SMILE PRO FOR HYPEROPIA

AI BASED ROBOTIC LASER

AI BASED ROBOTIC LASER

India’s only exclusive Laser Vision Correction centre now offers the world’s first lenticule extraction procedure for hyperopia, performed on the ZEISS VISUMAX 800 platform.

For the first time, farsighted patients can benefit from the same flapless, minimally invasive approach that has already been used to treat over 10 million eyes worldwide for myopia and astigmatism. SMILE Pro for hyperopia extends the treatment range to correct farsightedness up to +7.0 D with or without astigmatism up to 4.0 D — bringing a corneal-based, flapless solution to patients who previously had limited laser options.

Note: SMILE Pro Hyperopia is exclusively available on the VisuMax 800 platform and is not supported on the VisuMax 500.

Why Farsighted Patients Have Had Fewer Corneal Laser Options

For years, the most advanced corneal laser vision correction procedures were designed primarily for myopia. If you were farsighted, your options were more limited.

Hyperopic LASIK exists, but it requires creating a corneal flap. Clear lens exchange, on the other hand, is an intraocular procedure. ZEISS describes SMILE PRO for hyperopia as a flapless, corneal-based alternative to clear lens exchange, offering the benefits of lenticule extraction to hyperopic patients.

What was missing was a flapless corneal option for hyperopia. A procedure that could correct farsightedness while keeping the corneal surface largely intact.

That gap has now been addressed. ZEISS has extended the treatment range of SMILE PRO the world’s leading lenticule extraction platform to include hyperopia with or without astigmatism. This makes SMILE PRO the first lenticule extraction procedure capable of treating myopia, hyperopia, and astigmatism on a single platform.

What Is SMILE PRO for Hyperopia?

SMILE PRO — Small Incision Lenticule Extraction — is a flapless laser vision correction procedure. It works by creating a small, lens-shaped piece of tissue called a lenticule within the cornea, which is then extracted through a tiny incision. This reshapes the cornea and corrects the refractive error. The corneal surface remains largely untouched throughout the process.

For myopia, a lenticule is created and extracted to correct nearsightedness. For hyperopia, the lenticule shape is different designed to correct farsightedness with or without astigmatism.

The SMILE platform has been in clinical use for over a decade. ZEISS reports that more than 10 million eyes have been treated with SMILE technology worldwide. The extension to hyperopia announced by ZEISS in December 2024 represents a significant expansion of this established procedure into a treatment area that was previously unavailable through lenticule extraction.

Treatment Parameters

The hyperopic treatment range for ZEISS SMILE PRO is:

Sphere: +0.15 D to +7.0 D
Cylinder: 0.0 D to 4.0 D
Axis: 0° to 180°

Note: The specified parameter ranges are accessible under the most favorable parameter combinations. Additional limitations due to inter-parameter dependencies can reduce the available adjustment range. Your surgeon will determine the treatable range for your specific eyes during the pre-operative evaluation.

How Hyperopic SMILE PRO Differs from Myopic SMILE PRO ?

Aspect	Myopic SMILE PRO	Hyperopic SMILE PRO
Planning Parameters	Standard lenticule planning	Requires two additional planning values: central lenticule thickness (to ensure a complete lenticule at the centre of the cornea) and transition zone (the area between the optical zone and the outer edge of the lenticule diameter). Configured by the surgeon using the ZEISS software.
Lenticule Size	Smaller diameter	Larger diameter — includes the transition zone in addition to the optical zone
Laser Time	Standard	Slightly longer due to larger lenticules. A typical hyperopic lenticule is still created in under 13 seconds.
Instruments	Standard SMILE dissector	Dedicated SMILE hyperopia dissector that features a longer spoon, specifically designed to access and extract the larger lenticule
Surgical Experience	Flapless, small incision, laser portion in seconds	Same — flapless, small incision, laser portion in seconds. The patient experience remains similar to myopic SMILE PRO.

Note: SMILE Pro Hyperopia is exclusively available on the VisuMax 800 platform and is not supported on the VisuMax 500.

SMILE PRO Compared to Other Hyperopia Correction Options

ZEISS describes SMILE PRO as the first lenticule extraction solution to treat hyperopia, myopia, and astigmatism. Here is how it compares to the other established approaches for hyperopia correction.

SMILE PRO for Hyperopia vs. Hyperopic LASIK

Both are corneal laser procedures that reshape the cornea to correct farsightedness. The fundamental difference is in surgical approach. LASIK requires creating a large corneal flap, which is lifted to allow excimer laser reshaping of the underlying corneal tissue. SMILE PRO does not create a flap. Instead, the lenticule is created within the intact cornea and extracted through a small incision.

ZEISS describes SMILE PRO for hyperopia as a safe and effective flapless option, offering an alternative to clear lens exchange with the benefits of lenticule extraction. Clinical data from ZEISS indicates that SMILE PRO outcomes for hyperopia are comparable to hyperopic LASIK in terms of efficacy and predictability.

