RelEX SMILE Diopter Reduction

RelEx SMILE laser surgery is the most up-to-date technique for reducing diopters, which can be performed with the Carl Zeiss Meditec VisuMax femtolaser laser.

How do you know you need RelEX SMILE surgery?

You may occasionally experience blurred vision, vision in a brown or yellow shade and difficulty seeing well at night, along with sensitivity to bright light and the presence of halos around lights, especially at night. All of these symptoms are clear evidence that you need an eye examination.

The investigations required for this intervention are as follows:

  • visual acuity
  • kerato-refractometry
  • corneal examination with Pentacam
  • examination of the fundus
  • pachymetry
  • corneal topography
  • pupil diameter
  • ocular biometry
  • visual field

Even if these investigations are appropriate for the procedure, there are some cases when it is not recommended. These include age under 18, unstable diopters, eye disorders, history of herpes simplex or shingles in the eyes, etc.

What does the RelEX SMILE surgery involve?

The RelexSmile technique uses femtosecond laser technology to correct diopters. It does not involve removal of the epithelium, as is the case with PRK, nor does it involve flap cutting (FemtoLasik technique).

The procedure is minimally invasive, and is performed using the innovative VisuMax® Zeiss system, which is currently the only femtosecond precision laser to perform SMILE. It is also the laser with the lowest pressure increase in the eye, low enough that the patient feels nothing during the procedure. In a single step, a refractive lenticule and small incision is created, inside the intact cornea. The laser makes a series of pulses in the cornea, outlining the tissue to be removed and creating a small connecting tunnel through which it can be extracted. The rest of the cornea remains intact, and the femtosecond laser changes the shape of the cornea to achieve the desired refractive correction. The whole process takes less than four minutes.

The patient sees well immediately after the surgery and the recovery is completely painless. Vision recovers in a very short time, usually requiring only 72 hours rest, after which patients can return to their daily activities. The full healing process can take up to 3 months, but the patient feels no discomfort during this time.

What to expect after RelEX SMILE surgery?

RelEX SMILE turns laser ophthalmological surgery into a minimally invasive procedure that can be performed in minutes. There is no pain during surgery, the recovery period is short and visual acuity stabilizes very quickly after surgery. Your vision will start to improve within a few hours and will be almost normal after the first 24 hours. However, vision may be slightly blurred in some patients and returns to normal within 2-4 weeks. The complete corneal healing time after ReLEx SMILE will take approximately 3 to 6 months. You can resume daily activities after approximately 24-72 hours after surgery. Add this to the short time of the surgery itself and you have an incredibly convenient and effective procedure that is suitable for athletes, business people and anyone with an active schedule.

The day after the procedure, you will have a check-up, and the doctor will check the progress of your vision after the surgery.

Patients reported up to 80% better vision within hours of surgery. Your vision will continue to improve over the coming weeks as you continue to follow the clinic’s recovery instructions. Over the next few days you should gradually resume normal activities as your cornea heals.

Unlike other laser procedures, there is a lower risk of developing chronic dry eye syndrome or corneal flap displacement following surgery. To make sure you are on the road to a quick and comfortable recovery, it is very important to have regular check-ups, as well as following treatment as instructed.

What complications can occur after RelEX SMILE surgery?

Side effects for ReLEx® SMILE vary from person to person, but what commonly happens in patients is blurred vision and dry eyes. All of these side effects are usually temporary and will gradually disappear a few months after ReLEx® SMILE. In extremely rare cases infections can occur, but they are 100% treatable so this would not be a problem either. Infections occur much more often in contact lens wearers, for example, rather than those who have RelEX SMILE.

Possible temporary side effects during the healing process:

  • Increased sensitivity to light and glare
  • Temporary overcorrection
  • Burning, itching, foreign object sensation due to dry eyes

What are the specialist's recommendations after RelEX SMILE surgery?

Although RelEX SMILE eye surgery requires a short recovery time, you should gradually resume activities in the days following surgery as the cornea heals. Avoid any activities involving water, such as swimming in pools or using a jacuzzi for the first few days after the procedure. Make sure no water gets into your eyes – even in the shower – until you are completely healed. Cut back on exercise for at least two to three days. You should be able to return to normal daily exercise only with your ophthalmologist approval.

The day after the procedure, you will have a check-up with your surgeon. Be sure to inform it of any side effects or vision progress during these appointments.

