Quick Recovery SMILE Surgery, Enhancing Vision Quality by Lowering Laser Energy

Foreign visitors often struggle to choose medical institutions for vision correction surgery in Korea. It is important to check if the facility is designated as a Gangnam Medical Tour Center and to verify the medical staff's extensive experience and expertise in the surgery, their use of the latest surgical techniques and equipment, ongoing research efforts, and the implementation of personalized surgeries. Let's take a closer look at the recent trends in SMILE surgery in Korea, which aim to enhance vision quality after vision correction.

SMILE (Small Incision Lenticule Extraction) surgery, which is becoming increasingly popular for laser vision correction for myopia and astigmatism, significantly reduces recovery time by requiring only about 1/10 of the corneal incision compared to traditional LASIK, allowing for a quicker return to daily activities. While SMILE surgery offers faster recovery and greater convenience, it should not be considered as an easy or simple procedure, nor should it be performed in a standardized manner for everyone. Even with the same surgery, the level of vision satisfaction can vary depending on how the procedure is performed.

How long should you plan to stay in Korea for SMILE surgery?

SMILE surgery, which allows daily activities such as face washing, light exercise, and makeup the day after the procedure, is a popular choice among foreign tourists and international students visiting Korea. Foreign patients typically begin online consultations three months in advance to discuss the surgical method, recovery period, interpretation support, the English fluency of medical staff (as patient satisfaction with the procedure and staff is heavily influenced by effective communication), and post-operative appointment schedules. There has been a noticeable increase in foreign patients visiting Korea for SMILE surgery in the fall of 2024.

As it is important to minimize unnecessary time and movement, many foreign patients traveling to Korea often visit the eye clinic directly on the day of their arrival. Surgery is typically scheduled as early as possible during their stay, allowing the remaining time to be used for travel. A one-day surgery program starts with precision tests to assess if the patient's eyes are suitable for vision correction. If SMILE surgery is deemed appropriate, the procedure is performed on the same day. For example, with a week-long travel itinerary, SMILE surgery is performed on day 1, followed by a post-surgical check-up with the doctor the next morning. The patient can then proceed with their planned travel itinerary, with a final outpatient visit before departure to receive instructions on eye drop use and guidance for regular check-ups at a local eye clinic after returning home. A minimum stay of five days is recommended for those undergoing SMILE surgery.

However, ICL lens implantation or PRK surgery may be more suitable, depending on the patient's corneal conditions. In such cases, a minimum stay of two weeks is advised, provided that regular check-ups are possible in the patient's home country. 

Advanced SMILE Surgery, "Low Energy SMILE" Enhancing Vision Quality

Even with the same vision after correction surgery, patient satisfaction with vision quality can vary. All corneal refractive surgeries increase high-order aberrations in the cornea. These high-order aberrations can cause night glare and halos, so the surgery should aim to minimize high-order aberrations from the start. Unlike low-order aberrations like myopia, astigmatism, and hyperopia, corneal high-order aberrations cannot be corrected by changing contact lenses or glasses. As a result, post-operative clarity may differ depending on how the surgery is performed.

After research to reduce corneal high-order aberrations following SMILE surgery, Eyereum Eye Clinic began performing SMILE surgery with lower laser energy in 2016. Lowering the energy applied to the cornea during the surgery resulted in a smoother corneal cut surface, positively impacting vision quality. The importance of a smooth and refined cornea can be compared to eyeglass lenses. Imagine two eyeglass lenses with the same prescription: one clean and smooth, the other scratched. Which lens would provide clearer and more comfortable vision? Clearly, the smooth and clean lens is the better choice. Similarly, the doctor's surgical expertise is essential not only for correcting myopia and astigmatism, but also for ensuring that the corneal surface remains smooth.

According to an SCI paper I co-authored with Yonsei University College of Medicine, when microscopically analyzing the roughness of the corneal lenticule surface after SMILE surgery by energy levels, higher energy levels resulted in increased roughness of the corneal surface. Specifically, in the high energy group above 115nJ, the corneal surface became progressively rougher and more irregular with each 15nJ increase in energy.

"Plasma SMILE" Surgery Performed with Pure Plasma