[5th Generation LASIK] Smart vs. SMILE Pro: Which is better for astigmatism correction?

Hello. This is Gangnam Smile Eye Clinic 😊

Today, we will compare astigmatism correction between Smart LASIK (=New SMILE) and SMILE Pro, both referred to as 5th-generation LASIK, based on papers presented at the 2023 ESCRS (European Society of Cataract & Refractive Surgeons) conference, where Dr. Hyo-Sung Yoon, director of Gangnam Smile Eye Clinic, was invited to speak.

(First presentation of SmartSight surgical results in Korea)

https://blog.naver.com/smileeye2019/223334600674?trackingCode=blog_bloghome_searchlist

What is 5th-generation LASIK?

First, SMILE surgery, known as 4th generation, differs from 3rd generation LASIK and LASEK in that it minimally touches the corneal epithelium and corrects the stromal tissue. It combines the advantages of LASIK (fast recovery) and LASEK (safety due to no flap).

However, conventional SMILE also had drawbacks such as:

limited astigmatism correction for small amounts

halo and glare

5th-generation LASIK is a surgical procedure that adopts the already proven ‘SMILE’ method, ensuring safety as a foundation, while compensating for the aforementioned drawbacks with upgraded technological equipment.

Among the improvements over the 4th generation, the most significant is the ‘amount of astigmatism correction’.

Conventional SMILE surgery had the disadvantage of being difficult for eyes with high astigmatism.

Moreover, there were many results indicating that residual astigmatism after surgery was significantly inferior compared to LASEK.

So, among the 5th-generation vision correction surgeries that are often compared these days, Schwindt Atos and Visumax800 (= Smart vs. SMILE Pro), which one is the winner for astigmatism correction when comparing post-operative results from papers?

First, residual astigmatism within +-0.25D after surgery is generally considered the best astigmatism correction.

Within +-0.5D is also considered a very good range for astigmatism correction.

According to the paper presented by Chief Director Hyo-Sung Yoon at the conference, Smart LASIK performed with Atos showed a remarkable 99% of residual astigmatism within +-0.5D!

(= This means that 99% of patients after surgery have a residual astigmatism value within an error range of +-0.5D.)

(= The higher the percentage, meaning more patients are within a small error range, the better the result.)

For reference, although the same Atos machine was used for surgery, the residual astigmatism within +-0.5D reported in China was 89%, indicating that the difference in results due to the surgeon's skill cannot be ignored.

(The surgical results from Gangnam Smile Eye Clinic in Korea are significantly higher, aren't they? 😊)

Now, let's look at the paper results for Visumax800.

It was reported as 89% within the +-0.5D range.

As explained above, there may be differences due to the surgeon's skill, but comparing it to Gangnam Smile Eye Clinic's result of 99%, it would be difficult to consider the astigmatism correction result as good.

Additionally, residual astigmatism within +-0.5D for Visumax800, as presented by the famous Dr. Dan from London, also showed a value of 84%.

Comparing this to the previous Visumax500 (i.e., 4th-generation SMILE equipment) which showed similar 80% range within +-0.5D, these research results are even more disappointing.

We also additionally compared higher-order aberrations before and after surgery, which is a criterion indicating the quality of vision after surgery.

According to the results presented by Director Hyo-Sung Yoon, our clinic using Atos showed a change from 0.32 to 0.38, indicating almost no difference before and after surgery.

On the other hand, for Visumax800, the difference is very large, from 0.37 to 0.64.

If the centration function during surgery works well, there is little change in higher-order aberrations.

In the case of Atos, the machine automatically tracks, but with Visumax800, the surgeon must manually mark the cornea and adjust the angle, which can lead to significant variations depending on the surgeon.

Conclusion: Although Visumax was introduced with excellent results, further observation of its progress will be necessary.

If you would like to see more detailed information about this post, please refer to the video content:

https://youtu.be/3oxqkfRKI04?si=JvO64x7v6GJvTWxc

Our next post will be: 'Why is Atos's laser irradiation time longer than Visumax Pro?'

Gangnam Smile Eye Clinic always puts patients first and prioritizes transparency and safety.

If you have any other questions, please feel free to contact the eye clinic anytime 😊

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