SMILE手術について
SMILEとはSMall Incision Lenticule Extractionの略であり、小切開からレンチクル（角膜切片）を摘出する手術です。この手術ではフェムトセカンドレーザーという精密なレーザーを照射して、光切断でレンチクル（角膜切片）を作り、それを抜き取ることで屈折矯正を行います。
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.100.50.0,0,1920,960.file/zeiss-smile-procedure.jpg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.360.180.0,0,1920,960.file/zeiss-smile-procedure.jpg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.768.384.0,0,1920,960.file/zeiss-smile-procedure.jpg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.1024.512.0,0,1920,960.file/zeiss-smile-procedure.jpg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.1280.640.0,0,1920,960.file/zeiss-smile-procedure.jpg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.1440.720.0,0,1920,960.file/zeiss-smile-procedure.jpg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/zeiss-smile-procedure.jpg/_jcr_content/renditions/original.image_file.1920.960.0,0,1920,960.file/zeiss-smile-procedure.jpg"})
視力を改善してメガネやコンタクトレンズの依存を減らしたい場合、SMILEというレンチクル摘出術が解決策となるかもしれません。ここではSMILE手術がどのように行われ、どのようにして視力を改善するかを説明します。
SMILEとは
SMILEというレンチクル摘出術は、海外で実績を積み重ねたレーザー屈折矯正手術です。すでに世界中の数百万人の人々が治療を受けています3。こちらをご覧ください。
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.100.56.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.360.203.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.768.432.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.800.450.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.800.450.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.800.450.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg/_jcr_content/renditions/original.image_file.800.450.0,5,800,455.file/anesthetic-drops-are-put-into-the-eye-to-numb-it.jpg"})
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.100.56.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.360.203.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.596.335.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.596.335.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.596.335.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.596.335.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/a-laser-creates-a-small-opening-in-the-eye-lens.jpg/_jcr_content/renditions/original.image_file.596.335.0,73,596,408.file/a-laser-creates-a-small-opening-in-the-eye-lens.jpg"})
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.100.56.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.360.203.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.596.335.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.596.335.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.596.335.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.596.335.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-lenticule-is-removed-through-the-small-opening.jpg/_jcr_content/renditions/original.image_file.596.335.0,13,596,348.file/the-lenticule-is-removed-through-the-small-opening.jpg"})
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.100.56.0,78,595,413.file/the-small-opening-seals-itself.jpg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.360.203.0,78,595,413.file/the-small-opening-seals-itself.jpg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.595.335.0,78,595,413.file/the-small-opening-seals-itself.jpg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.595.335.0,78,595,413.file/the-small-opening-seals-itself.jpg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.595.335.0,78,595,413.file/the-small-opening-seals-itself.jpg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.595.335.0,78,595,413.file/the-small-opening-seals-itself.jpg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/procedure/the-small-opening-seals-itself.jpg/_jcr_content/renditions/original.image_file.595.335.0,78,595,413.file/the-small-opening-seals-itself.jpg"})
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original.image_file.100.56.file/zeiss-smile-teaser-recovery.jpg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original.image_file.360.203.file/zeiss-smile-teaser-recovery.jpg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original.image_file.768.432.file/zeiss-smile-teaser-recovery.jpg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original.image_file.1024.576.file/zeiss-smile-teaser-recovery.jpg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original.image_file.1280.720.file/zeiss-smile-teaser-recovery.jpg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original.image_file.1440.810.file/zeiss-smile-teaser-recovery.jpg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile-lasik-or-prk-lasek/teaser/zeiss-smile-teaser-recovery.jpg/_jcr_content/renditions/original./zeiss-smile-teaser-recovery.jpg"})
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/minimal-invasive_zeiss-icon.svg/_jcr_content/renditions/original./minimal-invasive_zeiss-icon.svg"}){kind=icon}
