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Comparison of SMILE Pro with SILK and Smarth Sight Lenticule Extraction Methods
Nowadays, two new minimally invasive lenticule extraction methods have been introduced in the field of laser eye treatment. As we have known for over 10 years, SMILE is a proven method. This article provides information about the other systems and a comparison to the SMILE laser eye method. These new techniques (SmartSight and SILK) offer similar benefits to SMILE, including lower incision depths and faster healing times, but it is important to understand the differences in terms of precision, patient comfort, and long-term results. This comparison allows patients and professionals to better decide which method is best suited for their specific needs.
SMILE Pro
SMILE® Pro is a state-of-the-art method of laser eye surgery that uses the globally recognized Carl ZEISS Visumax® 800 femtosecond laser. This advanced technology enables precise and reliable vision corrections and has earned an excellent reputation worldwide. To date, the SMILE® procedure has successfully helped more than 10 million people achieve their desired vision results. The popularity of this method is based on its precision, shortened recovery times, and the minimally invasive nature of the surgery, which overall leads to high patient satisfaction rates. As more and more people choose SMILE® for its proven results and safety profile, its influence on refractive surgery continues to grow, setting new standards in this field.
SMILE Pro vs. SmartSight
SmartSight represents a novel advancement in laser eye surgery and uses a surgical technique similar to the SMILE-Pro method, known as lenticule extraction. This new approach utilizes the Schwind ATOS laser system. Like SMILE-Pro, SmartSight focuses on creating and extracting a small piece of corneal tissue (lenticule), which allows for the correction of refractive errors such as myopia and astigmatism with minimal intervention.
Both SMILE-Pro and SmartSight incorporate advanced technological features:
- Cyclotorsion Control: Allows intuitive rotation of the laser pattern for cyclotorsion alignment. The complex but easy-to-use system automatically recalculates the treatment pattern and helps compensate for possible cyclotorsions.
- Automated Pupil Centering: The computer-controlled assistance system ensures easy centering. The system uses the pupil center and vertex position to give you full control over the centering during docking. Since the patient’s eye is already centered before docking, the cut pattern does not need to be changed after docking.
- Curved Patient Interface: Like the surface of the human cornea, the patient contact lenses are also curved. The cornea largely retains its natural physiological shape. This way, artifacts in the cut results can be avoided, as well as unnecessarily increased intraocular pressure for the patient.
Advantages of SMILE-Pro:
Shorter Treatment Duration (10 seconds)
With the faster laser pulse frequency of 2 MHz, lenticules can be created in less than 10 seconds, and flaps in about 5 seconds. The shorter suction time can provide relief and greater safety during the laser treatment, both for your patients and the doctors. Lenticle creation in SmartSight takes more than 35 seconds.
Minimum Lenticle Thickness of 10 mm
Safer, as the likelihood of leaving lenticule residues is lower.
Most Tested System (over 10 million cases worldwide)
This level of widespread use typically indicates a high degree of trust and effectiveness, making the system a proven choice in its field. Such data are often used to reassure potential users of the system’s safety, efficacy, and performance based on an extensive track record.
Most Common Lenticule Extraction System in Germany and Worldwide
This suggests that it is the preferred choice among ophthalmologists due to its effectiveness, safety, or technological advantages over other methods.
Smart Robotic Assistance – Everything Under Control
Smart robotic assistance can increase control during the procedure.
Regulatory Approval
SMILE Pro is FDA- and CE-certified, ensuring it meets US safety and efficacy standards, whereas SmartSight lacks FDA and CE approval.
Refractive Correction
SMILE Pro shines with its wider correction range, addressing myopia up to -10 diopters and astigmatism up to -5 diopters, and also correcting hyperopia. SmartSight cannot correct hyperopia, and the myopic range is also unclear.
SMILE Pro vs. SILK
SMILE Pro and SILK eye surgeries both excel in reshaping the cornea (the eye’s outermost layer) and restoring clear vision.