SMILE PRO for Hyperopia vs. Clear Lens Exchange

ZEISS positions SMILE PRO for hyperopia as a flapless, corneal-based alternative to clear lens exchange. While corneal-based options were not the first choice for hyperopic patients for years, ZEISS states that its extensive experience in Laser Vision Correction has enabled the development of a safe and effective flapless option, offering an alternative to clear lens exchange with the benefits of lenticule extraction.

For eligible hyperopic patients, SMILE PRO now offers a less invasive corneal-based option — without the need for lens removal.

Choosing Between Them

Not every hyperopic patient is a candidate for SMILE PRO. A thorough pre-operative evaluation is the only way to determine which approach is best for your eyes. At Visual Aids Centre, this evaluation includes corneal mapping with Pentacam HR, wavefront analysis, and a comprehensive assessment of ocular health.

Clinical Evidence Supporting SMILE PRO for Hyperopia

ZEISS SMILE PRO for hyperopia is supported by clinical investigation data. A designated prospective multicenter 12-month clinical study was conducted using the predecessor VisuMax platform. The study — titled “SMILE for Hyperopia With and Without Astigmatism: Results of a Prospective Multicenter 12-Month Study” — was published in the Journal of Refractive Surgery.

The study demonstrated that lenticule extraction for compound hyperopic astigmatism correction delivers a high level of efficacy, predictability, safety, and stability. The outcomes were found to be comparable to those of hyperopic LASIK.

The clinical programme involved contributions from leading refractive surgeons including Prof. Dan Reinstein and Prof. Walter Sekundo, whose case studies and practical insights have informed the clinical framework for hyperopic SMILE PRO.

Why Visual Aids Centre for SMILE PRO Hyperopia

Visual Aids Centre is not a general ophthalmology hospital that offers laser vision correction as one of many services. It is India’s only exclusive Laser Vision Correction centre and has been since its founding in 1980.

Track Record

Founded by Vipin Buckshey, Visual Aids Centre was the first eye centre in Delhi to introduce LASIK surgery in 1999. In the 26 years since, the centre has performed over 250,000 laser vision correction procedures — the highest number by any private eye centre in India. For his contribution and expertise in eye care and Laser Vision Correction, the Indian Government conferred Vipin Buckshey with the Padma Shri, one of India’s highest civilian honours.

The Platform

Visual Aids Centre operates the ZEISS VISUMAX 800 one of the femtosecond laser platforms on which SMILE PRO for hyperopia is performed. The VISUMAX 800 features AI-guided alignment systems including CentraLign (for precise centration on the corneal vertex) and the improved OcuLign® pattern rotation system for astigmatism correction.

The centre is not adopting a new platform for hyperopic SMILE PRO. It is extending the capability of the same system already in daily use for myopic SMILE PRO a natural expansion backed by deep operational familiarity with the technology.

Diagnostic Capability

Determining candidacy for SMILE PRO hyperopia requires precise corneal and refractive measurements. Visual Aids Centre’s diagnostic portfolio includes:

Pentacam HR by Oculus – Comprehensive corneal topography and tomography, measuring the entire cornea from surface to posterior for advanced screening.
Advance Ray Tracing – Using Innoveyes to create a unique 3D model of the eye for precise vision correction.
Topolyzer Vario by Allegro – Captures up to 22,000 unique corneal data points, essential for customised treatment planning.
WaveScan by Advanced Medical Optics – Wavefront acquisition and diagnostic measurement for refractive profiling.
Cirrus 5000 by Carl-Zeiss – Full-spectrum OCT for retinal and anterior segment analysis.
Lipiscan – To review the tear producing meibomian glands for a faster visual recovery.

This diagnostic depth ensures that every patient receives a thorough evaluation and that the decision to proceed with SMILE PRO hyperopia (or any alternative procedure) is based on complete data.

Note: SMILE Pro Hyperopia is exclusively available on the VisuMax 800 platform and is not supported on the VisuMax 500.

How do you begin your SMILE PRO Hyperopia journey?

Step 1: Comprehensive Eye Evaluation

Your journey begins with a detailed diagnostic assessment. This includes corneal mapping with the Pentacam HR, refractive measurements, wavefront analysis, and a complete examination of your ocular health. The data from this evaluation determines your candidacy and informs the treatment plan.

Step 2: Personalised Treatment Planning

If you are eligible for SMILE PRO hyperopia, your surgeon uses the ZEISS planning software to configure the procedure for your specific eyes. This includes setting the sphere and cylinder corrections, the optical zone, the transition zone, and the central lenticule thickness the additional parameters specific to hyperopic treatment.

Step 3: The Procedure

SMILE PRO for hyperopia is performed on the ZEISS VISUMAX 800. The laser creates the hyperopic lenticule within the cornea in under 13 seconds. The lenticule is then extracted through a small incision using the dedicated SMILE hyperopia dissector. There is no flap. The corneal surface remains largely intact.

Step 4: Recovery

Your surgeon will provide specific post-operative instructions and schedule follow-up appointments to monitor your recovery and visual outcomes.

Step 5: Ongoing Care

Visual Aids Centre provides continued monitoring beyond the initial recovery period to ensure your visual outcomes remain stable and optimal.

