How many years have you been performing refractive surgery in general and ReLEx SMILE in particular?

Dr. Zhou: I have been performing PRK for 21 years, LASIK for 20 years, LASEK for 19 years, epi-LASIK for 13 years, and SMILE for about 5 years.

For what reasons did you want to try SMILE?

Dr. Zhou: I liked that the procedure is minimally invasive and that it provides excellent vision quality.

Please share your clinical outcomes with SMILE.

Dr. Zhou: Along with my colleagues, I recently conducted a 4-year observational study of the predictability and stability of SMILE.1 In that study, we concluded that, in the long-term, SMILE provided a predictable and stable correction of moderate to high myopia. What we specifically found was that UDVA was 20/20 or better in 92% of eyes and that 89% were within ±0.50 D of the intended refraction. The safety and efficacy indices were 1.16 ±0.14 and 1.07 ±0.16, respectively. Further, there was no significant change in the spherical equivalent at any of the follow-ups (1, 3, and 6 months and 1, 2, and 4 years).

Has performing ReLEx SMILE been an advantage to your practice?

Dr. Zhou: Yes, of course.

Have you noticed any changes in your surgical volume since offering SMILE? What about patient demographics?

Dr. Zhou: We are now able to treat a larger range of patients, including those with up to -12.50 D spherical equivalent. At the Eye and ENT Hospital of Fudan University, we have treated patients as young as 18 years and as old as 60 years with SMILE.

What is the price of SMILE compared to LASIK and PRK?

Dr. Zhou: Patients pay the same price for SMILE as they do for LASIK and PRK.

Have your noticed an increase in revenue after SMILE?

Dr. Zhou: I believe that our overall revenue has been similar.

How does the postoperative management for SMILE patients compare to LASIK?

Dr. Zhou: The postoperative management process is similar for both surgeries.

In your practice, what is the main “wow” effect for patients?

Dr. Zhou: With SMILE, the biggest “wow” factor that patients communicate is the quick recovery of their visual acuity without any discomfort.

In your clinic, what is the current procedural volume for SMILE?

Dr. Zhou: About 92% of the procedures we perform are laser vision correction. The other approximate 8% is phakic IOLs.

How do you maintain such a high volume of SMILE procedures?

Dr. Zhou: The visual quality after SMILE surgery is the most important factor in why we suggest the procedure to our patients (Figure 1).

Figure 1. Patient satisfaction and visual quality after SMILE.

What is your preferred method of marketing to attract patients to your clinic?

Dr. Zhou: We do not use marketing efforts in my hospital. With that said, I do my best to serve every patient with my whole heart, and our team does its best to achieve good visual quality after every surgery.

1. Han T, Chen Y, Gao Y, He L, Zhou X. Four-year observation of predictability and stability of small incision lenticule extraction. BMC Ophthalmol. 2016;16:149-156.