WHAT IS SMILE LASER VISION CORRECTION?

SMILE (Small Incision Lenticule Extraction) is an advanced form of laser vision correction, also commonly known as SMILE laser eye surgery. It reshapes the cornea through a small incision to reduce dependence on glasses or contact lenses for many everyday activities.

SMILE may be suitable for selected people with myopia (short-sightedness) and astigmatism, following a comprehensive assessment of the eyes. Unlike LASIK Laser Vision Correction, SMILE does not require a corneal flap. Instead, it reshapes the cornea by removing a small disc of tissue through a tiny incision.

Although SMILE has become increasingly popular, it is not automatically the best option for everyone. The most appropriate procedure depends on your prescription, corneal measurements, eye health, lifestyle and visual goals. For some people, LASIK, PRK, Implantable Collamer Lens (ICL) or Refractive Lens Exchange may provide a better long-term solution.

Our role is not to recommend the newest procedure. Our role is to understand your eyes, explain every appropriate option and help you choose the vision correction treatment that best matches your individual needs.

People choose SMILE for many different reasons, but there is no single procedure that is right for everyone. The most appropriate option depends on your eyes, your lifestyle and your long-term visual goals rather than the newest technology alone.

One of the main differences between SMILE and LASIK Laser Vision Correction is that SMILE reshapes the cornea through a small incision without creating a corneal flap. For some patients, this may be an important consideration, particularly when a flap-free approach better suits their individual circumstances.

Many suitable patients also appreciate that SMILE offers a relatively rapid visual recovery, allowing them to return to many everyday activities soon after treatment. Others are attracted by the small-incision approach, particularly if they lead active lifestyles or participate in work or sports where reducing dependence on glasses or contact lenses may be beneficial.

Our recommendations are never based on one feature alone. We also consider your prescription, corneal measurements, tear film, eye health, occupation and visual requirements before deciding whether SMILE is the most appropriate treatment.
If your work or hobbies place high demands on your vision, you may also find our guide to Vision Correction for Work, Sport and Active Lifestyles helpful. It explains how lifestyle can influence the choice between LASIK, SMILE, PRK and other vision correction procedures.

For some people, another procedure may provide a better long-term outcome. Depending on your assessment, we may recommend LASIK Laser Vision Correction, PRK Surface Laser Vision Correction, Implantable Collamer Lens (ICL) or Refractive Lens Exchange instead.

SMILE Laser Vision Correction improves vision by reshaping the cornea, the clear front surface of the eye. By changing the shape of the cornea, light focuses more accurately inside the eye, helping to reduce blurred vision caused by myopia (short-sightedness) and astigmatism.

Unlike LASIK Laser Vision Correction, SMILE does not require a corneal flap. Instead, a femtosecond laser creates a small disc of tissue, known as a lenticule, within the cornea. Dr Daya Sharma removes this lenticule through a tiny incision, changing the shape of the cornea while preserving the surface layers in a different way.

Although the laser treatment itself usually takes only a few minutes for each eye, the planning that takes place before surgery is far more important. We use detailed measurements of your cornea, prescription, tear film and overall eye health to determine whether SMILE is the most appropriate procedure for you.

If you would like to understand how the eye focuses light and why refractive errors occur, our illustrated guide to Understanding Refractive Errors explains these concepts in simple language.

If you’re comparing different laser procedures, our LASIK vs SMILE vs PRK comparison guide explains how each procedure works and the situations where one may be more appropriate than another.

Whether SMILE is appropriate depends on much more than your glasses prescription. A comprehensive assessment helps us determine whether your eyes can safely support the procedure and whether it is likely to achieve the visual outcome you hope for.

SMILE may be suitable for selected people with myopia (short-sightedness) and astigmatism who have maintained a stable prescription. We also assess:

• your corneal shape and thickness
• tear film and ocular surface health
• pupil size
• overall eye health
• your occupation and sporting activities
• your visual goals and expectations.

Your lifestyle is an important part of the decision. Whether you spend your time surfing, playing sport, working in emergency services or simply want greater freedom from glasses, your daily visual demands help guide our recommendations. Learn more in our guide to Vision Correction for Work, Sport and Active Lifestyles.If SMILE is not the most appropriate option, we will explain why and discuss alternatives such as LASIK Laser Vision Correction, PRK Surface Laser Vision Correction, Implantable Collamer Lens (ICL) or Refractive Lens Exchange.

If you are considering laser vision correction, we recommend starting with our 2-minute Vision Correction Suitability Assessment, followed by a comprehensive consultation.

SMILE has continued to evolve since it was first introduced. You may come across terms such as SMILE Pro, VisuMax 800 or even wavefront-guided SMILE when researching your options.

These names can be confusing, but they do not necessarily describe different procedures.

Our goal is to explain what these terms mean and, more importantly, whether they are likely to make a meaningful difference for your eyes.

SMILE Pro is the latest generation of SMILE Laser Vision Correction performed using the ZEISS VisuMax 800 laser platform.

