Smile Eye Surgery Pregnancy

For soon-to-be mothers, the days leading up to childbirth are often characterised by an array of medical dos and don’ts. Among the list of things to consider, is eye surgery one of them?

If you are pregnant and are considering SMILE eye surgery (Small Incision Lenticule Extraction) or are merely curious about the intersection of these complex subjects, then this post was crafted with you in mind. We will be breaking down the safety and considerations pertaining to this revolutionary refractive surgery during pregnancy.


What is SMILE Eye Surgery?

For starters, let’s briefly unpack what SMILE eye surgery is and why it has become a popular choice for vision correction. Developed by Carl Zeiss Meditec, this minimally invasive procedure involves creating a small incision in the cornea using a femtosecond laser to remove a thin lenticule of tissue.


Can You Have SMILE Eye Surgery During Pregnancy?
The answer is generally no. It is not recommended to undergo elective surgeries during pregnancy or while breastfeeding unless absolutely necessary.


The Ocular Dilemmas of Motherhood – Vision and Hormonal Fluctuations

Given the myriad changes that accompany pregnancy, from weight gain to hormonal fluctuations, ocular health is not exempt. Here are the key takeaways:

  • Hormonal Fluctuations and Corneal Changes:
    Pregnancy is a dynamic journey characterised by significant hormonal changes. These fluctuations can significantly yet temporarily impact the eyes, particularly the cornea. During this period, the following can be experienced:
  • Swelling:
    Increased fluid retention, common during pregnancy, can cause slight corneal swelling, altering its shape and thickening the cornea, notably in the second and third trimesters.
  • Decreased Intraocular Pressure (IOP):
    Pregnancy-associated changes in intraocular pressure have been documented, showing a decrease during gestation. This raises concerns about the potential effects on the cornea and its response to the surgical reshaping inherent in SMILE procedures.
  • Curvature Alteration:
    Hormonal changes may lead to a slight corneal curvature steepening, affecting vision clarity.
  • Dry Eyes:
    Fluctuations in hormone levels can disrupt the tear film, the protective outer layer lubricating the eyes, especially during the third trimester. This can lead to dryness and discomfort, potentially making the post-surgical healing process less comfortable.
  • Contact Lens Intolerance:
    Changes in corneal shape and tear production during pregnancy can make wearing contact lenses challenging, especially in the second trimester.
  • Changes in Refractive Error:
    While not universally experienced, some women may notice temporary shifts in their nearsightedness, farsightedness, or astigmatism during pregnancy.

These temporary changes pose significant challenges for SMILE surgery:

  • Inaccurate Measurements:
    Pre-surgical assessments rely on precise corneal measurements to calibrate the laser. However, if the cornea is swollen or has altered curvature due to pregnancy hormones, the measurements may be inaccurate.
  • Incorrect Laser Corrections:
    The laser might reshape the cornea based on inaccurate data, potentially resulting in unsatisfactory vision outcomes.
  • Exacerbate Post Side Effects:
    Because of increased hormone production, common SMILE surgery side effects such as dry eye, light sensitivity, blurriness, and halos/glare around lights may become exacerbated.
  • Unsuitable Candidacy:
    In some cases, the changes in the cornea due to pregnancy might render the patient temporarily unsuitable for SMILE surgery.
  • Need for Additional Procedures:
    If vision changes after surgery due to hormonal fluctuations, additional procedures might be necessary to achieve the desired correction.
  • Medication Concerns:
    While minimal, certain medications used during and after SMILE surgery, such as mild sedatives and eye drops, might not be recommended for pregnant women due to potential risks to the developing baby.
  • Prioritizing Safety:
    As with any elective surgery, the safety of both mother and baby is paramount. Minimising potential risks associated with the procedure during pregnancy is crucial.


When is the Best Time to Consider SMILE Eye Surgery?

A few months (approx 3-5 months) after breastfeeding typically provides a stable hormonal landscape for reliable SMILE outcomes. Even if your vision hasn’t shown any changes, it’s advisable to hold off for now.


Benefits of Waiting for SMILE Eye Surgery

By waiting until after pregnancy and breastfeeding, several key benefits come into play:

  • Stable Vision:
    Following the stabilisation of hormonal levels postpartum and their return to pre-pregnancy levels, a thorough eye examination ensures precise and stable vision measurements. This approach facilitates a more accurate and efficient laser vision correction during SMILE surgery. However, seeking guidance from an ophthalmologist to address individual circumstances is crucial.
  • Reduced Risks:
    Waiting minimises the potential risks associated with the surgery on both the mother and the baby.
  • Optimal Results:
    Performing the surgery on stable and predictable vision measurements significantly increases the likelihood of achieving optimal and long-lasting results from SMILE surgery.


The Balance of Motherhood and Personal Health

SMILE surgery is a remarkable advancement in vision correction, but when it comes to pregnancy, the general rule is to wait. The health and well-being of the child should always be the priority. When the time is right, SMILE surgery can be an empowering choice for women seeking to reclaim their vision.

It is a personal and significant milestone, a moment of celebration, and a reminder that motherhood doesn’t have to mean sacrificing clear sight.

So, here’s to seeing the world through new eyes – both as a mother and as an individual.


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