SMILE LASIK Side Effects Can Be Avoided! 3 Key Pre-Op Checks

Hello, this is BGN Eye Clinic at Jamsil Lotte Tower.

Today, I would like to discuss a topic I address dozens of times a day in my consultation room: preventing SMILE LASIK side effects and the three essential pre-operative checks. Feel free to relax your eyes and smile a bit while reading this article.

By the way, something major happened at home yesterday. My boiler suddenly broke down, and as soon as I woke up in the morning, I found myself rubbing my eyes in confusion, thinking, 'What do I do now?' A cold shower on a winter morning? That was not just a 'willpower test' to unlock human potential; it felt like straight-up punishment. Just imagining washing my hair was enough to shock my eyes wide open.

So, after much deliberation, I made the wisest (and warmest) decision possible: I headed straight to a nearby local sauna. The moment I closed my front door, I caught myself thinking, 'Wow... I am truly living life to the fullest today...' Stepping into the warm water, all the cold and frustration instantly melted away, leaving me to think, 'Ah, yes. Life should be this warm and cozy.'

I washed up, cleaned my hair, and even gave my tired eyes a gentle warm rest at the sauna. After all, I couldn't possibly present myself to my patients in an unkempt state. 

Once I composed myself and opened the consultation room door, I reaffirmed my commitment: 'Let's welcome our patients today with a clean and prepared posture.' In fact, every small detail of daily life ultimately serves as preparation to treat patients safely and prevent side effects. Just as I washed with warm water at home, there are many things to check and prepare for your eyes before surgery. The same applies to SMILE LASIK. Thorough preparation ensures a comfortable and safe outcome after surgery.

I received quite an intense lesson on 'the importance of preparation' from our household boiler this morning. Therefore, today I would like to share three essential checking points to safeguard your eyes, wrapped up in a relaxed and engaging story alongside the lesson learned from my sauna-bound morning. Are you ready?

Introduction: Even a Chief Surgeon Wants to Smile Sometimes

After finishing yesterday's consultations and returning home, I stood in front of the mirror for a moment. Looking at myself thinking, 'How exhausted must I have been today...', I unknowingly mumbled, "Ah, my head hurts, my eyes are tired, and my shoulders are so stiff..." Well, even a chief surgeon is human after all.

While I always greet patients with a bright smile in the clinic, the truth is that not every day can be identical; some days are harder, others are brighter. Looking back at yesterday, it was an immensely hectic day. The number of surgeries was high, and as soon as the door opened, another patient walked in, followed by another, and another... I barely managed to eat lunch, relying on a few sips of coffee to power through the day.

Even amidst such a schedule, because every patient's eyes are invaluable, I must stay fully focused. (That is precisely why I am here.) This is why I find myself repeating explanations about pre-op checklists, side effect prevention, and recovery management dozens of times a day. From a patient's perspective, you might think, "Ah, the doctor is covering that topic again..." However, that repetition is precisely what builds the foundation of safety.

One of the most frequent questions I receive in the clinic is about SMILE LASIK side effects: "Doctor, can side effects really be completely avoided?" I always reply:

"There is no surgery in the world that is 100% free of risk, but if we conduct meticulous pre-operative checks, we can minimize those risks to the absolute minimum."

In truth, this statement reflects the genuine reality I experience in the clinic daily. Doing my best for the patients' eye health, even on tough days or during unexpected situations, is my duty. On good days, I share more smiles, crack light jokes, and brighten the room's atmosphere. These accumulated efforts lead to "safe surgery and satisfying recovery." Today, I will walk you through those three critical pre-operative checks.

1. Corneal Thickness and Shape – Proceed with Caution If It Is Thin!

The first check point is corneal thickness and shape.

While scanning the cornea thoroughly in the examination room, I often tell patients: "The cornea is like the foundational pillars of a building. Just as a building cannot be built sturdily with thin pillars, a thin cornea may compromise post-operative stability." While secretly worrying, 'What if someone gets disappointed today because their cornea is too thin for surgery?', I add with a reassuring smile: "Don't worry. This doesn't mean it's impossible; we will find a safe path together."

I actually find these moments quite meaningful. While patients often appear nervous, their expressions quickly relax when I explain things with a touch of humor. Then, an internal dialogue begins inside my mind: 'Ah... this patient's corneal thickness is a bit borderline, but we can make it completely safe by adjusting the parameters,' I calculate internally while continuing to scan their eyes.

Side effects generally include dry eyes, reduced night vision, or, in severe cases, corneal ectasia. That's why I occasionally throw in a light dad joke: "If your cornea is thin, you need to be careful with surgery, and careful with potato chips... You can't eat chips with your eyes, but tired eyes are no fun!" When the patient chuckles, I breathe a sigh of relief and mentally finalize: 'Great, the tension is gone. Now we can discuss the surgical plan.'

A comprehensive corneal examination is an absolute necessity. Only after meticulously verifying thickness, topography, and structural stability do I inform the patient, "Surgery is a GO," or "We need to adjust some options for maximum safety." Deep down, I always remind myself: 'You cannot undo a mistake with someone's eyes, so we must be impeccably thorough today...' Thus, I maintain a friendly conversation while conducting the exam with a sharp focus on ensuring a safe surgical outcome.

2. Astigmatism and Refractive State – Customized Design Is Essential!

The second core check point is astigmatism and refractive status. One of the biggest misconceptions regarding SMILE LASIK is the belief that 'the same procedure can be applied to all eyes.' However, because every individual possesses unique ocular shapes and refractive patterns, the surgical plan must be customized to achieve optimal satisfaction.