The underlying procedure remains the same. Like earlier versions of SMILE, it reshapes the cornea by creating and removing a small lenticule through a tiny incision without creating the corneal flap used in LASIK Laser Vision Correction.

The newer laser platform performs part of the procedure more quickly and includes workflow improvements that may enhance the treatment experience for both patients and surgeons.

However, choosing the newest technology does not automatically mean it is the best option for every patient.

The most important factor remains selecting the procedure that best matches your eyes.

Patients often ask whether SMILE Pro is “better” than SMILE.

A better question is:

Is SMILE the most appropriate treatment for my eyes?

Both procedures aim to achieve the same result.

The newer technology offers faster laser treatment and workflow improvements, but the overall outcome still depends on careful patient selection, detailed assessment and personalised treatment planning.

Our role is not simply to recommend the newest technology.

Our role is to recommend the treatment that is most appropriate for your eyes.

Wavefront technology measures subtle optical imperfections that extend beyond a standard glasses prescription.

At present, wavefront-guided treatment is a well-established feature of LASIK, where it may be used in selected patients to personalise treatment.

SMILE uses a different treatment approach. While research into personalised SMILE techniques continues to evolve, the procedure is not currently performed in the same way as wavefront-guided LASIK.

If reducing higher-order optical imperfections is an important consideration for your eyes, we will discuss whether LASIK Laser Vision Correction, SMILE Laser Vision Correction or another procedure is likely to provide the most appropriate outcome.

Technology is only one part of the decision.

We also consider:

• your prescription
• corneal thickness and shape
• tear film and ocular surface health
• lifestyle and occupation
  sporting activities
• long-term visual goals
  overall eye health.

If you would like to compare all of your options, our LASIK vs SMILE vs PRK comparison guide explains how these procedures differ and the situations where one may be more appropriate than another.

You may also find our guide to Vision Correction for Work, Sport and Active Lifestyles helpful, as occupation and lifestyle often influence the choice of procedure.

SMILE is a carefully planned procedure that usually takes only a few minutes for each eye.

Before treatment begins, we apply anaesthetic eye drops to maximise comfort. Dr Daya Sharma then uses a femtosecond laser to create a small lenticule within the cornea. He removes this tissue through a tiny incision, reshaping the cornea without creating the flap used in LASIK.

Although the treatment itself is quick, every stage is carefully planned. The detailed measurements collected during your assessment allow us to personalise the treatment to your eyes rather than relying solely on your glasses prescription.

Many suitable patients notice clearer vision within the first few days, although recovery varies from person to person. We will explain what to expect before, during and after your procedure and provide personalised advice about returning to work, driving, exercise and sport.

If you would like to compare the experience of SMILE with other laser procedures, our LASIK vs SMILE vs PRK guide provides a detailed comparison of treatment, recovery and suitability.

One of the reasons many suitable patients choose SMILE Laser Vision Correction is that visual recovery is often relatively quick. Many people notice clearer vision within the first day or two, although every eye heals at its own pace.

Because SMILE uses a small incision rather than creating the corneal flap used in LASIK Laser Vision Correction, the recovery experience differs slightly. Most patients return to many normal daily activities soon after treatment, while vision continues to sharpen and stabilise during the following days and weeks.

We will provide personalised instructions about eye drops, driving, work, exercise, swimming and other activities based on your recovery and the way your eyes are healing. Attending your scheduled follow-up appointments is an important part of achieving the best possible outcome.

Recovery is only one factor when choosing between procedures. If you are comparing different forms of laser vision correction, our LASIK vs SMILE vs PRK comparison guide explains how recovery, suitability and lifestyle considerations differ between each procedure.

If your work or hobbies place high demands on your vision, you may also find our guide to Vision Correction for Work, Sport & Active Lifestyles helpful.

Day of Treatment

• Vision is often blurred immediately after treatment.
• Resting your eyes for the remainder of the day is recommended.
• Begin your prescribed eye drops as instructed.

First 24–48 Hours

• Many suitable patients notice a significant improvement in vision.
• Most people feel comfortable returning to many everyday activities.
• Continue using your eye drops and follow your post-operative instructions.

First Week

• Vision usually continues to improve.
• Most people return to work, depending on their occupation.
• Avoid swimming and follow advice regarding strenuous exercise.

First Month

• Vision continues to stabilise.
• The surface of the eye continues to heal.
• Continue attending your scheduled follow-up appointments.

Long-Term

• The reshaping of the cornea is permanent, although your eyes continue to age naturally.
• You could still develop presbyopia or cataracts later in life.

SMILE Laser Vision Correction has become an increasingly popular option for suitable patients because it combines a minimally invasive approach with excellent visual outcomes. However, like every form of vision correction, it has both potential benefits and limitations.

Understanding both is an important part of making an informed decision.

