Moorfields Eye Hospital will receive the Zeiss Visumax femtosecond laser in January 2015. The Visumax laser is one of the most innovative new technologies in laser eye surgery and allows the surgeon to perform RELEX SMILE laser eye surgery- small incision lenticule extraction. Moorfields Eye Hospital London will be one of the few centres in the world to offer RELEX SMILE surgery. The entire RELEX SMILE procedure is performed with the Visumax femtosecond platform. LASIK on the other hand requires 2 lasers - a femtosecond laser for flap creation and an excimer laser for vision correction.
Unlike LASIK, which involves first making a flap in the cornea which is then lifted up and laser vision correction performed on the underlying corneal tissue, RELEX SMILE is a flap free procedure. During RELEX SMILE the shape of the cornea is altered and the patient's vision is corrected by removing a precisely shaped lens of tissue from within the cornea through a tiny 2mm keyhole incision.
Several published studies of patients have shown that RELEX SMILE is as effective and safe as LASIK for levels of short-sight up to -10D. Over 80'000 patient's have had RELEX SMILE worldwide. RELEX SMILE has several potential theoretic advantages over LASIK. The absence of a flap means that the patient's cornea may be stronger after RELEX SMILE and there is certainly no risk of flap dislocation at a later stage. The absence of a flap may also mean that the quality of vision is better after RELEX SMILE due to the absence of micro-flap folds. Further more as the nerve distribution within the front of the cornea is undisturbed in RELEX SMILE there may be better post surgical sensation on the surface of the eye and possibly less risk of dry eye. RELEX SMILE is also relatively pain free compared to surface laser surgeries such as LASEK or PRK.
So is RELEX SMILE better than LASIK? The truth is that there isn't sufficient current evidence that establishes whether the theoretical benefits of SMILE are borne out in practice. What we do know is that SMILE is as good as LASIK. The Refractive Research Lab at Moorfields Eye Hospital in London hopes to answer some of these questions by performing a comparison study of RELEX SMILE versus LASIK.
*Mr Angunawela's published research papers
1: Riau AK, Angunawela RI, Chaurasia SS, Lee WS, Tan DT, Mehta JS. Early corneal wound healing and inflammatory responses after refractive lenticule extraction (ReLEx). Invest Ophthalmol Vis Sci. 2011 Aug 5;52(9):6213-2
2: Angunawela RI, Poh R, Chaurasia SS, Tan DT, Mehta JS. A mouse model oflamellar intrastromal femtosecond laser keratotomy: ultra-structural,inflammatory, and wound healing responses. Mol Vis. 2011;17:3005-12. Epub 2011
3: Ang M, Chaurasia SS, Angunawela RI, Poh R, Riau A, Tan D, Mehta JS. Femtosecond lenticule extraction (FLEx): clinical results, interface evaluation, and intraocular pressure variation. Invest Ophthalmol Vis Sci. 2012 Mar 15;53(3):1414-21.
4: Angunawela RI, Riau AK, Chaurasia SS, Tan DT, Mehta JS. Refractive lenticule re-implantation after myopic ReLEx: a feasibility study of stromal restoration after refractive surgery in a rabbit model. Invest Ophthalmol Vis Sci. 2012 Jul 26;53(8):4975-85.
5: Riau AK, Angunawela RI, Chaurasia SS, Tan DT, Mehta JS. Effect of different femtosecond laser-firing patterns on collagen disruption during refractive lenticule extraction. J Cataract Refract Surg. 2012 Aug;38(8):1467-75
6: Riau AK, Angunawela RI, Chaurasia SS, Lee WS, Tan DT, Mehta JS. Reversible femtosecond laser-assisted myopia correction: a non-human primate study of lenticule re-implantation after refractive lenticule extraction. PLoS One. 2013