The ReLEx SMILE Technique in refractive surgery · ReLEx SMILE: flapless & minimally invasive Small...

$: The ReLEx SMILE Technique in refractive surgery · ReLEx SMILE: flapless & minimally invasive Small incision - big advantage Minimally invasive surgery: 80% less side cut (compared$
The ReLEx SMILE Technique

in refractive surgery

Moschou Konstantinos M.D.

Diathlasis Day Care Unit

2016 TVRS Open Day

Electra palace

Thessaloniki Mediterretina School

I HAVE NO FINANCIAL INTEREST

Diathlasis Day Care Unit, Thessaloniki, Greece

VisuMax – the only femtosecond laser made for ReLEx SMILE


Spherical patient interface and unique corneal

suction for minimum eye irritation

Less tissue compression

Automated vacuum system

Shortest suction time

Minimal IOP increase

No vision loss during suction

Lowest IOP increase during treatment for all

fs-systems on the market

VisuMax – the only femtosecond laser made for ReLEx SMILE


ReLEx The next generation method for laser vision correction

PR

K

LASEK

Epi-LASIK

LA

SIK

Standard LASIK

Femto-LASIK

R

eL

Ex

Flex Femtosecond Lenticule Extraction

Smile Small Incision Lenticule Extraction


//cznet/dfsroot/dejen/Czm5/R_Refraktiv/Marketing/Messen_Kongresse_2008/AA0_2008_Atlanta/Booth PPT Refractive Lasers/refractive_pres.exe

ReLEx SMILE The 3rd generation Laser Vision Correction

“SMILE is LASIK without a flap and PRK without pain.”


ReLEx

ReLEx®

ReLEx® SMILE

ReLEx® FLEX

Femtosecond Lenticule Extraction Small Incision Lenticule Extraction

Advancement


ReLEx flex


ReLEx Released treatment range for myopic indication

ReLEx option for VisuMax provides the following indication range:

Myopic sphere range: -0.50 … -10.00 D

Cylinder range: 0 … 5.00 D

Spherical equivalent range: -0.75 … -10.00 D

The ReLEx myopic treatment range covers almost 85% of the common

patients population

ReLEx shows excellent outcomes for higher corrections > -7 D opening a

new target segment


ReLEx smile Flapless. All-femto. Single step.

Step 1

In a single step, the VisuMax

Femtosecond laser creates a

refractive lenticule and a small

incision of less than 4mm in the

otherwise intact cornea – more or

less regardless of the ambient

conditions or individual corneal

stucture.


Step 2

The lenticule is then manually

removed through a very small

incision in the cornea. This

means there is no need for a flap

cut, and the disruption to the

biomechanics of the cornea is

minimal in comparison to other

methods.



Step 3

The removal of the

refractive lenticule changes

the shape of the cornea,

permanently correcting the

refractive error.



ReLEx SMILE: flapless & minimally invasive Small incision - big advantage

Minimally invasive surgery: 80% less

side cut (compared to LASIK) 30% less

cap cut

Greater integrity of upper corneal layers

Indicates preservation of corneal

biomechanical stability

SMILE combines the advantages of PRK and LASIK.


Less nerves severed

Indicates less varying severity of dry eye syndrome

No flap ⇾ minimizes the risk for flap complications such as

epithelium ingrowing, flap dislocation, infections

Faster healing of epithelium

ReLEx SMILE: flapless & minimally invasive Small incision - big advantage


ReLEx All-Femto: precise and robust Lenticule extraction advantages over cornea ablation

No laser calibration or fluency test with impact on treatment

result required

No controlled airflow and plume removal necessary

Refractive correction by femtosecond lenticule cut is not affected

by ambient room conditions

Fully corrected optical zone from center to periphery

Corneal topography maps post-op confirm prolate shape of optical

zone

ReLEx SMILE user reports showed lower induction of wavefront

errors than LASIK, in particular for spherical aberration


Single step: fast & efficient A new principle for a better workflow

ReLEx

Flap cut

Patient transfer

Tissue ablation

LASIK

Flap opening

Lenticule cut

Lenticule extraction

12 min*

20 min*

Femto laser

Manual

surgery

Excimer laser


ReLEx SMILE The new surgical procedure


Statistical analysis of ReLEx SMILE, based on a sample of Diathlasis Day Care Unit.

Gender distribution

Prefecture distribution

Age distribution

Distribution of pre-operative & post-operative SE refraction

Predictability

Stability (post-operative SE 1w, 1m, 3m, 6m & 12m)

Seasonality (preferred season undergoing SMILE procedure)


Gender Distribution

27%

73%


Prefecture Distribution


Age Distribution


Statistical analysis of patients, undergone ReLEx SMILE

Age = (28.400 ± 5.935) years 21 years < Range of Age < 48 years SE refraction = (-6.911 ± 1.791) D -2.500D < SE refraction range < -12.000D SE correction = (-0.143 ± 0.435)D 0.625D < SE correction range < -2.250D

Mean Standard

Deviation Mode Range

Age (n=150 eyes) 28.400 5.935 23 21 48

Pre-operative SE

(n=146 eyes) -6.911 1.791 -5.5 -2.500 -12.000

Post-operative SE

(n=146 eyes) -0.143 0.435 0.00 0.625 -2.250


Distribution of pre-operative SE refraction

Pre-operative SE (D) Eyes (n=146) Eyes (%)

> 10.50 3 2%

-8.01 to -10.50 37 25%

-6.01 to -8.00 55 38%

-3.01 to -6.00 50 34%

-3.00 < 1 1%

total eyes (n) 146 100%


0

20

40

60

80

100

120

> -2.25 -1.01 TO -2.25 -0.51 TO -1.0 -0.01 TO -0.50 0.00 +0.01 TO +0.65

0 7 11 12

103

13 0,0% 4,8% 7,5% 8,2%

70,5%

8,9%

Eyes

(n)

1 month post operative SE (D)

Post-operative SE for patients undergone SMILE procedure

Eyes (n=146) Eyes (%)

Post-operative SE (D) Eyes (n=146) Eyes (%)

> -2.25 0 0.0%

-1.01 to -2.25 7 4.8%

-0.51 to -1.0 11 7.5%

-0.01 to -0.50 12 8.2%

0.00 103 70.5%

+0.01 to +0.65 13 8.9%

Distribution of post-operative SE refraction


Predictability of ReLEx smile 1 month post-operative correction


Stability of SE Refraction for 1 month, 3 months, 6months & 12 months post-operative outcome


Preferred season

SMILE

Season Eyes (n=150) %

Spring 40 27%

Summer 36 24%

Autumn 32 21%

Winter 42 28%


CONCLUSION

ReLEx smile is an exciting new treatment in refractive surgery

Better biomechanical stability

Patients in the ReLEx SMILE group had fewer higher-order

aberrations after surgery compared with femtosecond LASIK

patients

Significantly reduce risk of developing dry eyes

Indicated for athletes and for people involved in sports


Thank you and don’t forget to smile!

The moment flapless surgery becomes clearly visible: in a smile.


The ReLEx SMILE Technique in refractive surgery · ReLEx SMILE: flapless & minimally invasive Small...

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