First, what is astigmatism? Put simply, it is a condition where the curvature of the cornea or lens is uneven, preventing light from focusing onto a single point and scattering it instead. Consequently, individuals experience blurred vision or light halos, similar to glare from car headlights at night. If an eye with astigmatism undergoes standard SMILE LASIK without custom adjustments, visual acuity may improve, but the quality of vision might fall short of perfection.

While reviewing patient data in the examination room, I verify every detail: corneal refractive power maps, corneal thickness, and curvature across both central and peripheral zones. My internal thought: 'This patient has notable astigmatism today... A standard procedure won't fully satisfy them...' At that moment, I might drop another light joke: "If we don't fully correct astigmatism, driving at night might feel like driving through thick fog with headlight glare. It's as if your eyes are putting on an unwanted light show!"

Evaluating refractive status goes beyond checking simple visual acuity numbers (such as 20/20 or 20/100). Multiple variables including corneal asymmetry, overall refractive errors, and accommodative ability are integrated into the optimal surgical plan. In short, true results from SMILE LASIK are realized when Custom Eye Design + Laser Precision + Post-op Care come together seamlessly. Higher cost does not automatically guarantee superior results, nor does the newest equipment alone prevent all side effects.

3. Tear Film Stability – The Foundation of Eye Health

The final check point is tear film stability. Interestingly, this is the element patients most frequently overlook. While examining eyes, I often mention: "If the tear film is unstable, dryness can become more pronounced after surgery. Dryness delays recovery and increases the risk of complications."

Most patients laugh at first, but then take their eye health more seriously. When they ask, "Doctor, my eyes are naturally a bit dry... Will it get much worse after surgery?", I offer a detailed explanation: "Yes, if you naturally have dry eyes, they may feel noticeably stiffer during the first few days after surgery. That is why pre-operative management and consistent use of artificial tears post-op are essential."

Weak tear film stability shows signals not just in the clinic, but in daily life. For instance, office workers spending all day in front of monitors, students using smartphones for extended periods, or individuals staying in heavily air-conditioned or heated offices... These environments cause eye fatigue and reduce blink rates, rapidly destabilizing the tear film.

In conclusion, small daily habits play a major role in preventing post-operative side effects. Rather than relying solely on equipment or surgical procedures, create an environment where your eyes can properly heal. Eyes are living tissue; when given regular rest and care, they recover far more robustly.

Checklist Before Entering the SMILE LASIK Operating Room

Are you curious about what a surgeon actually verifies right before entering the operating room? Let me explain the process I go through to prepare for your surgery during those few minutes while you lie comfortably on the bed.

1. Re-evaluating All Examination Results
The first step in surgical preparation is always reviewing data. Even if verified during initial consultations, I open and review every file again. Human eyes can present subtle differences daily. Ophthalmic surgery is a discipline sensitive to variations as small as 0.01mm. Entering the operating suite only after completely eliminating margin for error is my strict standard.

2. Reviewing the Nursing Team's Patient Condition Report
I do not look at the eyes in isolation; I assess the patient's overall physical condition. I check whether the patient feels overly anxious, slept well, or shows signs of a cold. I never compromise on safety. "If there is the slightest anomaly, we reschedule by a day." This principle remains unshakeable.

3. Micro-adjustments Based on "Today's Eye Condition"
Depending on subtle variations in pupil size, dryness, or astigmatism axes, I fine-tune laser ablation volume and incision positioning down to fraction-of-a-millimeter scales. This microscopic adjustment creates a profound difference in visual clarity and reduction of night glare.

4. Direct Assessment of Eyelid Muscles and Stability
Direct clinical observation often yields insights beyond diagnostic scans. Engaging in a brief conversation right before surgery allows me to evaluate the patient's anxiety level, eyelid tension, and involuntary micro-movements.

5. Personal Inspection of Surgical Equipment
Equipment is not merely a machine; it is my partner. I personally conduct final checks on laser calibration, eye-tracker response speed, and data input accuracy. When it comes to safety, over-preparation is the only standard.

Concluding the Surgeon's Day

My workday usually seems to end when the operating room doors close, but that is actually when a period of emotional reflection begins. "Doctor... I was so terrified and nervous, but now that it's over, it was nothing at all!" These words spoken by a patient today resonated deeply with me. I keep it etched in my heart that for someone, today was one of the most important days of their life.

"Doctor, was the world always this bright...?" Hearing this single sentence from a patient who experienced rapid visual recovery instantly clears away my fatigue. Being a physician is a remarkable profession; while it appears I am restoring their vision, my patients are often the ones restoring my energy.

After the surgical lights are turned off, I pause for a moment and reflect: "Human eyes... are tiny miracles capable of changing each other's lives." I hold the privilege of crafting those "first moments" together with my patients. I will open the operating room doors tomorrow with complete dedication to ensuring safe, side-effect-free outcomes for every single individual.

And... What Happened Upon Returning Home?

There was a moment today when my heart beat faster than performing 10 surgeries back-to-back: standing right in front of my broken boiler at home. The moment I gently pressed the hot water button... warm water came gushing out! Words cannot describe that relief! My expression was probably identical to my patients' faces when they see the world brightly after surgery.

Brightness and warmth truly revitalize people. Keeping this precious lesson of "small happiness" taught by a boiler close to my heart, I will continue doing my absolute best to help patients enjoy a more comfortable and crystal-clear daily life.

Thank you deeply for today. Dear boiler, let's keep up that warm passion tomorrow as well! (If cold water comes out tomorrow morning, I might actually cry... haha)

SMILE LASIK side effects can be prevented through thorough pre-operative checks.
BGN Eye Clinic fully supports your precious eye health and a brighter tomorrow.

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