Potential Benefits

For suitable patients, SMILE may offer:

A small-incision procedure that does not require the corneal flap used in LASIK Laser Vision Correction.
Reduced dependence on glasses or contact lenses for many everyday activities.
Relatively rapid visual recovery for many suitable patients.
Treatment of selected cases of myopia (short-sightedness) and astigmatism.
Personalised treatment planning based on detailed measurements of your eyes.
An established procedure with growing long-term clinical evidence.

Many patients considering SMILE also value the convenience of reducing dependence on glasses for work, travel, sport and other everyday activities. If your occupation or hobbies place high demands on your vision, explore our guide to Vision Correction for Work, Sport & Active Lifestyles.

Limitations

SMILE is not suitable for everyone.

It currently treats selected refractive errors and may not be the most appropriate option for people with hyperopia (long-sightedness), certain corneal conditions or other eye diseases.

Like every laser vision correction procedure, SMILE cannot prevent the natural ageing of the eye. Some patients will still require reading glasses because of presbyopia, while others may eventually develop cataracts that are unrelated to their laser treatment.

Our goal is to help you understand both the potential benefits and the limitations before recommending treatment.

There is no single “best” vision correction procedure.

SMILE is an excellent option for many suitable patients, but another treatment may provide a better long-term outcome depending on your eyes.

Following a comprehensive assessment, we may recommend:

LASIK Laser Vision Correction

LASIK may be appropriate for patients with a broader range of refractive errors or where personalised treatment planning makes it the preferred option.

PRK Surface Laser Vision Correction

PRK may be recommended when a surface laser procedure better suits the shape or health of the cornea.

Implantable Collamer Lens (ICL)

ICL may be appropriate for selected patients with higher prescriptions or where laser vision correction is not the preferred treatment.

Refractive Lens Exchange
For some patients over 45 years of age or those developing early lens changes, refractive lens exchange may provide a better long-term solution than corneal laser treatment.

Choosing between these procedures depends on far more than your glasses prescription.

We also consider:

• your refractive error
• corneal thickness and shape
• tear film and ocular surface health
• occupation and sporting activities
• long-term visual goals
  overall eye health.

If you’re deciding between procedures, our comprehensive LASIK vs SMILE vs PRK comparison guide explains the differences between each procedure, while our guide to Vision Correction for Work, Sport & Active Lifestyles explains how lifestyle and occupation influence the decision.

Every surgical procedure carries potential risks as well as potential benefits.

Most patients recover without significant complications, but no procedure can guarantee a particular outcome. Understanding the potential risks is an important part of making an informed decision.

Potential risks may include:

• temporary dry eye symptoms
  glare or halos around lights
• under-correction or over-correction
• regression of vision over time
• infection or inflammation
• the possible need for enhancement surgery
• rare complications that may affect vision.

A comprehensive assessment helps us identify factors that may increase risk and determine whether SMILE is the most appropriate procedure. If another treatment is likely to provide a safer or more suitable outcome, we will explain why and discuss those options with you.

You may also wish to learn more about:

Dry Eye
LASIK vs SMILE vs PRK
Vision Correction Suitability Assessment

Is SMILE better than LASIK?

Neither procedure is better for everyone. SMILE and LASIK Laser Vision Correction each have advantages and limitations. The most appropriate option depends on your prescription, corneal measurements, eye health, lifestyle and visual goals.

What is the difference between SMILE and SMILE Pro?

SMILE Pro uses the newer ZEISS VisuMax 800 laser platform to perform the same underlying SMILE procedure. The surgical concept remains the same. The newer platform offers workflow improvements and faster laser treatment, but choosing the most appropriate procedure depends on your eyes rather than the technology alone.

Is there such a thing as Wavefront-Guided SMILE?

Wavefront-guided treatment is well established in selected LASIK procedures. SMILE uses a different treatment approach. During your assessment, we will discuss which procedure and technology are most appropriate for your eyes.

Does SMILE hurt?

Most patients experience little discomfort because we numb the eye with anaesthetic drops. Mild irritation, watering or light sensitivity may occur during the first day of recovery.

How long does SMILE take?

The laser treatment usually takes only a few minutes for each eye. Your appointment is longer because we perform final checks, prepare your eyes and review your recovery instructions.

How quickly will my vision improve?

Many suitable patients notice clearer vision within the first few days, although vision continues to stabilise over the following weeks.

Will I still need glasses after SMILE?

Many suitable patients become much less dependent on glasses or contact lenses for everyday activities. However, natural age-related changes such as presbyopia may still mean reading glasses are needed later in life.

Can I play sport after SMILE?

Many patients return to sport once their eyes have healed sufficiently. The timing depends on your recovery and the type of activity. Learn more in our guide to Vision Correction for Work, Sport & Active Lifestyles.

What if I have been told I am not suitable for SMILE?

Being unsuitable for SMILE does not necessarily mean you are unsuitable for vision correction. Depending on your eyes, another procedure such as LASIK, PRK, Implantable Collamer Lens (ICL) or Refractive Lens Exchange may still be appropriate.

Is SMILE permanent?

SMILE permanently reshapes the cornea. However, your eyes continue to age naturally, so vision may still change because of presbyopia or cataracts later in life.