refractive correction after which the flap is repositioned. With LASIK, visual recovery is fast and relatively pain-free.

Who is suitable for SMILE surgery?

SMILE is currently available for correction of short sight and short sight combined with moderate astigmatism. SMILE is recommended for moderate to high short sight, it can correct from -0.5D to -10.0D and up to 5 diopters of astigmatism. It is not currently available for treatment of long sight or presbyopia. However, Carl Zeiss Meditec is continuing to develop SMILE and long sight and presbyopia correction will be available in the future.

SMILE is particularly suitable for:

  • Athletes who may be exposed to eye trauma; such as rugby players, netballers and martial artists and also members of the armed forces and Police who may be concerned about the trauma to their eyes after laser vision correction.
  • People at risk of dry eye symptoms after surgery.
  • Correction of large amounts of short sight.

VisuMax® and SMILE® are registered trademarks of Carl Zeiss Meditec.

If SMILE is so good, why don’t other clinics in New Zealand offer it?

The simple truth is that only the VisuMax femtosecond laser is accurate and precise enough to cut the lens shaped piece of tissue with the necessary accuracy. Other femtosecond lasers such as the Intralase, which is the most commonly used femtosecond laser in New Zealand, do not have the accuracy or precision required for this surgery.

How do we know that SMILE is safe?

SMILE surgery has undergone a very extensive research programme during development by Carl Zeiss Meditec. A large numbers of papers have been published in medical journals documenting SMILE's safety, predictability and stability. In addition research has been performed and results published showing that SMILE has less effect on corneal strength, corneal sensation and dry eyes compared to LASIK.

SMILE has received FDA approval in the USA and CE approval (the European equivalent of FDA approval). SMILE is currently performed in Europe, America, the Middle East, India, Asia, Australia and New Zealand. SMILE is currently undergoing trials in the USA prior to seeking FDA approval to perform the surgery in North America.

How can I find out if I am suitable for SMILE?

Free laser surgery assessments are available at our clinics in Wellington, Napier and Nelson. You can book an assessment online or by phoning our Wellington or Napier offices.

Download the smile surgery brochure