ReLex Smile – the modern method of laser eye surgery

ReLex Smile – the modern method of laser eye surgery

More and more people have their eyes lasered, even when there is no medical need. As the German Ophthalmological Society (DOG) indicates, the number of interventions grew to up to 140,000 annually in 2020. Patients often pay up to 3,000 euros out of pocket. (Image: GettyImages, goir)

The field of eye surgery has developed steadily over the past few years. The so-called “ReLex Smile” method is one of the most modern methods. In contrast to older treatment methods, the ReLeX Smile procedure is a minimally invasive application. Since the top layer of the cornea remains almost intact, the laser eye procedure is particularly painless and gentle.

Advantages and areas of application

For a long time, it has been possible to double individual vision with the help of certain laser operations. So far, certain side effects have occurred mainly in the course of the LASIK method. Since the surgeons remove the thinnest layers of the cornea, this can lead to undesirable impairments such as dry eyes or the feeling of foreign bodies.

In contrast, the “Small Incision Lenticule Extraction” is a minimally invasive procedure that uses a femtosecond laser he follows. The method was developed in 2006 by Carl Zeiss Meditec before it was introduced internationally in 2011. It was used more than 100,000 times around the world – including in Europe and China – as early as 2014.

It is above all the advantages that doctors and patients address: The femtosecond laser makes it possible to make the smallest incisions in the cornea, which means that it remains stable. In contrast to other methods, this reduces the incision area by up to 80 percent. External factors such as the air in the room or the humidity also have no effect on the result. Patients benefit from this almost painless method because it has a lower risk of infection and the eyes heal more quickly. This allows patients to resume sporting activities on the day of the operation.

Although the ReLex Smile procedure is now widely used, it is not suitable for all forms of ametropia. So recommend well-known laser surgeons from the laser eye center in Cologne the minimally invasive procedure for certain groups of people: This includes patients with astigmatism or thin corneas, severe myopia and people with dry eyes. For the procedure to be used, patients must be at least 18 years old. A “constant” visual impairment is another criterion that must be met before the operation. As the “Commission for Refractive Surgery (PDF)” farsighted people, pregnant women, people over 50 and people with chronic inflammatory eye diseases may not be treated. The same applies to people who have one or more autoimmune diseases and their wounds heal poorly.

Preliminary examination and preparations are crucial

The specialist determines whether a patient is suitable for the procedure through an extensive preliminary examination. Among other things, he checks the current ametropia and the ability of the eyes to moisten themselves. The doctor also measures the size of the pupils and intraocular pressure. Finally, the expert also includes the condition of the corneal tissue and the general physical condition in the assessment.

Provided that patients meet the requirements, there are a few guidelines they must follow before the procedure. Contact lenses may no longer be worn up to 14 days before the operation. On the day before the procedure, ophthalmologists also recommend avoiding perfume and cosmetic products. About 15 minutes before the operation, the doctors numb the eyes with drops. It then takes around 20 minutes before the outpatient procedure is completed under local anesthesia. In contrast to LASIK treatment, patients do not have to actively “cooperate” during the operation. Since the eyes do not have to be focused on a specific point of light, the treatment is less stressful for the patient. At the same time, the operation is odorless and silent, so that the patient feels safe.

Expected side effects and risks known

Although the ReLex Smile method heals quickly, vision may initially be impaired after the procedure. Some patients develop a foreign body sensation within the first hour or two. Itchy or burning eyes are also expected side effects. Special follow-up care is recommended to patients to reduce the risk of complications. During the first few days, the surgeons recommend that you avoid using make-up. Furthermore, patients should only exercise to a limited extent and not drive a car at first. Regular follow-up examinations are also required to support wound healing. Sometimes those who have been operated on have to be patient for up to six weeks before the acquired eyesight is stable.

Serious risks rarely arise with the safe and gentle ReLex Smile method. Flap-related risks are eliminated and the flow of tears is preserved. However, medical risks cannot be completely ruled out. As after any surgery, infections may occur as a result of treatment. Observation shows that less than one percent of patients suffer from glare sensitivity or require correction.

Only specialized doctors offer ReLex Smile procedures

Whether the minimally invasive procedure is carried out is ultimately a question of cost. With a price range between 2,000 and 3,000 euros, the method is considerably more expensive than other interventions. If there is no medical need, the statutory health insurances do not cover any treatment costs. In turn, private health insurances often offer special tariffs that cover such an intervention in terms of costs. Furthermore, it is difficult for some patients to find a suitable eye clinic. As state-of-the-art technology is required for the procedure, specialized laser eye clinics in particular offer this type of treatment.

According to the federal association, ReLex Smile is still in its infancy

Experts see the modern, minimally invasive method as a great advance in eye surgery. Nevertheless, it remains to be seen whether and when the process will replace other, common methods on a large scale. The cost-intensive form of treatment has a disadvantage: Patients cannot immediately notice improved visual performance, as this sometimes only sets in days or weeks later. In addition, doctors can only use this method once. As soon as a correction is required, another procedure must be chosen for the eye operation. Chairpersons of the “Refractive Surgery Commission” also rate ReLex Smile as a very promising procedure. Nonetheless, they admit that the method will need more time to be tested. In general, one could say that the ReLex procedure has not yet fully grown out of its infancy. It is still too early to scientifically evaluate the method in its entirety in the long term.

December 21, 2021

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