For over a decade, SMILE® (Small Incision Lenticule Extraction) revolutionised eye surgery. It introduced the world to “keyhole” laser vision correction, offering a minimally invasive alternative to LASIK.
But technology does not stand still. Just as mobile phones evolved from the early bricks to modern smartphones, lenticule extraction has evolved.
SmartSight NOVA, performed with the Schwind ATOS, is widely considered a Second Generation or the successor to the original SMILE procedure. While the basic principle is the same (removing a disc of tissue through a small incision), SmartSight NOVA introduces critical upgrades that address the limitations of the earlier technology.
1. Cyclotorsion Control
The biggest challenge with first-generation lenticule extraction was treating Astigmatism. When you sit up during a consultation, your eye is in one position. When you lie down for surgery, your eye naturally rotates – a phenomenon called Cyclotorsion.
- The earlier systems relied largely on manual markings or the surgeon noting the rotation. If the eye rotated significantly, the astigmatism correction could be off-axis.
- The SmartSight Way: The Schwind ATOS features Intelligent Static and Dynamic Cyclotorsion Control. The laser tracks your eye’s unique iris pattern and automatically compensates for rotation instantly. This allows for astigmatism correction that is significantly more precise.
2. Low-Energy Pulsing
Recovery speed is determined by how smooth the laser cut is. SmartSight NOVA uses a higher frequency laser (up to 4 MHz) which allows for Low-Energy Asymmetric Spacing.
Instead of hitting the eye with high-energy pulses to ensure a cut, SmartSight NOVA overlaps pulses tightly at lower energy. This creates a smoother stromal bed.
Why it matters: A smoother surface means less light scattering (haze) immediately after surgery. This is why many SmartSight NOVA patients report that WOW effect on Day 1 that rivals LASIK, something that was historically inconsistent with older lenticule methods.
3. Pupil vs. Visual Axis
The first systems centered the treatment on the pupil. But you don’t actually look through the dead-center of your pupil – you look through your Visual Axis. SmartSight NOVA centers the treatment on that visual axis. This seemingly small detail is critical for reducing coma or ghosting and ensuring sharper contrast sensitivity, especially in low light.
SMILE® was the pioneer that proved keyhole surgery was possible. SmartSight is the refinement that perfected it. By adding eye-tracking and cyclotorsion control, we can now offer the safety of a lenticule procedure with the precision previously reserved for advanced LASIK.
