Posted by: Clear Vision Cataract & LASIK Center

You’ve probably heard about a newer laser vision correction procedure called SMILE and have questions about how it compares to the most commonly performed laser vision correction procedure, LASIK. First of all, SMILE is NOT a dental procedure designed to give you shiny white teeth! Although after having SMILE, you will be smiling a lot more given your new independence from glasses and contacts!

What is SMILE?

SMILE stands for SMall Incision Lenticule Extraction. This procedure uses the advanced Zeiss Visumax femtosecond (very fast!) laser to create a round disc of excess tissue inside the cornea (the lenticule) which is then carefully removed by the laser surgeon through a very small incision. SMILE is painless, as the eye is numbed with eye drops prior to the procedure, and typically takes less than 10 minutes per eye.

How is SMILE different from LASIK?

With LASIK, a corneal flap is created by a femtosecond laser, and then the vision correction is performed by a second, excimer laser which essentially vaporizes excess tissue in the cornea. In both procedures, excess corneal tissue is removed, which reshapes the cornea and gives you the desired vision correction. With SMILE, that tissue is removed by an experienced surgeon instead of the laser, but both effectively create the desired vision correction. SMILE only requires one laser, the Zeiss Visumax femtosecond laser, and requires a much smaller incision than LASIK.

What are the Advantages of SMILE?

With SMILE, the incision to remove the tissue is very small. This preserves the corneal nerves which are often disrupted by the larger flap created in LASIK. With less corneal nerve disruption, having dry eye symptoms after the procedure is much less common with SMILE. Also, since no flap is created, we avoid potential flap complications such as flap dislocations, which may be a concern for those with high-impact lifestyles or professions. Recovery from SMILE is also typically painless and fast, meaning you can be back to work typically by the next day.

What are the Limitations of SMILE?

Unlike LASIK where vision quality is often excellent immediately following the procedure, it is common for SMILE patients to take 3-5 days for the vision to reach its best quality. However, large clinical studies have shown that the vision results are comparable between LASIK and SMILE! In the US, SMILE is only approved to correct myopia (nearsightedness) with or without astigmatism, and not hyperopia (farsightedness). It also doesn’t correct presbyopia (loss of near vision with age), so an alternative procedure may be indicated if you are 45 or older.

What are the Risks of SMILE?

As with any procedure, SMILE has some risks, which we review in detail at your consultation. While we carefully screen every patient prior to any procedure, not every scenario can be predicted ahead of time. Similar to LASIK, patients having SMILE may experience dry eye symptoms, under or over correction of vision requiring laser enhancement, and night vision issues such as glare or halos.