ReLEx SMILE

Smile at SMILE! The revolutionary third generation of laser vision correction: a single painless laser.

The Future of Vision Correction Is Now

ReLEx SMILE (Small Incision Lenticule Extraction) is at the forefront of technological innovation in refractive surgery as it is based on a single laser treatment. Unlike FemtoLASIK and PRK, ReLEx SMILE does not require the creation of a corneal flap or surface ablation respectively. Thanks to this fast non-invasive procedure based on a single Zeiss VisuMax® painless femtosecond laser, the surgeon is able to make one or two small lateral incisions of 2 to 4 mm (0.08″ to 0.16″) in less than 28 seconds. The surgeon then extracts a tiny disc of tissue of up to 7 mm (0.27″), known as lenticule, which has been sculpted by the laser to the desired correction. The procedure takes less than 2 minutes per eye and relieves the stress associated with switching lasers. No injections are required. Local anesthetic eye drops numb the eyes.

ReLEx SMILE is recommended for the treatment of myopia and myopic astigmatism. It is a safe and effective procedure that guarantees rapid recovery.

XTRA: The Xtra Advantage in Refractive Surgery
The purpose of this parasurgical therapy, also known as ‘corneal photodynamic treatment’, is to enhance the connections between corneal fibers and increase their strength. This reduces the risk of corneal weakening over time and improves long-term refractive stability.

The XTRA procedure involves two main steps:

  • during the first phase, the cornea is saturated with Riboflavin eye drops (Vitamin B2) for approximately 10 minutes per eye
  • the second phase involves exposing the corneal tissue to low-dose ultraviolet A (UVA) light for another 10 minutes. The combined action of Vitamin B2 and UVA rays increases the molecular cross-links that strengthen the innermost layers of the cornea, making it stiffer and less susceptible to degradation

The new XTRA procedure allows ReLEx Smile to be safely performed on patients with borderline corneal features, such as thin corneas or corneal irregularities. It also offers a solution for cases where high ablation levels are required, leaving residual corneal thickness within the limits specified by treatment nomograms.

ReLEx SMILE Procedure Steps

Step 1 Lenticule Creation

The VisuMax® femtosecond laser creates the refractive lenticule (a tiny disc of tissue) in the cornea and then makes a small incision of less than 3 mm (0.12″), all in a single surgical step

Step 2 Lenticule Extraction

The lenticule is removed through the less than 3 mm-long (0.12″) incision made at the end of the first step, with minimum impact on the corneal biomechanics

Step 3 The extra procedure

At the end of the surgery, the instromal pocket created by the removal of the lenticule is flushed with a corticosteroid antibiotic solution

Step 4 Error Correction

Removing the lenticule reshapes the cornea and allows for the desired vision correction

The Best Candidate
  • 22 years old and above
  • Myopia between 1.00 to -10.00 diopters
  • Astigmatism up to -5.00 diopters
  • Stable eyeglass prescription in the 12 months prior to surgery
  • Corneal topography, pachymetry and pupillometry within the reference range
  • Good overall eye health and no history of previous eye diseases
  • Not pregnant

The Benefits of ReLEx SMILE

  • Shorter procedure time with greater patient comfort
  • Can be performed on thin or flat corneas and on deep-set eyes
  • Excellent postoperative corneal tensile strength
  • No problem with any sport including contact sports or those inducing intraocular pressure increases
  • Rare risk of dry eye after surgery
  • Excellent vision correction outcomes
  • Rapid recovery time
  • No postoperative pain or discomfort
  • No corneal opacities
Visual Recovery
  • No intraoperative or postoperative pain
  • Visual recovery on the day after surgery (patients can resume normal activities with no mechanical, traumatic or visual restrictions)
  • Quality of vision keeps improving in the days following surgery

Potential Risks and Complications of ReLEx SMILE

ReLEx SMILE is the least invasive laser eye surgery procedure of all. Although innovative technology reduces the risk of complications, under and/or overcorrection may still occur as in all other procedures.
Some patients mention a postoperative foreign body sensation, which usually goes away shortly after surgery.
This is a relatively new technology (7-year follow-up) and no long-term studies exist. However, the procedure is practically risk-free and produces excellent outcomes when it is carried out by an experienced laser eye surgeon with manual skills honed in a wide range of laser treatments at state-of-the-art clinics with the highest quality standards and thorough control procedures.

Make an appointment today

Dr. Appiotti performs laser eye surgery in state-of-the-art eye clinics in Milan or Verona. To make an appointment and determine whether you are a good candidate for the laser treatment available for your vision problem, please contact us by email or phone

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