Tatiana Shilova is the Head of the "Dr. Shilova Clinics" and the Founder of the Russian branch of an international chain "SMILE EYES", the Clinical Expert of the
company "Carl Zeiss" in cataract surgery. Her surgical activity is on average up to 200 cataracts, up to 30 vitreoretinal operations and about 100 laser operations
per month, including all complex cases, cases of combined pathology and severe eye injuries. She combines clinical work with teaching activities-she works as
a CLINICAL PROFESSOR and Training Surgeon in Cataract, Vitreoretinal and Refractive Surgery. She is the Member of the European Society of Cataract and
Refractive Surgeons (ESCRS) and the American Academy of Ophthalmology (AAO). She is Russia's leading expert on laser vision correction ReLEx SMILE.
Purpose: To study results and features of laser vision correction ReLEX SMILE under general anesthesia.
Materials & Methods: The study included 24 eyes from 12 patients between the age groups of 28 and 35 years, undergoing
bilateral surgery with ReLEX SMILE for correction of myopia within the range of -1.65 to-8.15 D (-4.5 ±3.5 D), with
astigmatism of 0 to -2.25 D (-1.15 D). Central corneal thickness (um) from 515 to 580, keratotopography in all cases were
regular. Operations were performed under general intravenous anesthesia by fractional injection of Propofol at doses of
200 to 400 ml with monitoring of blood pressure, heart rate, saturation, and a moistened oxygen supply (3-4 liters per
minute). The ReLEX SMILE was performed in the "Expert mode", the energy level from 26 to 28 MJ (*15), the mechanical
centration of the pre-determined position of the optical axis on the aberrometer, taking into account the Kappa-angel.
At the moment of laser-cuts the eye was fixed manually. The standard separation of the lenticule by Reinstein Lenticule
Separator with the positioning of the eyeball with the help of an assistant.
Results: Visual Acuity in the first day after surgery was 0.95-1.5 (1.15) in all cases. The interface was clean. Patients were
subjectively very satisfied. Keratotopography made after 1 week, 1 month and 3 months after correction showed a good
centration of the optical zone. Comparative evaluation keratotopography data patients after correction by SMILE method
under general anesthesia and patients after operation SMILE under local anesthesia revealed no significant differences.
Conclusion: ReLEX SMILE procedure under general anesthesia makes it possible to obtain high refractive results in
patients with the inability to perform it under local anesthesia. However, it requires a competent anesthesia and high
manual skill of the surgeon.