Both SMILE Pro (Small Incision Lenticule Extraction) and SILK (Smooth Incision Lenticule Keratomileusis) are minimally invasive procedures that use femtosecond lasers to model the cornea to correct refractive errors such as myopia (nearsightedness) and astigmatism.
However, there are significant differences in their approach, the technology used, and the long-term implications.
Differentiating between SMILE Pro Eye Surgery and Silk Elita Eye Procedure:
Technology
SMILE Pro, developed by Zeiss in Germany, and SILK, created by Johnson & Johnson in the USA, use different laser technologies.
SMILE Pro uses the VisuMax 800 laser, whereas SILK employs the ELITA (Epithelial Laser In-situ Keratomileusis). These differences in laser technology lead to variations in the surgical experience.
Additionally, SMILE Pro represents an upgraded laser platform compared to the already existing SMILE introduced in 2016. SILK, on the other hand, represents an entirely new technological approach.
Treatment Profile
In the Smile PRO operation, the Visumax 800 laser first creates the lower interface of the intrastromal lenticule in a spiral pattern (from outside to inside), forming the refractive surface, followed by the creation of the upper interface in a spiral pattern (from inside to outside), known as the cap, which is a neutral smooth surface. This means that the lenticule is only monoconvex.
SILK uses a raster pattern with a biconvex (double curved) lenticule profile. The problem with this biconvex lenticule creation is that if it is not perfectly aligned or shaped to match the specific visual needs of the patient, a biconvex lenticule can cause distortions or blurriness in vision.
Regulatory Approval
SMILE Pro has successfully obtained FDA (Food and Drug Administration) and CE approval, demonstrating its compliance with stringent US regulatory standards for safety and efficacy. Through rigorous studies and tests, this achievement provides patients with the assurance that the procedure meets strict medical device standards, making it a reliable and effective method for vision improvement.
In contrast, SILK only has CE marking (Conformité Européenne) for compliance with European safety standards, indicating adherence to the safety standards of the European Union. It is important to mention that SILK has yet to receive FDA approval. The lack of US certification may raise concerns among patients who prioritize regulatory safety.
Considering these factors, SMILE Pro proves to be a potentially safer choice for those seeking regulatory assurance and peace of mind.
Correction Range
SMILE Pro excels with its broader correction range, addressing myopia up to -10 diopters and astigmatism up to -5 diopters, and also correcting hyperopia. This is a significant difference.
On the other hand, SILK is recommended by most surgeons to stay within a more conservative range, correcting myopia up to -8 diopters and astigmatism up to -3 diopters.
This difference is crucial for patients with higher refractive errors and hyperopia, as they can choose SMILE Pro to benefit from its extended correction range.
Speed and Comfort of the Procedure
When it comes to surgical efficiency, SMILE Pro has the edge. The laser component of the procedure is completed in just 7-9 seconds per eye, which is significantly faster compared to the 22 seconds per eye with SILK.
This means less time under the laser, potentially reducing discomfort, anxiety, and the overall duration of the operation.
Patient comfort is a critical factor when choosing eye surgery methods, and here SMILE PRO stands out significantly compared to other techniques like SILK. While SILK uses a flat corneal surface during the procedure, which puts pressure on the eye, SMILE PRO employs a gentler approach. This method merely touches the cornea, conforming to its curvature without exerting significant pressure. This results in a considerably lower pressure sensation on the eye during treatment, greatly enhancing the patient experience and increasing comfort during the procedure. Additionally, the difference in the time required for the procedures contributes to the perception of SMILE PRO as much more comfortable. Patients choosing SMILE PRO experience not only effective vision correction but also a more comfortable and less invasive treatment.
Data Availability for System Effectiveness
SMILE Pro, a well-established technology, has gained global recognition and is available worldwide, benefiting over 10 million people. Experienced surgeons around the world use this reliable technology, making it a readily accessible option.
SILK, still in its early stages, has limited availability. It may not be widely accessible in all geographic regions or eye care facilities, resulting in fewer people having undergone the procedure. Additionally, it requires specialized equipment and expertise, making it harder to find a qualified practitioner.
