Relex Smile For Ametropia Correction Induced By Refractive Surgery (7 Years Clinical Outcomes).

There are patients, who need an enhancement the effect after primary operation. We used RELEX SMILE technic to treat the refractive errors after different types of corneal surgery: RK, PRK, LASIK, SMILE as a method that will provide maximum accuracy, safety, and stability after readjustment.

We assessed the long terms results of these enhancements.

A retrospective, single-surgeon, consecutive case-series study. All patients had residual myopia and astigmatism after previous cornea refractive surgery.

Doctor’s Shilova Clinic in Moscow, Russia

A total of 100 eyes were included in the observation group. ReLEX SMILE after РК we performed in 36 cases. Study included SMILE after PRK for 16 eyes, SMILE after LASIK have undergone surgery - 32 eyes (24 patients) with mean preoperative sphere of -1.85 diopters (D) and cylinder - 1.25 D (range: -0.5 to -2.5 D), they were divided into two groups. Group 1 (19 eyes) underwent SMILE and group 2 (13 eyes) FLEX in a flap. ReLEX SMILE® post ReLEX SMILE® - 16 eyes with SEQ – 2.25 D with sufficient thickness of residual stroma.

Due to long term observation, we could asses a safety, predictability and stability of results for each technic and develop an algorithm for conducting them.

Patients postoperative outcomes at 1 month indicated high spherical equivalent refraction accuracy with 92 % of eyes within ±0.25 D and 100% within ±0.50 D. In addition, 96% of eyes had a residual cylindrical error of not higher than ±0.50 D, and 100% were within ±1.00 D. Rapid restoration of high stable distance visual acuity with a reduced risk of flap tearing along old scars, displacement of the “petals” of the flap, and the appearance of irregular astigmatism associated with longitudinal-transverse dissection of the corneal tissue.

SMILE an excellent tool for the primary correction of refractive problems and it also expands the surgeon’s capabilities. It takes advantage of opportunities of endoscopic technology by extracting lenticules with certain parameters, with correct calculation of tissue to be removed and energy parameters, with impeccable manual skills, precise centering and knowledge of the basics of technology. You can achieve high and stable visual acuity and reduce the likelihood of postoperative risks. The results of 7 years of observation confirm the high efficiency of the method and the ideology of “less is more”.