Surf Cat

After years of wearing contacts or glasses, he can see without needing either one due to the latest thing in laser-assisted vision correction.

On Oct. 17, Garcia underwent a procedure called SMILE, the acronym for “Small Incision Lenticule Extraction, performed by Dr. R. Krishna Sanka at the Kenosha location of the Eye Centers of Racine & Kenosha.

The procedure is the latest surgical laser tool for medical providers to correct vision. It joins the longer-established laser techniques, photorefractive keratectomy, known as PRK and Laser-Assisted In Situ Keratomileusis, or LASIK.

All three address the correction of sight by adjusting the shape of the cornea, explained Sanka

To see, light enters the eye through the cornea, pupil, iris and inner lens at specific angle to reach the retina at the back of the eye which in turn sends image information to the optic nerve in the brain.

When a person has misshaped corneas he or she experiences vision challenges such as nearsightedness and regular astigmatism.

Laser technologies of SMILE, LASIK and PRK address this through different methods of removing tissue from the cornea.

In use since the late 1990s, LASIK and PRK use a two-step, two laser process; SMILE, just one laser.

Describing these procedures Sanka said,

“With LASIK one laser cuts a flap in the corneal tissue which is lifted up. The patient is then transferred to another laser that removes corneal tissue and reshapes it per the patient’s prescription.

“PRK does not make a flap but the surgeon removes the surface cells of the cornea and then uses the laser to reshape it to the prescription.”

Sanka noted that one of the reasons some patients chose LASIK over PRK is decreased healing time. Others choose PRK because they don’t want to have a flap cut into their eyes.

SMILE utilizes only one laser which does not touch the surface of the cornea but cuts and removes a very thin sliver from within the cornea (a lenticule). “Then the overlying layer of cornea collapses into the empty area, and the vision is corrected,” Sanka said.

The incision through which the lenticule is removed is only about 4 millimeters compared to that used by LASIK which is about 20 millimeters, noted Sanka.

Fast healing times and a very minimally invasive incision gives SMILE all of the benefits of both LASIK and PRK, Sanka said.

Introduced in Europe in 2007, SMILE has been in use in the U.S. following FDA approval in 2017.

First in the area

Looking to expand its offerings in laser surgery to its patients, the Eye Centers of Racine & Kenosha recently purchased a VisuMax laser from the Carl Zeiss company capable of performing SMILE procedures.

Sanka is the first and currently only ophthalmologist in Wisconsin or Illinois to perform SMILE. “If we didn’t offer it here, patients would have to go to Minnesota or Detroit,” he said.

Although Sanka had performed SMILE previously in Mexico, Garcia’s Oct. 17 procedure was the first SMILE procedure done in Kenosha. To date he has performed over ten SMILE procedures in Kenosha.

Garcia says he found his way to Sanka’s Kenosha office after getting fed up with wearing glasses and contacts for most of his 24 years.

“My eyesight got worse as I got older,” Garcia said. As his prescription got stronger, the glasses got thicker. Going to contacts worked but the more he wore them, the drier his eyes got, he said.

“I just wanted to take my contacts out but then I was completely blind; I might as well stay at home,” he said.

Garcia, a Racine resident and area manager at Amazon, sought out the Eye Centers of Racine and Kenosha for a permanent solution that would allow him to enjoy an active lifestyle.

Garcia says Sanka talked with him about laser vision correction, explaining LASIK, PRK and the newest tool in his toolbox, SMILE.

Garcia said SMILE appealed to him due to its lower risk of infection and fast healing time.

“Alberto was had a significant amount of nearsightedness which made SMILE an ideal procedure,” for him, Sanka said.

“He also demonstrated an understanding of what he was getting in for and how to take care of himself post-procedure.”

A quick procedure

Like other laser surgeries, SMILE is a quick procedure. “The actual laser portion of the procedure only takes about 24 seconds. Then the surgeon uses tools to remove the piece of corneal tissue and that takes a few minutes. To do both eyes, the procedure takes about ten minutes at the most—It’s pretty amazing,” Sanka said.

Sanka says that most patients feel nearly nothing during surgery.

“It’s a very gentle procedure,” Sanka said “Patients describe it as the feeling of having a contact lens put on their eye.”

Garcia says he “felt his eye move” but no pain during the procedure.

Post-op he says he felt pain, however. “I should have gone home immediately and gone to sleep but I didn’t. After I finally went to sleep it was OK because I woke up with zero pain.”

Not everyone is a candidate for SMILE — if someone’s eyes are already naturally too dry Sanka says he may decline treatment.

Significant malformations of the cornea may also preclude a patient from receiving SMILE corrective surgery, Sanka said.

But for those who qualify, SMILE is a good option, added Sanka.

“SMILE is a proven, gentle and fast procedure to help reduce the need for glasses and contacts,” Sanka said.

“The day of the surgery I could already see ten times better,” Garcia said. “It’s the best money I ever spent,” he said.

“SMILE is the latest tool to offer the Kenosha community; we feel very privileged to offer this,” Sanka said.