Equipment

Clinical Publications & Resources

Explore the clinical evidence and technical details behind ZEISS SMILE pro for hyperopia.

Case Study

Back to the Cornea: Treating Hyperopic Patients with Lenticule Extraction

Author: Prof. Dan Z. Reinstein, MD MA(Cantab) FRCSC FRCOphth DABO FEBO
Published by: Carl Zeiss Meditec AG (Case of the Month)

A detailed case study exploring the journey of hyperopic corneal treatments and a 30-year-old male patient treated with ZEISS SMILE pro for compound hyperopic astigmatism using the ZEISS VISUMAX 800. Includes lenticule geometry design, the role of CentraLign® and OcuLign® alignment systems, surgical technique, and day-one post-operative outcomes.

Key finding: Lenticule Extraction for hyperopia achieved outcomes comparable to hyperopic LASIK, with less tear film depression.

Download Case Study (PDF)

Technical Overview

New: Hyperopia Treatment Range for SMILE® pro from ZEISS

Published by: Carl Zeiss Meditec AG
Date: 4 December 2024

The official ZEISS customer presentation covering the extended hyperopic treatment range for SMILE pro. Includes the full treatment parameters (sphere +0.15 D to +7.0 D, cylinder 0.0 D to 4.0 D), planning differences compared to myopic lenticule extraction (central lenticule thickness and transition zone), laser time, instrumentation requirements, procedure licensing, and activation details.

ZEISS SMILE pro: the first Lenticule Extraction solution to treat hyperopia, myopia, and astigmatism.

Download Presentation (PDF)

Frequently Asked Questions

What is the difference between SMILE Pro for hyperopia and SMILE Pro for myopia?

The core procedure is the same a lenticule is created within the cornea using the ZEISS VISUMAX 800 femtosecond laser and extracted through a small incision. The key differences are in the lenticule shape (designed differently for hyperopia than for myopia), the additional planning parameters (central lenticule thickness and transition zone), slightly longer laser time due to the larger lenticule size, and the use of a dedicated hyperopia dissector with a longer spoon. The patient experience flapless, minimally invasive remains consistent.

Can SMILE Pro correct both hyperopia and astigmatism at the same time?

Yes. The extended treatment range for SMILE Pro includes compound hyperopic astigmatism. The procedure can correct hyperopia up to +7.0 D and astigmatism up to 4.0 D simultaneously, with axis correction from 0° to 180°. The improved OcuLign® pattern rotation system on the VISUMAX 800 helps ensure accurate alignment with your eye’s astigmatism axis.

How long does the SMILE Pro hyperopia procedure take?

The laser creates the hyperopic lenticule in under 13 seconds.

Is the recovery different from myopic SMILE Pro?

ZEISS describes the learning curve and workflow for hyperopic SMILE Pro as short and similar to SMILE Pro for myopia. Your surgeon will provide specific post-operative care instructions tailored to your procedure.

What clinical evidence supports SMILE Pro for hyperopia?

The procedure is supported by a prospective multicenter 12-month clinical study published in the Journal of Refractive Surgery, which demonstrated high levels of efficacy, predictability, safety, and stability for lenticule extraction in the correction of hyperopia with and without astigmatism. The outcomes were found to be comparable to hyperopic LASIK. The study was conducted using the predecessor VisuMax platform, and ZEISS has carried forward the clinical framework to the current VISUMAX 800 / SMILE Pro platform.

What if I am not eligible for SMILE Pro hyperopia?

Visual Aids Centre is an exclusive Laser Vision Correction centre offering a complete range of corneal procedures. Depending on your evaluation results, alternative options may include Contoura Vision (topography-guided LASIK), Femto LASIK, or Trans-PRK. Your surgeon will recommend the best option based on your specific clinical data.

Is SMILE Pro for hyperopia available in India?

Yes. Visual Aids Centre in Delhi operates the ZEISS VISUMAX 800 one of the platforms on which SMILE Pro for hyperopia is performed. ZEISS announced the hyperopia extension in December 2024, and global rollout is ongoing. Contact Visual Aids Centre to confirm current availability and schedule your evaluation.

Am I a Candidate for SMILE Pro Hyperopia Correction?

The ZEISS SMILE Pro hyperopic treatment range includes:

Sphere: +0.15 D to +7.0 D
Cylinder: 0.0 D to 4.0 D
Axis: 0° to 180°

It is important to understand that the maximum treatment parameters are achievable under the most favorable parameter combinations. Additional limitations due to inter-parameter dependencies can reduce the available adjustment range. This is precisely why a comprehensive pre-operative evaluation is essential it determines not just whether you are eligible, but what outcome can realistically be expected for your eyes.

Specific ZEISS SMILE Pro hyperopia Procedure Licenses are required, and the procedure requires VISUMAX 800. Your surgeon will assess your individual suitability based on a thorough examination of your eyes.

If you are not eligible for SMILE Pro hyperopia, Visual Aids Centre offers a complete range of laser vision correction alternatives including Contoura Vision (topography-guided LASIK), Femto LASIK, and Trans-PRK. Your evaluation will determine the most suitable option.