Eyeworld

63 EW REFRACTIVE November 2017 Dr. Reinstein agreed. "Once the learning curve for SMILE has been mastered and appropriate experience acquired, SMILE affords patients with fewer postoperative management requirements, less use of artificial tears, and faster return to activities that we would warn LASIK patients to stay away from until the flap is fully healed and secured," he said. Future of SMILE The future of SMILE is bright. According to Dr. Parkhurst, more indications for SMILE are expected to be approved relatively soon. "At least the treatment of myopic astig- matism is expected to be approved, and that's the most common patient presenting for refractive surgery to- day. When that indication is opened up, we will see SMILE really take off," he said. According to Dr. Reinstein, the future of SMILE will incorpo- rate aspheric profiles, hyperopic treatment, and mixed astigmatism treatment. "While LASIK remains an extremely safe, accurate, and mature procedure, SMILE is likely to be the procedure of choice for most prima- ry refractive surgery corrections for those with the technology to offer it," he said. EW Editors' note: Drs. Parkhurst, Reinstein and Yoo have financial interests with Carl Zeiss Meditec. Contact information Parkhurst: Gregory.parkhurst@gmail.com Reinstein: dzr@londonvisionclinic.com Yoo: syoo@med.miami.edu for LASIK, we might still consider him or her eligible for SMILE." According to Dan Reinstein, MD, London, SMILE is the treat- ment he employs most frequently for myopic refractive surgery. "Ad- ditionally, we are currently getting impressive results for myopia above –10 with unprecedented accuracy in our prospective IRB [Institutional Review Board] approved study," he said. "It is particularly helpful for patients who are a little on the dry side to start with, and it provides a much less invasive and safer way of treating them compared to reverting to surface PRK treatment. SMILE is currently not available for hypero- pia, although the clinical trials we are carrying out show that it will provide an excellent alternative to LASIK for those patients as well." SMILE vs. LASIK Both procedures are corneal surgery performed with a laser, however, there are some important differenc- es. "SMILE is different than LASIK in that it does not involve the creation of a corneal flap," said Sonia Yoo, MD, Miami. "Instead, a small pocket is made through which a thin sliver of tissue (lenticule) is removed to achieve the desired refractive effect. SMILE involves the use of one advanced technology femtosecond laser as opposed to the use of two la- sers (femtosecond followed by an ex- cimer laser) in LASIK. Because there is no flap created during SMILE, it is thought that there may be less risk of dry eye after SMILE due to fewer corneal nerves being disturbed during the procedure." Uniform epithelium removal in 5 - 7 seconds Corneal Xlinking, PRK Advanced Surface Ablation Improved clinical outcomes of CXL and PRK with Amoils Epithelial Scrubber Minimize total procedure time Avoid alcohol damage to surrounding tissue No need for subsequent scraping T. 800.461.1200 www.innovativexcimer.com order online www.innovativexcimer.com AMOILS EPITHELIAL SCRUBBER AMOILS www.innovativexcimer.com " At least the treatment of myopic astigmatism is expected to be approved … When that indication is opened up, we will see SMILE really take off. " —Gregory Parkhurst, MD

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