Risks and side-effects of eye laser surgery with SMILE^®

Both in femto-LASIK and LASIK, a flap incision of around 20 mm is required since the excimer laser cannot penetrate the topmost corneal layer. This incision destabilizes the eye's surface and has many additional side-effects which do not occur with SMILE^®. "Dry eyes" and "sands of Sahara" occur significantly more rarely with the SMILE^® method. The same applies to injuries to the epithelium and weakening of the cornea which can be attributed to the fact that the topmost corneal layer never gets attached as firmly again as it was before the femto-LASIK.

We never had a patient complaining of dry eyes after SMILE^® treatment; at least theoretically, they can occur in the first days after the treatment. In dry eyes, a disorder of tear production occurs in the first few weeks as a consequence of the operation. By means of appropriate therapy, you can counteract this symptom. Sands of Sahara - which is actually called diffuse lamellar keratitis, DLK - is an inflammation below the flap after femto-LASIK or LASIK some patients experience. It can be treated with anti-inflammatory drops and has late consequences in rare cases only. In isolated cases, adhesions of the epithelium below the flap occur which can necessitate repeating the operation in an occasional case. As a consequence of these possible but rare complications, a reduction of visual acuity occurs in less than one percent of cases. However, this figure can be reduced even further by follow-up treatment. Therefore, please be sure to attend the aftercare appointments we indicated.

"The larger the surgeon's experience, the lower the risk."

Dr. Breyer, , 40,000 surgeries

Since the incision in the cornea is very small, these complications have not been described yet after SMILE^®. Therefore, it is also suitable for patients with dry eyes.

There is a learning curve with every operation, and it is therefore not only obvious but also proven that an experienced surgeon makes less mistakes. The SMILE^® eye laser surgery procedure firstly requires a lot of routine in handling the femtosecond laser and secondly requires a lot of practice in preparing the lenticule. Dr. Breyer is one of the first users of this eye laser surgery procedure globally and has performed more than 5.000 SMILE^® operations. In addition, he is a high-volume surgeon specialized in minimally invasive procedures who has performed more than 60.000 procedures. He knows how to also handle difficult situations correctly - this gives you additional security.

In eye laser treatment, there is always a risk of excessive or insufficient correction. While our patients have gained a visual acuity of 100% without additional correction by glasses or contact lenses after a SMILE^® operation so far, a slight deviation from the planned target refraction cannot be ruled out on principle. In this case, you would still have to wear glasses or contact lenses even after the treatment, even if they had much lower diopter values. In particular, this applies to activities in which you have to rely on very good vision, for example while driving.

The results for patients with astigmatism (abnormal corneal curvature) or very high values to be corrected are frequently not as good as those for patients with only very slight ametropia - in these cases, we are therefore recommending the placement of contact lenses (ICL) or lenses (IOL) into the eye. In most cases, the excessive or insufficient correction can be improved upon in a second operation. In this case, we would recommend PRK which also forgoes the flap. Another advantage is the stability of the result. The visual acuity you can achieve only a short time after the operation can worsen again over time. Glares and halos can also occur in twilight and at night, in particular with higher-degree ametropia.