In this book an international panel of authors offer a clear, step-by-step approach to Small Incision Lenticule Extraction (SMILE), a new refractive procedure approved for the treatment of myopia and astigmatism that is a truly minimally invasive key-hole type surgery. The book opens by discussing important fundamentals of the technology, followed by a close look at the healing response. The current surgical techniques are then described in detail with the aim of providing easy-to-understand guidance for all who wish to perform SMILE surgery or to identify solutions to pitfalls that may arise during the learning curve. Further sections cover the clinical science relating to SMILE (explaining underlying principles), discuss ongoing investigations to further expand the spectrum of SMILE surgery and offer suggestions on how to market the procedure and communicate it to the prospective patient. This guide is “a must” for everyone who wishes to enter the exciting world of SMILE.
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Basic principles: Femtosecond Laser for Advanced Single-Step Corneal Refractive Surgery: Basic knowledge of Physics and Optics.- Wound Healing after Femtosecond Laser Corneal Refractive Surgery.- Corneal Nerve and Keratocyte Response to Relex Surgery. Clinical Development and Current Techniques: Brief Historical Overview of the Clinical Development of Relex Surgical Procedure.- Current Technique and Instrumentation for SMILE.- Refining Results with SMILE: Tips & Tricks.- Overview of Clinical Results for Low and Mid Myopia.- Astigmatism Correction.- Clinical Results in High Myopia.- Complications after SMILE and its Management Including Re-Treatment Techniques.- Management of Laser Settings for Better SMILE Surgery.- Advantages and Disadvantages of Different Cap Thicknesses. Clinical Science Related to SMILE: The Key Characteristics of Corneal Refractive Surgery: Biomechanics, Corneal Sensation, Spherical Aberration and Contrast Sensitivity after SMILE.- Centration in Re LEx Surgery.- How to Improve the Refractive Predictability.- Transmission and Scanning Electron Microscopy of the Extracted Lenticules.- Collagen Characteristics & Refractive Outcomes. Future Concepts: SMILE for Very High Myopia.- Hyperopic Correction by Re LEx.- Concept of Reversible Corneal Refractive Surgery (Lenticule Re-Implantation). Marketing & Patient Communication: Marketing of SMILE.
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Walter Sekundo is a University Professor and Chairman at the Department of Ophthalmology, Philipps University of Marburg, Germany. Professor Sekundo studied Medicine in Mainz and Frankfurt (Germany) as well as New Orleans and Durham (USA). He took his first postdoctoral fellowship in Ocular Pathology with Prof. W.R. Lee at the University of Glasgow (UK). He continued his ophthalmology residency training at the University of Bonn (Germany) and became a board-certified ophthalmologist in 1996. In 1997 he joined the Faculty at the University of Marburg as Junior Consultant (“Oberarzt”) and then took a Corneal and Refractive Fellowship at Moorfields Eye Hospital (London/UK) under Mr. J. Stevens. Following his returning to Marburg he successfully defended his Ph D Thesis (“Habilitation”) in 2001 and was granted the title of “Privatdozent”. He went on to become a Leading Consultant Surgeon (“Leitender Oberarzt”) in Marburg, and Clinical Professor of Ophthalmology in 2006. In the autumn of 2006 he moved to the University of Mainz (Germany) to serve as a Professor and Deputy Chairman. As an ophthalmic surgeon, Professor Sekundo has performed some 20, 000 procedures, including complex cataract and corneal cases, glaucoma surgery, and vitreoretinal procedures. In 2014 Focus magazine ranked him for the fifth time as one of Germany’s leading corneal, cataract, and refractive surgeons. Professor Sekundo has published more than one hundred scientific papers in peer-reviewed and non-peer-reviewed journals and 28 book chapters. He has delivered over 500 presentations at national and international meetings and is also an editorial board member of Der Ophthalmologe. He has twice received the prestigious Leonhard Klein Award from the German Ophthalmological Society for the development of new surgical procedures in Ophthalmology, among them the Small Incision Lenticule Extraction (SMILE) for the treatment of myopia, for which he received the prizejointly with Prof. M. Blum of Erfurt. He also received the 1
st video prize from the American Society of Cataract and Refractive Surgeons in 2008 and from the Video Refrattiva (Italy) in 2009.