SMILE SURGERY A GUIDE FOR PATIENTS. Professional care for your eye health

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1 SMILE SURGERY A GUIDE FOR PATIENTS Professional care for your eye health

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3 Contents About Dr John Males... 1 Our Commitment to Our Patients... 2 COMMON QUESTIONS How Does an Eye Work?... 3 What is Myopia (short sightedness)... 4 What is Hyperopia (long sightedness)... 4 What is Astigmatism... 5 What is Presbyopia (age reading changes)... 5 What is SMILE all about?... 6 How does LASIK differ from SMILE?... 7 SURGERY INFORMATION SMILE might be the answer you have been looking for if... 8 Suitability for SMILE... 8 Frequently Asked Questions... 9 Recovery/Post Operative Period The SMILE Experience at Sydney Cornea Clinic Financing Options Benefits of Laser Vision Correction Possible Risks and Side Effects of Surgery... 13

4 About Dr John Males Dr Males is a consultant ophthalmologist at Sydney Eye Hospital, St Vincent s Public and Private Hospitals, Concord Hospital and Macquarie University Hospital. Dr Males is a clinical Senior Lecturer at Macquarie University and the University of Sydney. He has consulting rooms in Sydney and Liverpool and is the chair of the Corneal Unit at Sydney Eye Hospital as well as the Head of Department at St Vincent s Public Hospital. He is also the Production manager of the NSW Lions Eye Bank. Dr Males is a Principal Co-ordinator for the Masters of Refractive Surgery at the University of Sydney, the first post graduate degree in refractive surgery in the world. Dr Males performs all forms of laser vision correction surgery for the treatment of myopia (short sightedness), hyperopia (long sightedness) and astigmatism. At Sydney Cornea Clinic all of the latest surgical and technical advances are available and Dr Males tailors the treatment to the individual and their specific needs. 1

5 Our Commitment to Our Patients At Sydney Cornea Clinic we understand that your vision is one of your most precious senses. Being able to see clearly without the restriction of glasses and contact lenses is something many of us struggle with daily. Over half of the world s population requires an optical device to see clearly. Members of staff have had laser surgery and are more than happy to guide you through the process to achieve glasses and contact lens free vision. 2

6 How Does an Eye Work? A normal eye works by bending the light as it enters the eye. This is done by the cornea (the front surface of the eye) working in conjunction with the lens of the eye. In an eye that sees well for near and distance these two surfaces are perfectly balanced and the lens focuses for both near and distance. Light has to fall perfectly on the retina for all distances at all angles for us to see well. Any disturbance in this balance is called refractive error. 3

7 What is Myopia (Short Sightedness)? Myopia, or more commonly, short sightedness is caused when the eye is generally too powerful making near vision very sharp but the distance vision blurry. The light enters the eye and falls before the retinal surface creating a blurry image. What is Hyperopia (Long Sightedness)? Hyperopia or long sightedness is caused when the eye is under powered and the distance vision is clear but the near and especially reading vision is blurry. Light falls behind the retinal surface making close objects blurred. 4

8 What is Astigmatism? Astigmatism is when the front surface (the cornea) of the eyes curve is unequal. A shape that is similar to an AFL football curve rather than the symmetrical curve of a soccer ball. This asymmetry means that both near and far objects are blurred. What is Presbyopia? (Age Reading Changes) Presbyopia, or the need for reading glasses especially in those over 40 occurs when the natural lens inside the eye becomes less flexible over time. This causes near objects to become blurred and reading glasses are prescribed. 5

9 What is SMILE all about? ReLEx Smile Small Incision Lenticule Extraction SMILE is the third generation of laser vision correction, just like LASIK and PRK before it, SMILE is the latest innovation in safe, reliable vision correction. SMILE or SMall Incision Lenticule Extraction, is the laser for people who are concerned about the large incisions associated with LASIK or the discomfort associated with PRK. SMILE works by creating a micro-incision, a keyhole technique similar to many other widely practiced keyhole surgeries; through which the lasered lenticule is removed. 6

10 How does LASIK differ from SMILE? Fetmo-LASIK Laser in-situ keratomileusis LASIK requires a two-step procedure, two lasers and a larger incision into the cornea. SMILE patients are able to resume normal activities the next day and are able to swim and wear make up 3 days after surgery unlike LASIK or PRK. 7

11 SMILE might be the answer you have been looking for if: You have been told your eyes are too dry for LASIK Keyhole surgery appeals to you You have a busy or active lifestyle and want to resume swimming or the wearing of make up shortly afterwards You are interested in new and innovative treatments Suitability for SMILE Generally if you are suitable for LASIK you are suitable for SMILE, with the exception of longsighted people all of the suitability criteria are the same: Over 21 Stable prescription for 18 months No eye disease Not pregnant or breast feeding Prescription that falls in the treatable range SMILE also offers the added benefit of being far less dry eye inducing than other laser procedures. 8

