Does Finding the Center of the Eye Prevent Complications in SMILE Surgery?

Does Finding the Center of the Eye Prevent Complications in SMILE Surgery?

There are several reference points for determining the “center” of the eye. The visual axis is not aligned with the center of the cornea or the pupil. The visual axis is the line that connects the object we are focusing on with the fovea, the central part of the retina responsible for sharp vision. For the most accurate correction, surgery should be centered on this visual axis.


If the surgery is centered on the corneal center or pupil center, and there is a significant difference from the actual visual axis, it can lead to irregular astigmatism or glare and halos after surgery.


LASIK and LASEK surgeries allow for adjustment based on the visual axis using computer-guided systems.

However, SMILE surgery does not currently offer this alignment capability.



During SMILE surgery, the device gently presses and suctions the eye to perform the procedure.


The eye is connected to the surgical machine, and patients are instructed to look straight at a blinking light during the process.


However, once the eye is fixated and connected to the device, the blinking light may appear slightly off-center from the patient’s perspective.

It’s important to keep focusing on the light, even if it feels slightly off.

If the patient tries to move their eye instead, suction loss can occur — where the eye disconnects from the machine.


What Happens If Suction Loss Occurs during SMILE LASIK Surgery?



If the suction is lost, the procedure is immediately halted. The surgeon may be unable to complete the SMILE procedure and will switch to LASIK or LASEK instead. Alternatively, the surgeon might resume SMILE by creating a slightly larger corneal lenticule using additional tissue.



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