Precision and Control: Robotics vs. Human Hands
SMILE Pro is distinguished by its state-of-the-art technology. SMILE Pro features a fully robotic „Smart Robotic Assistance“ system powered by Artificial Intelligence (AI). This ensures precise and consistent lenticule creation, minimizing the possibility of human errors.
SILK, on the other hand, uses a semi-robotic approach, relying more heavily on the surgeon’s manual skill. While experienced surgeons can achieve excellent results with SILK, the lack of AI-powered robotics introduces potential variability in outcomes.
The SILK device does not have a built-in microscope, meaning the patient must be repositioned under the microscope after completing the SILK procedure. This increases the overall duration of the surgery.
In contrast, the VisuMax 800 used in SMILE Pro has a built-in microscope, optimizing the surgical process and enhancing patient comfort.
Long-term Results: Regression, Safety, Efficacy
SMILE (Small Incision Lenticule Extraction) has emerged as a popular choice for vision correction due to its minimal invasiveness and remarkable long-term stability, offering a lower likelihood of regression compared to traditional LASIK (Laser-Assisted In Situ Keratomileusis). This advantage stems from SMILE’s innovative method of reshaping the cornea without creating a large flap, preserving more corneal integrity and potentially leading to fewer complications and more predictable outcomes.
In contrast, SILK with the ELITA (Epithelial Laser In-situ Keratomileusis) laser system represents a newer technological advancement in vision correction. As such, it carries some uncertainty regarding its long-term effects, including its potential for vision regression. While SILK’s innovative aspects may offer unique benefits, the lack of extensive long-term studies makes it difficult to definitively assess its safety and efficacy over a longer period. This presents a crucial consideration for patients and medical professionals when weighing the risks and benefits of newer surgical techniques compared to more established ones like SMILE and LASIK.
Conclusions
When considering vision correction options, both SMILE Pro, SILK, and SmartSight are effective choices. However, the best decision depends on your specific needs, preferences, and risk tolerance. Consider the following factors:
Safety and FDA Approval: For ultimate peace of mind, the FDA approval of SMILE Pro could be crucial.
Speed: In this aspect, SMILE Pro leads.
Correction Range: SMILE Pro is capable of correcting a wider range of vision problems.
Technology and Future Advances: SMILE Pro offers a fully robotic system and a larger user base, providing a proven track record of success. On the other hand, SILK’s innovative potential may appeal to early adopters.
Patient Comfort: Less pressure on the eye, shorter laser and surgery time bring the comfort advantage to SMILE Pro.
Visual Outcomes: SMILE PRO has extensive data from over 9 million cases. The others lack sufficient data.
Long-term Results: The SMILE procedure has established itself as a formidable choice for those seeking stable and long-lasting vision correction, with over 9 million treatments performed worldwide. The high number of successful outcomes highlights SMILE’s ability to provide a reliable solution for long-term vision improvement, making it a preferred method for many seeking a life free from glasses or contact lenses.
Doctor Choice: The VisuMax 800 used for SMILE PRO is widely available globally and significantly more advanced compared to other systems.
Lasikwelt’s Approach to Lenticule Extraction Methods
At our state-of-the-art Lasikwelt Eye Laser Center, we use the Zeiss Visumax 800 femtosecond laser for lenticule extraction due to its many advantages over other systems. With the advanced technology of the Visumax 800, we offer Smile PRO, Relex Smile, Femto-LASIK, and Presbyond, providing our patients with the best choice for laser eye treatment. Our attractive pricing structures and use of cutting-edge technology enable us to offer excellent care for the correction of myopia, hyperopia, presbyopia, and astigmatism. The Visumax 800 is known for its precision and efficiency, reducing treatment times and improving outcomes. Our commitment to quality and safety ensures that our patients achieve the best possible experience and visual results. Using this state-of-the-art laser system demonstrates our dedication to staying at the forefront of technological development in ophthalmology and offering our patients innovative and reliable treatment methods.
