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FemtoSMILE: Latest technology in vision correction
Published in The Saudi Gazette on 26 - 05 - 2015


Dr. Mohamed Alaa El Danasoury
Chief of Cornea & Refractive surgery Units
Magrabi Hospitals & Centers
Since the discovery of laser and its massive use in several branches of medicine, ophthalmology holds the major stake in those applications and is taking the maximum advantage of the breathtaking developments being taken place in the field.
In the early 1980s, excimer laser had been used in the vision correction surgeries. Then emerged the surgery based on laser called LASIK (Laser In-Situ Keratomileusis) in which a flap of the corneal surface is raised and a thin layer of underlying tissue is removed using a laser. After the discovery of FemtoLASIK, it was developed as the latest version of vision correction. FemtoLASIK is a form of refractive eye surgery similar to LASIK that creates a corneal flap with a femtosecond laser microkeratome rather than with a mechanical microkeratome, which uses a steel blade.
During the last five years, femtosecond laser technology was the most popular and successful one in vision correction surgeries, but now FemtoSMILE technology shot to fame as the highly advanced vision correction procedure.
Dr. Mohamed Alaa El Danasoury, chief of Cornea & Refractive surgery Units at Magrabi Hospitals and Centers, member of the American Academy of Ophthalmology's Board of Trustees and president of the American Society of Cataract and Refractive Surgery, says that FemtoSMILE is the latest technology in laser vision correction for the treatment of myopia and astigmatism. It relies on the use of femto laser technology singlehandedly without raising any part of cornea during the procedure as happens in the laser procedures such as LASIK or femto LASIK, and this enables the corneal tissue intact and there are many benefits for this, mainly maintaining the strength and stiffness of cornea.
Danasoury said Magrabi Hospitals & Centers was the pioneer in using latest medical technology in the Middle East region as a whole. It was the first hospital to use laser, LASIK and Femto LASIK and now FemtoSMILE. About the surgical procedures, he said: Under FemtoSMILE procedure, the high-precision femtosecond laser is being used for about three minutes during which femto laser device will be used to reduce the curvature of the cornea to the extent required without raising the outer layer of the cornea through a 2 mm microscopic hole on the side of the cornea to allow the reflection of light on the retina for the patient to see the images clearly. In FemtoSMILE, the SMILE stands for Small Incision Lenticule Extraction.
On the difference between FemtoSMILE and other laser procedures, Danasoury said that FemtoSMILE has several advantages while comparing with others. In LASIK procedure, a mechanical cutting tool is used to create a thin flap of cornea. Almost a complete circle is cut in the upper layers of the cornea. The flap is then folded back and subsequently, the exposed corneal tissue is then ablated using an excimer laser in a separate stage of treatment. The greater the level of vision defect, the more tissue needs to be vaporized. In the final stage of treatment, the corneal flap is then folded back into its original position. During the first week after the surgery, the eyes shall be protected from exposure to water and dust or rubbing it out by hand.
But in FemtoSMILE, the high-precision femtosecond laser creates a small lens or lenticule inside the intact cornea, and this lenticule is then removed without any cutting or separation preserving an intact cornea. In contrast to earlier techniques, there is no flap incision in FemtoSMILE. The high-precision femtosecond laser provides targeted correction of the vision defect while leaving the surrounding corneal tissue virtually unaffected. This ensures high degree of security from vision impairment and the greatest degree of safety.


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