While SMILE eye surgery is generally safe and effective, complications, though rare, can happen.
Being aware of potential risks helps patients make informed decisions.
What is SMILE Eye Surgery?
Currently, SMILE is primarily approved for treating myopia and astigmatism, with limited use for farsightedness (hyperopia). It involves using a femtosecond laser to create a lenticule (a thin disc-shaped piece of tissue) inside the cornea, which is then removed through a small incision. This process reshapes the cornea, enhancing the focusing of light on the retina. SMILE is a popular alternative to LASIK, but like any procedure, rare complications can occur.
Common Complications in SMILE Surgery
While outcomes from SMILE are overwhelmingly positive, issues can arise. Understanding the possible complications allows patients to make informed decisions.
Prolonged Dry Eye Symptoms
Dry eyes are a common complaint after all forms of laser eye surgery. Although SMILE has a reputation for causing less dry eye compared to traditional LASIK, some patients may still experience prolonged or worsening dry eye symptoms. This happens because the corneal nerves, responsible for tear production, are affected during the procedure.
How to Address It?
- Use prescribed lubricating eye drops.
- Consider punctual plugs to retain moisture in the eyes.
- Follow your surgeon’s aftercare instructions religiously to mitigate symptoms.
Corneal Haze
Corneal haze refers to a clouding of the cornea that can affect vision clarity. While it is a more common complication in surface procedures like PRK, corneal haze after SMILE is rare and usually mild. If it occurs, it is typically temporary, but in rare cases, it may persist longer and impact visual outcomes.
Preventative Measures:
- Anti-inflammatory eye drops can reduce the risk of haze.
- A proper post-operative care regimen lowers the likelihood of prolonged complications.
Poor Visual Outcomes
Some patients report residual refractive errors or undercorrection, where the procedure does not fully correct the vision. Issues such as ghosting, blurry vision, or difficulty seeing in dim lighting conditions can arise in rare cases.
Causes of Poor Outcomes:
- Improper patient selection (e.g., unsuitable corneal thickness or stable prescription levels not confirmed).
- Surgical technique or device calibration flaws.
Remedies:
- Follow-up touch-ups or enhancement surgeries may be required.
- Ensure your surgeon performs thorough pre-surgical assessments to determine suitability.
Infection and Delayed Healing
Although infections are a rare outcome of SMILE surgery, they can lead to severe complications like reduced visual acuity or permanent corneal scarring if not treated promptly.
Preventative Steps:
- Use prescribed antibiotics as directed.
- Avoid touching or rubbing your eyes after surgery.
- Shield your eyes from dirt, dust, and potential irritants during recovery.
Vision Regression
A reduction in visual acuity may occur in some patients months or years following the procedure. Vision regression can occur due to natural ageing or inadequate initial correction.
Solutions:
- Regular eye check-ups to monitor vision post-surgery.
- Enhancement procedures may be required for long-term efficacy.
Factors That Contribute to Complications
Pre-existing Conditions
Certain eye conditions, like extreme myopia or dry eyes, increase the risk of unwanted outcomes. Before undergoing SMILE, patients are advised to undergo thorough assessments to rule out underlying issues.
Surgeon Expertise
The skill and experience of the eye surgeon performing the SMILE procedure are critical. Errors can lead to complications. Opt for a surgeon with a track record of successful SMILE surgeries and strong patient reviews.
Improper Aftercare
Neglecting post-operative care can lead to infections or delayed healing. Strict adherence to post-surgery guidelines significantly reduces risks.
When to Consult Your Surgeon?
If you undergo SMILE eye surgery and experience complications, early consultation with your doctor is vital. Symptoms such as severe pain, redness, persistent blurry vision, or excessive tearing require immediate attention. Prompt medical intervention minimises the risk of long-term damage.
How to Minimise Risks When Considering SMILE Surgery?
Conduct Thorough Research
Before committing to SMILE, conduct exhaustive research on both the procedure and surgeons who specialise in it. Consult reliable clinics with a high success rate and access to the latest technology.
Ensure Personal Suitability
Not everyone is a good candidate for SMILE. Disclose all medical history and current medications to your doctor during consultations. An ethical and skilled surgeon will only perform the procedure if you meet the necessary criteria.
Follow Post-operative Instructions
Your responsibility does not end after the surgery. Adhering to aftercare instructions, such as wearing protective eyewear and avoiding strenuous activities, is crucial to safeguard healing and prevent complications.
Consider Getting a Second Opinion
If you have doubts or unanswered questions about SMILE, don’t hesitate to seek a second opinion. Getting insights from another experienced surgeon can provide clarity and help you make an informed decision.
The Emotional Impact of SMILE Surgery Gone Wrong
For some, complications may not only affect physical vision but also take an emotional toll. Patients who encounter adverse outcomes may feel regret, frustration, or anxiety. If you’re grappling with these feelings, consider:
- Consulting a Vision Specialist: Discuss your concerns and potential corrective measures.
- Seeking Emotional Support: Sharing your experience with others who have encountered complications can provide emotional relief and practical solutions.
- Educating Others: Turning your experience into an opportunity to raise awareness empowers prospective patients to make informed choices.
Is SMILE the Right Choice for You?
SMILE eye surgery offers life-changing benefits to countless patients around the world. However, understanding the risks is just as important as exploring the rewards. The success of your surgery largely depends on careful planning, the surgeon’s expertise, and adherence to aftercare protocols. Equip yourself with the right knowledge and take the time needed to make an informed decision.