Smiles adorned the faces of four patients today at Naval Medical Center San Diego's (NMCSD) Navy Refractive Surgery Center San Diego, after undergoing a new type of refractive surgery called SMILE - the first ever performed at a Navy medical facility.

SMILE stands for Small Incision Lenticular Extraction, and is the newest option for treating myopia, which is also known as nearsightedness.

Today's procedures were led by Cmdr. John Cason, head ophthalmologist at the center. According to Cason, SMILE stands out from other common refractive eye surgery procedures.

"With PRK, you take the skin covering of the cornea off and use a laser that burns away tissue. For LASIK (laser in situ keratectomy), you cut a flap, lift it and then use the laser to burn tissue and then put the flap back down. So that flap has a cut that goes about 270 degrees around the cornea and severs some of those corneal nerves, which can affect the corneal sensation for several months increasing dry eye symptoms. It is also a flap that could potentially become dislocated with trauma," said Cason.

SMILE is a procedure employing the same laser used in Lasik, but instead of cutting a flap the surgeon cuts a tunnel incision much smaller than what would be required for Lasik. "Instead of burning tissue away into the atmosphere, you're now cutting a shape, removing that shape through the tunnel incision and there's no flap. So now you got kind of a combination of the benefits that you have with both Lasik and PRK," he said.

After wearing glasses for 17 years, Lt. j.g. Alyssa Ortiz, a pediatric nurse at NMCSD, became the first person to undergo SMILE at a Navy medical facility. "I have been wearing glasses and contacts for 17 years now and I am tired of wearing them," she said, adding that the benefits of less dry eye and short healing time are the main reasons she chose SMILE.

"The procedure went much easier than I expected," said Fire Controlman 3rd Class Jarrian Solomon, Cason's second patient of the day. "It is a great opportunity and the doctors said SMILE would probably be the best procedure for me to have."

"SMILE is now one of several great options available to our service members for the treatment of myopia. Thanks to the efforts of our fine staff at the Navy Refractive Surgery Center San Diego, our military personnel receive the highest standards of refractive surgery care and vision outcomes," said Cason.

CDR Cason is the lead investigator of an FDA trial investigating the safety and efficacy of SMILE for active duty personnel in coordination with U.S. Army Lt. Col. Bruce Rivers, at the Ft. Belvoir, Virginia-based Refractive Surgery and Research Center, and U.S. Air Force Lt. Col. Matt Caldwell, at the Joint Base San Antonio, Texas-based Wilford Hall Medical Center. The Army, Navy and Air Force are evaluating the new surgical technique together.

"This is a great example of collaboration in the DoD," said Cason. "Now, refractive surgeons combine their time and resources through research studies to shape policy together whenever possible."


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