12 Frequently Asked Questions When can I return to work? Depending on your job most people are able to go to work two days after surgery. When can I drive? The majority of SMILE patients should be cleared to drive 24 hours after their operation. When can I swim? Because SMILE is keyhole surgery the eye is safe to be wet after only 3 days unlike LASIK and PRK which may be up to 4 weeks. When can I wear makeup? Like swimming and getting the eyes wet, 3 days after your surgery you are permitted to wear eye makeup. Does it hurt? SMILE is the third generation of laser vision correction and as such it is even less uncomfortable than LASIK or PRK. The pressure sensation reported during LASIK is dramatically decreased with SMILE and there is none of the prolonged healing time as with PRK. What do I need to do to prepare for my SMILE procedure? After your suitability assessment and medical clearance with your surgeon you will be given booking information by our Surgical Booking staff. Please read all of the information carefully and do not hesitate to call if you have any questions about your SMILE procedure. 9

13 Recovery/Post Operative Period Your eye surgeon will prescribe some medicated eye drops and lubricant drops for you after your surgery. It is essential that you use these as directed. While it is normal for the eyes to be gritty, irritated and teary after your laser vision correction surgery and excessive pain that is not tolerable after taking Panadiene needs to be reported to your surgeon immediately. The SMILE Experience at Sydney Cornea Clinic As a service to our patients a free booking can be made with our clinical staff to assess your suitability before seeing the doctor. Before this appointment we ask that soft contact lenses are removed for 3 days prior to the consultation to allow the cornea to return to its natural shape. Rigid gas permeable contacts need to be removed for 3 weeks before the initial consultation as they substantially change the cornea s surface. However glasses may be worn as normal and it is advisable that your glasses are brought to the consultation to measure their strength. After an initial successful suitability screening an appointment can then be made with the surgeon to look at the health of the eyes and discuss your refractive options further. If required a trial of contact lenses can be arranged to assess suitability for blended vision (otherwise known as monovision) for those patients over 40 having trouble with their reading vision. 10

14 Financing Options While making the decision to have an eye procedure may be daunting, rest assured that at Sydney Cornea Clinic you are in the safest of hands. In order to make it even easier we have the option of offering finance to our patients so that the barriers to great vision and a fantastic experience are even lower. Ask our friendly staff for more information to organise your finance options with MAC. 11

15 Benefits of Laser Vision Correction The benefit each individual receives from a laser vision correction procedure depends upon the nature of their eye condition, amount of prescription required to be treated and patient expectation. On the whole, if you are a suitable candidate, it is expected that after the initial recovery period that your vision should be the same as it was in your glasses or contact lenses. The benefit comes from the freedom that you will experience without being hampered by multiple sets of glasses (reading, distance, clear and tinted), contact lenses and all of the solutions that go with them. Imagine a lifestyle where you are able to wake up in the morning and see the alarm clock. Where falling asleep in front of the television, doesn t mean waking up with sore eyes. A lifestyle where you are able to swim at the beach and not have to worry about losing your contact lenses in the water. 12

16 Possible Risks and Side Effects of Surgery While the frequency of a poor outcome and adverse events are very low patients still need to be informed. Many of these complications are not vision threatening and with proper aftercare resolve over time. Complications can be divided into intra operative and post operative. Intra operative complications are issues that arise at the time of surgery. These may include: inability to free the refractive lenticule from the pocket, a tear in the lenticule or loss of suction causing an incomplete lenticule. Post operative complications may be divided in to: post operative over/under correction, regression and can be remedied with re-treatment (enhancement) or mild glasses for the required distance. Dry eye, generally this is a short-term problem and resolves as the cornea heals. Lubricating drops are given to all patients as some level of dryness is expected. Patients with pre-existing dry eye are at an increased risk of severe dryness. Visual changes such as increased glare or haloes may be noticed while driving at night. This is more prevalent in people with high prescriptions or pre-existing night vision problems. Generally over time patients notice a settling of their night vision without intervention. Corneal ectasia can occur when the cornea becomes progressively thinner after a laser procedure and the vision is distorted and 13

17 blurred. Glasses or contact lenses may be prescribed to correct the vision and Collagen Cross Linking may be performed to halt any progressive thinning. All efforts are made by your surgeon to screen out any patients who are at a greater risk of this complication. Presbyopia/age related reading changes affect everyone over the age of 40 to some degree or another. Short sighted people simply take their glasses off to read while normally sighted or long sighted people wear reading glasses. While we cannot halt the natural processes as the eye ages your surgeon may discuss monovision or blended vision to minimise these natural changes. 14

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