Smartsight With Schwind Atos: Our First Experience.

The aim of the study was to develop some surgical tips and tricks of the SmartSight laser vision correction method with femtosecond laser system Schwind Atos (SCHWIND eye-tech-solutions GmbH, Germany).

«Astana Vision» clinic, Astana city, Republic of Kazakhstan.

We have started refractive lenticular intrastromal surgery with novel femtosecond laser technology SmartSight in January 2023. The distinctive feature of this procedure is that tracking system of Schwind Atos effectively enable to centrate and compensate cyclotorsion before starting lenticule creation of the SmartSight procedure,  however it blocks the optical path and patient hasn't able to see fixation light, so they should lie quietly about 1 minute and, at the same time, the surgeon observes the progress of the procedure only through the monitor. A very important option, also, is the ability to quickly change the energy level of the procedure, when OBL appears, for example.

We start each SmartSight procedure with carrying out moderate compression through eyelids to introduce the patient with sensations of the slight vacuum during the procedure. To minimize the risk of formation of black spots we put a microdrop of BSS on the cornea before docking. We use a slim phaco chopper to form the upper and lower lenticular plane because of the very thin lenticule edge in this method. On the 1-st day after treatment we see very calm eyes with transparent corneas and it is almost impossible to see the edge of the formed lenticule due to lower pulse energy level. This allows us, if necessary, to check the refractive and visual outcomes already a few hours after the SmartSight procedure.

SmartSight with Schwind Atos laser system is a minimally invasive, flapless laser vision corneal correction method, with a very fast recovery period, including very important options such as centration and cyclotorsion control, fairly easy to perform by surgeons with good experience in refractive lenticular intrastromal surgery.