Posted by: Clear Vision Cataract & LASIK Center

Most people who look into laser vision correction start and (sometimes) stop at LASIK. It’s the name they know. And for good reason: it has a strong track record, excellent outcomes, and millions of happy patients. But LASIK isn’t the only option, and for some patients, it’s not even the best one.

SMILE has been FDA-approved since 2016 and is now one of the most widely performed laser vision correction procedures in the world, with over 12 million procedures performed globally. Yet we find a lot of patients have never heard of it. That’s what we’re here to fix.

What Is SMILE, and How Is It Different?

SMILE stands for Small Incision Lenticule Extraction. Which, admittedly, is a lot of words. The simpler version: it’s a flapless, all-laser procedure that corrects nearsightedness and astigmatism in many cases — by removing a small piece of corneal tissue through a tiny, self-sealing opening.

In LASIK, the surgeon creates a flap in the cornea’s surface, lifts it, uses a second laser to reshape the tissue beneath, and then lays the flap back down. Which can work extremely well for some. But of course, like all things, it might not be the best option for all. Sometimes, patients have chronic dry eye, autoimmune conditions, and physical reasons why we may turn someone away.

SMILE skips the flap entirely. The laser creates a disc-shaped piece of tissue called a lenticule inside the cornea, then removes it through a small incision. No flap. No flap complications. Just a very tiny opening that seals on its own.

Who Is It Best For?

SMILE tends to be a particularly strong fit for patients who:

  • Those who play intense contact sports like martial arts
  • Work in environments with potential for eye impact (military, law enforcement, certain trades)
  • Have concerns about dry eye — studies show SMILE severs fewer corneal nerves during the procedure, which is associated with lower rates of post-op dry eye symptoms, particularly in the first six months
  • Have been told they may have thin-ish corneas, though this needs to be confirmed in a full evaluation

That said, SMILE is also appropriate for plenty of patients who don’t fit any of those categories. Candidacy is determined by corneal mapping, prescription stability, and a full diagnostic workup at our office.

What SMILE Doesn’t Do That LASIK Does

For now, SMILE is primarily approved for nearsightedness and astigmatism. If you’re farsighted, LASIK or a different procedure may be a better option. Recovery also tends to be slightly different, and some patients notice that their vision takes a day or two longer to fully stabilize than with LASIK, though both procedures are considered equally effective at the one-month mark and beyond.

We aren’t ranking these against each other; it’s just a different tool for different eyes. The goal is always to get you out of glasses and contacts permanently, in the way that is best for you.

The Results

In the FDA clinical trial for SMILE, 99% of participants achieved 20/40 or better vision, and 88% achieved 20/20 or better at the six-month mark. Patient satisfaction rates consistently come in above 95%.

The Procedure Itself

SMILE takes about the same amount of time as LASIK: roughly 10 to 15 minutes for both eyes. It’s performed with topical anesthetic drops, so there are no needles and no general anesthesia. Patients go home the same day, and most resume light activity within 24 to 48 hours.

The most common thing we hear from SMILE patients afterward? They expected it to feel like more than it did. The procedure is quiet, fast, and far less dramatic than most people imagine.

So, How Do You Know Which Procedure Is Right for You?

You don’t — and you can’t — without a proper evaluation. That’s not a dodge; it’s just the truth. The same prescription in two different corneas can point toward completely different procedures. A free screening is the only way to know what you’re actually working with.

At Clear Vision Center, we offer both LASIK and SMILE, along with other alternatives for patients who aren’t candidates for laser procedures. If you’ve been curious about SMILE or have been told you might not be a LASIK candidate, it’s worth a conversation.

Schedule your free 15-minute LASIK screening or give us a call at (248) 215-0326 and we’ll tell you exactly where you stand.