Smile Eye Surgery Explained

Tired of fumbling for your glasses just to see the sunrise? Dream of diving into the ocean without contact lenses, blurring your underwater adventure? If the idea of waking up to sharp, unassisted vision sets your soul alight, then SMILE eye surgery might just be the answer you’ve been searching for.

This innovative procedure offers a minimally invasive approach to correcting vision problems like near-sightedness (myopia) and astigmatism. But before you dive headfirst into the decision, it’s crucial to understand what SMILE entails, its benefits and risks, and whether you’re a suitable candidate.


When Does a Refractive Error Occur?

For you to have clear vision, light rays must pass through both your cornea and lens. The cornea, the clear front surface of the eye, plays a significant role in bending light as it enters the eye. Working in conjunction with the lens, which further refines the focusing process, these components ensure that light is refracted (bent) accurately to land on the retina, the light-sensitive tissue at the back of the eye.

A refractive error arises when the cornea or lens is misshapen, hindering the proper bending of light. When the light fails to focus precisely on the retina, the result is blurred vision, impacting visual clarity and acuity.


What is SMILE Eye Surgery?

SMILE stands for Small Incision Lenticule Extraction. It’s a laser-based procedure that uses a femtosecond laser to reshape the cornea, the clear dome at the front of your eye. This reshaping process corrects the way light rays enter your eye, focusing them precisely on the retina for clear vision.

SMILE, a modern innovation, gained FDA approval for correcting myopia in 2016 and for treating astigmatism in 2018. Unlike traditional LASIK surgery, which involves creating a corneal flap, SMILE uses a unique keyhole approach.


Potential Benefits of SMILE:

  • Minimally invasive:
    Compared to LASIK, SMILE avoids creating a corneal flap, potentially reducing the risk of flap-related complications and promoting faster healing.
  • Potentially less dry eyes:
    Since the procedure minimally disrupts the corneal surface, it may lead to a lower risk of dry eyes, a common side effect of LASIK.
  • Faster recovery:
    Many patients experience improved vision within 3-4 days after SMILE and can return to most activities within a few days.
  • Stronger cornea:
    The keyhole incision technique employed in SMILE surgery could result in a structurally stronger cornea compared to flap-based LASIK, which may make it a more suitable option for active individuals. Additionally, it has the potential to eliminate the risk of flap dislodgment, thereby avoiding associated complications.
  • Suitable for a wider range of patients:
    SMILE may be a good option for individuals with thinner corneas or dry eyes who might not be eligible for LASIK.


Is SMILE Right for You? Who is a Candidate for SMILE?

SMILE is not suitable for everyone. To qualify as a strong candidate, you should meet the following criteria:

  • Minimum age of 22 years
  • Maintain stable vision (no significant prescription changes in the past year)
  • Nearsightedness ranging from -1 to -10 diopters
  • Astigmatism within 5 diopters
  • Healthy corneas and good overall eye health
  • Maintain realistic expectations regarding the procedure’s capabilities


Who Shouldn’t Have SMILE?

Certain conditions may disqualify you from SMILE surgery, including:

  • Unstable or changing vision
  • Very thin corneas
  • Irregular astigmatism
  • Certain skin or eye diseases affect the healing
  • Severe glaucoma
  • Cornea scars
  • Advanced keratoconus (thinning of the cornea)
  • Uncontrolled diabetes
  • Cataracts affecting vision
  • Certain past eye surgeries or infections
  • Pregnancy or breastfeeding


How Long Does a SMILE Procedure Take?

The SMILE surgery is a quick process, requiring only 10-15 minutes for each eye. The laser component lasts approximately 22 seconds per eye.


What Should You Expect Before, During, and After SMILE?


Before Surgery:

  • Consultation:
    Begin by discussing your expectations and suitability with your ophthalmologist.
  • Eye examination:
    Your ophthalmologist will conduct a thorough eye examination to evaluate your candidacy for the procedure. This includes testing your vision to ensure its stability and determining the extent of your nearsightedness and astigmatism to assess if SMILE is suitable for correcting your vision. Additionally, they will check for any underlying eye conditions that could impact the surgery or be exacerbated by SMILE. The surface of your cornea will be measured and mapped to assess its thickness and provide precise data for the laser procedure. Pupil size will also be measured.
  • Pre-operative instructions:
    will be given detailed guidelines on avoiding specific medications, activities, and eye makeup prior to the surgery. Also, it being an outpatient procedure means you won’t have to stay overnight at the hospital.



The procedure takes place in three key steps:

  • Numbing:
    Local anaesthesia is applied during the procedure. Eye drops with medication are given to numb the eyes.
  • Laser creation:
    The femtosecond laser is precisely calibrated to your eye’s unique measurements. It creates a precise, lens-shaped piece of tissue (lenticule) within your cornea. This lenticule is customised to match your specific vision needs.
  • Lenticule extraction:
    Through a small 2-4 mm incision made by the same laser, the surgeon carefully removes the lenticule, reshaping your cornea and correcting your refractive errors. Your cornea naturally heals over time, and your vision gradually improves. You’ll need someone to drive you home after the surgery and should plan to rest for the day. Follow your doctor’s instructions for eye drops and medication.



  • Vision improvement:
    Most patients experience significant vision improvement right after surgery, which will gradually improve over the next few days and weeks.
  • Restrictions:
    Avoid getting water in your eyes for a few days, and use protective eyewear as advised by your doctor.
  • Follow-up Appointments:
    Regular follow-up appointments are essential to monitor your healing process and vision progress.


Risks and Complications:

As with any surgery, there are potential risks associated with SMILE, although these are relatively rare. Some potential complications include:

  • Glare and halos:
    You may experience light sensitivity or halos around lights, especially at night.
  • Dry eyes:
    Some patients may experience dry eyes, especially in the initial healing phase.
  • Residual Debris:
    Debris may remain after the corneal disc removal, necessitating additional surgery to address debris presence or corneal irregularities.
  • Under- or overcorrection:
    Your vision may not be fully corrected, requiring additional procedures or glasses.
  • Infection:
    While uncommon, infections can occur and require prompt medical attention.
  • Loss of vision (very rare):
    In extremely rare cases, vision loss can occur.


SMILE offers a promising option for those seeking freedom from glasses and contacts. However, it’s not a miracle cure, and understanding its benefits, risks, and limitations is essential before making a decision. Consult with your ophthalmologist and embark on your journey to clearer vision with confidence!


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