![]({"xsmall":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.100.100.0,2,300,302.file/no-flap_zeiss-icon.png","small":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.300.300.0,2,300,302.file/no-flap_zeiss-icon.png","medium":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.300.300.0,2,300,302.file/no-flap_zeiss-icon.png","large":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.300.300.0,2,300,302.file/no-flap_zeiss-icon.png","xlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.300.300.0,2,300,302.file/no-flap_zeiss-icon.png","xxlarge":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.300.300.0,2,300,302.file/no-flap_zeiss-icon.png","max":"https://www.zeiss.co.jp/content/dam/vis-b2c/reference-master/images/eye-surgery/correction-surgery/smile/icons/no-flap_zeiss-icon.png/_jcr_content/renditions/original.image_file.300.300.0,2,300,302.file/no-flap_zeiss-icon.png"}){kind=icon}
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SMILEに関するよくある質問
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SMILEによるレーザー視力矯正は、乱視の有無にかかわらず、近視をお持ちの方に適応しています。近視は遠くの物が、遠視は近くの物や文字がぼやけて見える原因となります。乱視は、角膜が丸ではなく楕円形（サッカーボールではなくラグビーボールのような形）になっているため、視界が歪んだりぼやけたりする原因となり、頭痛や目の疲れを引き起こすことがあります。
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担当の眼科医が患者に手術前の準備リストを提供します。コンタクトレンズの着用を止めるタイミング、手術当日の食事・服装、術後に処方された点眼薬を使用するタイミングなど、様々な情報が記載されています。手術後は患者一人で帰宅せず、ご自宅までどなたかに付き添いをしていただく必要があります。
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手術後は、目をこすったり触ったりしないようにしてください。治療後、眼科医によっては、睡眠時に保護用アイシールドの着用を勧める場合があります。
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SMILEによる手術後、多くの患者はすぐに視力の改善を実感し、その後数日間でさらに良くなるケースが一般的です。
ただし、手術後は車の運転ができないため、ご自宅まで送ってもらえる方を手配する必要があります。患者自身の状況に関する詳細については、担当医がご判断ください。
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1
このサイトは医療従事者に対しての基本的な治療に関する情報提供を目的としており、患者にとって医師による診断や医師との相談の代替となるものではありません。屈折矯正手術の際に考えられるリスク、副作用、制約事項については、必ず患者は医師との相談を通じて確認します。治療の選択肢は国によって承認状況や提供状況が異なり、承認内容や使用方法の説明も国ごとに異なる場合があります。
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2
日本眼科学会 (2023). SMILE｜日本眼科学会による病気の解説. https://www.nichigan.or.jp/public/disease/treatment/item09.html
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3
Zeiss. (2024). Zeiss at AAO 2024. Retrieved from https://www.zeiss.com/meditec-ag/en/media-news/press-releases/2024/zeiss-at-aao.html
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4
Ganesh S, Brar S, Swamy DT. Comparison of Clinical Outcomes and Patient Satisfaction Following SMILE Performed With the VisuMax 800 in One Eye and VisuMax 500 in the Contralateral Eye. J Refract Surg. 2025 Jan;41(1):e14-e21. doi: 10.3928/1081597X-20241113-02. Epub 2025 Jan 1. PMID: 39783817. Original text: "Therefore, the VisuMax 800, with a 2-MHz pulse repetition rate and average lenticule creation time of 8 to 9 seconds, has a definite advantage over the VisuMax 500, which has a 500-KHz frequency and average lenticule creation time of 25 to 27 seconds". https://journals.healio.com/doi/epdf/10.3928/1081597X-20241113-02
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Wan KH, Wang XY, Lai KHW, Alio JL, Ang M, Chan C, Chan TCY, Cheng GPM, Elsheikh A, Hjortdal J, Huang G, Jhanji V, Mehta JS, Rao SK, Sato M, Sekundo W, Sharma N, Shetty R, Wang Y, Xiao Y, Yang Y, Zhai C, Zhang F, Zhou X, Lam DSC. Controversies, consensuses and guidelines on Small Incision Lenticule Extraction (SMILE) by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) and the Asia-Pacific Myopia Society (APMS). Asia Pac J Ophthalmol (Phila). 2025 Jul-Aug;14(4):100221. doi: 10.1016/j.apjo.2025.100221. Epub 2025 Jun 28. Erratum in: Asia Pac J Ophthalmol (Phila). 2025 Jul-Aug;14(4):100226. doi: 10.1016/j.apjo.2025.100226. PMID: 40588075. https://www.sciencedirect.com/science/article/pii/S216209892500088X?via%3Dihub
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Liu T, Dan T, Luo Y. Small Incision Lenticule Extraction for Correction of Myopia and Myopic Astigmatism: First 24-Hour Outcomes. J Ophthalmol. 2017;2017:5824534. doi: 10.1155/2017/5824534. Epub 2017 Jun 7. PMID: 28680704; PMCID: PMC5478873.Original text: Some patients could even return to their jobs or have a physical examination on the same day of the surgery. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5478873/
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Reinstein, D. Z., Archer, T. J., & Gobbe, M. (2014). Small incision lenticule extraction (SMILE) for myopia and myopic astigmatism: A review. Eye and Vision, 1(1), 3. https://doi.org/10.1186/s40662-014-0003-1
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Moshirfar M, Somani SN, Patel BC. Small Incision Lenticule Extraction. [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [cited 2025 Sep 6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549896/. PMID: 31751086. Original text: "Furthermore, the small incision of SMILE was theorized to reduce injury to the subbasal nerve plexus and avoid flap-related complications."