To ensure that your SMILE eye surgery recovery is quick and easy, follow these recommendations in the weeks following surgery:

  • Don’t wear makeup – Makeup applicators and brushes can be associated with micro-bacteria that can lead to severe eye infections. To avoid any disruption to a healthy recovery, avoid makeup for at least a week after surgery.
  • Continue to take all medications and eye drops as directed by your ophthalmologist – In the following weeks after surgery, you will need to continue taking all eye drops and prescribed medications. Even if side effects begin to decrease, you should always continue to follow all aftercare instructions. Do not use unapproved eye drops, painkillers or medications while recovering from RelEX SMILE surgery.
  • Wear protective glasses – Make sure you wear while you sleep the protective glasses received. Whenever you go outside, you will need to protect your eyes from harmful UV rays with polarized sunglasses. Avoid any possible eye injury by wearing protective glasses when participating in any contact sports or other such activities.
  • Avoid areas with smoke or dust in the air – In the weeks after surgery it is best to avoid areas with airborne particles such as sand, smoke or dust. Small irritants of this kind can cause eye damage or cause discomfort as you heal.
Text medically reviewed by Dr. Teodor Holhoș, Ophthalmic Surgeon
Written by Dr. Holhos Team

SMILE PRO is the second generation of SMILE surgeries. Following the success of RelEx SMILE, Zeiss has developed the next level of this technology.

RelEx SMILE laser surgery is the most up-to-date technique for reducing diopters, which can be performed with the Carl Zeiss Meditec VisuMax femtolaser laser.

The FemtoLASIK surgery is part of the suite of refractive surgeries available in the Dr. Holhoș network, and is part of the 2nd generation of laser surgeries.

Excimer Laser Diopter Reduction surgery is for those who want to get rid of glasses and have been diagnosed with myopia, astigmatism, myopia and myopic astigmatism, hypermetropia.

Presbyopia is an age-related disorder that makes it more difficult to see nearby objects.

High diopters (myopia, hypermetropia, astigmatism or presbyopia) can be corrected with a lens implant. The procedure is similar to cataract surgery, except that in this case the lens is replaced before the cataract appears.

Lens implant surgery (cataract surgery) is necessary for people with cataract and is the only method of treatment. Find out what the surgery involves and what the consequences are.

The eye is a very complex organ, the component parts working as a whole so that we can see. The center of the eyeball contains vitreous fluid, a clear gel that maintains the spherical shape of the eyeball.

The vitreous body is located in the center of the eyeball, between the lens and the retina, and appears as a “gel”. A healthy vitreous is completely transparent allowing light to reach the retina without any problems, resulting in a clear vision.

Retinal membranes are diseases of the interface area between the back of the vitreous and the central area of the retina, the macula; they are characterized by the appearance of a translucent “sheet” in this area, which pulls and folds the macula, thus affecting the retinal cells and causing specific symptoms.

Glaucoma is a chronic, bilateral eye disorder characterized by progressive destruction of the fibers of the optic nerve, the nerve responsible for transmitting information from the eye to the brain. Learn more about glaucoma surgery.

Pterygium is a triangular extension of the degenerated bulbar conjunctiva (the transparent sheet above the eyeball) over the edge of the cornea.

Crosslinking surgery is the procedure used for patients with Keratoconus, a disorder in which the cornea is deformed.

See all

You can make an appointment quickly via the form on the right, or directly over the phone. Our colleagues at the reception desk will be happy to provide you with the availability and information you need to make an appointment. Filling in the form does not represent the registration or confirmation of an appointment, but submitting an appointment request. You will be contacted by our team to check the availability of doctors and make an appointment.


Important note regarding patient consultations and surgery appointments

A patient who cancels a consultation or surgery appointment once, at least one day prior to the scheduled appointment, has the right to a second appointment under the same conditions.
If the patient cancels the second consultation and/or surgery appointment, a new appointment can be made only if the patient accepts to pay for both the consultation and the surgery in advance. This can be done either by payment order or in cash at the clinic reception.
A patient who does not show up for their consultation or surgery, who does not cancel the appointment in due time, or does not answer the clinic’s calls, may request a second appointment only if they pay for the consultation/surgery in advance. 
Patients requesting an appointment for retinal surgeries or laser Prk/Femtolasik/Smile Pro must pay 30% of the cost of the surgery in advance. The appointment will be scheduled only after receiving the advance payment. If the patient is unable to attend the scheduled consultation or surgery, and cancels the intervention at least 48 hours beforehand, they will be refunded in full. If the patient does not show up and does not cancel or contact the clinic at least 48 hours in advance, the advance paid is considered to be lost as damages and will no longer be refunded.