FLAPLESS LASER - RELEX-SMILE LASER TECHNOLOGY FOR MYOPIC AND MYOPIC ASTIGMATIC TREATMENT

DEVELOPMENT AND EVOLUTION

OF EYE LASER SURGERY AND TECHNIQUES

UNTIL SMILE LASER METHOD...

Eyeglasses were the only way of correcting refractive errors for seven hundredyears until the development of contact lenses in 1950's. After contact lenses, which are alternative to the eyeglasses, development of laser devices and surgical techniques in the last 25 years has made Laser Surgeryan alternative treatment for glasses and contact lenses.

First of all, incision was started to be performed in the cornea layer of the eye, which is the anterior surface, in the 1980's by scratching with diamond knives in clock face alignment. Myopic refractive errors were treated by providing the flattening of the cornea through this technique called RK (Radial Keratotomy). This method is colloquially known as ''eye crossing out’’. And still many patients ask as "Will you cross out my eye?". In terms of RK method, scientists embarked on other quests instead of this technology due to the facts that the numbers quickly recurred in time in the patients with high eyeglasses numbers and side effects occurred such as night vision disorder problems depending on these scratches on the cornea.

As a result of intense studies of the scientists after 1980's, PRK method was replaced with RK by the development of Excimer Laser devices. PRK (Photorefractive keratotomy) is based on flattening of cornea by laser. It received FDA approval in the USA in 1995. We still use PRK method in higher eye-glasses numbers since we may work in upper surface, the possibility of recurrence of the high numbers of eye-glasses is more, but it is a technique, which causes more pain and has the possibility to result in haze/marks on the surface of the cornea.

LASIK METHOD = FLAP LASER METHOD

Eye laser surgery techniques have also developed with the development of Excimer laser surgery devices and removing flap devices from the surface of the cornea. Lasik method is based on creating a flap by incision over the surface of the cornea instead of skinning epithelial in PRK and performing ablation with Excimer laser , in other words re-shaping the cornea by trimming. While knife (mechanical keratome) was used to create a flap from the cornea at first, flap was started to be formed with bladeless laser from the surface of the cornea by the development of Femtosecond laser. Cutting flap fragmentally, thus applying laser in this case are impossible in the laser performed by knife, 3 to 6 months are required in order that the cornea is recovered properly. If proper cornea recovery occurs, flap may be formed by incision with knife for the second time. Moreover, mechanical keratome (knife) applied on the eye may lead to emboli and losses of vision by damaging eye blood stream due to approximately 160 millimeter mercury pressure applied on the eye.

Therefore, Femtosecond lasers were quickly replaced with knives (Mechanical Keratome). It is called femtosecond lasers (bladeless laser).Even if the laser is left half-finished during the formation of flap as bladeless with Femtosecond laser, flap formation is resumed and completed without any problem. Hence, no problem is encountered in the formation of flap by laser. The pressure applied on the eye in the formation of flap from the cornea by femtosecond laser is 40 millimeter mercury pressure, and when compared to mechanical keratome, we can observe how less it risks the eye. Creating flap by Femtosecond laser and treating the number with Excimer laser are called iLasik.

SMILE LASER METHOD = FLAPLESS LASER METHOD

The cornea, anterior part of the eye, is entered from only 3 mm space without forming flap with Femtosecond laser.

Excimer laser is not used in this technique.

All stages are carried out by Femtosecond laser.

SMILE method is based on removing the tissue causing the eyeglasses number by Femtosecond laser.

Smile method;

• Not causing dry eyes,

• May be performed on high eye-glasses numbers,

• May be performed on thin corneas,

• Not weakening endurance of cornea since it may be performed in lower layer of cornea,

• Not damaging biomechanical structure of cornea,

• Only 20-30 millimeter mercury pressure may be applied on the eye at the stage of forming lenticular by Femtosecond laser,

• No flap complication occurs since there is no flap in Smile method.. Fragmental flap formation, wrinkle in flap, particle remains under flap etc.

• Removing tissue causing eyeglasses number instead of trimming the number with Excimer laser (recurrence of eyeglasses numbers is nearly none.)

These reasons listed reveal how outstanding Smile technology compared to other methods.

When we regard the current situation compared to the situation, in which computers and mobile phones have newly been used, we now have both phones and computers in our pockets. Our lives and comfort get easy, such as achieving all information at any time, to perform transactions such as bank transactions at any time, establishing our connections with social media via our phones etc...

The developments in the technology of eye laser surgery now provide that the applications of devices and surgical techniques are quite comfortable in the current point and they are protective for the eye tissues and minimize the risks of the application.

Smile laser surgery is only applied in Talya medical center in Antalya and also in the Mediterranean region. We recommend that the people, who decide to have laser surgery, should question the technology to be performed.