SMILE Pro is a safer option than SMILE because it uses advanced laser technology, faster treatment times, and AI-guided precision to reduce complications and deliver more accurate, consistent results.
While both procedures are minimally invasive and highly effective, SMILE Pro’s technical innovations set a new standard for safety and patient comfort.
If you’re considering laser eye surgery, understanding the differences between SMILE and SMILE Pro can help you make the best choice for your vision and peace of mind. This blog explains how SMILE Pro’s features translate to real safety benefits, what the research shows, and why more surgeons are recommending it for a wider range of patients.
The Foundation: How Does SMILE and SMILE Pro Work?
What Is SMILE?
SMILE (Small Incision Lenticule Extraction) is a flapless, minimally invasive laser procedure for correcting myopia and astigmatism. A femtosecond laser is used to create a small disc-shaped lenticule within the cornea, which is then extracted through a tiny incision. This reshapes the cornea and corrects vision without the need for a large flap, reducing the risk of flap-related complications.
What Is SMILE Pro?
SMILE Pro is the next-generation evolution of SMILE, performed exclusively with the ZEISS VisuMax 800 femtosecond laser. It builds on the proven safety of SMILE but adds faster laser speeds, AI-guided alignment, and enhanced software for even greater surgical precision and patient safety.
Faster Laser Speed: Less Time, Lower Risk
Why Laser Speed Matters?
SMILE Pro completes laser scanning in under 10 seconds per eye, compared to 22 seconds for traditional SMILE. This dramatic reduction in treatment time means:
- Less exposure of the eye to the environment, lowering infection risk
- Reduced patient discomfort and anxiety during surgery
- Lower chance of inflammation and faster recovery
A shorter laser time also helps prevent corneal dryness and reduces overall stress on the eye. For patients who struggle to stay still or experience surgical anxiety, this speed is a major safety advantage.
Reduced Risk of Suction Loss
During SMILE and SMILE Pro, the eye is gently suctioned to keep it perfectly still. Longer laser times increase the risk of suction loss—a complication that can interrupt surgery and require rescheduling. With SMILE Pro’s faster laser (2 MHz vs. 500 kHz), the risk of suction loss drops dramatically, making the procedure safer and more predictable.
AI-Guided Precision: Smarter, Safer Surgery
Automated Centration and Cyclotorsion Control
Traditional SMILE relies on the surgeon’s skill to manually align the laser with the centre of the cornea and the axis of astigmatism. This manual process can lead to small errors, especially with high astigmatism or unique eye shapes.
SMILE Pro uses advanced AI-guided systems—CentraLign and OcuLign—to automatically align the laser with the eye’s centre and correct for natural rotation (cyclotorsion).
- CentraLign ensures perfect centration on the corneal vertex, reducing the risk of decentration and higher-order aberrations.
- OcuLign digitally rotates the cutting pattern to match the eye’s astigmatism axis, improving correction accuracy.
These features minimise human error, deliver more consistent results, and make the procedure safer for a broader range of patients.
Enhanced Imaging and Real-Time Guidance
The VisuMax 800’s digital interface and heads-up display give surgeons real-time feedback, allowing for more precise planning and monitoring throughout the procedure. This lowers the chance of accidental mistakes and improves overall safety.
Smaller Incision, Less Trauma
Both SMILE and SMILE Pro use a small incision (2–4 mm), but SMILE Pro’s faster, more precise laser allows for even finer cuts. This means less disruption to corneal nerves, lower risk of dry eye, and better preservation of corneal strength.
- Less nerve damage means a lower chance of dry eye syndrome after surgery.
- The cornea retains more of its natural biomechanical integrity, which is especially important for active or younger patients.
Improved Outcomes for Complex Cases
Better Results for Astigmatism and Hyperopia
SMILE Pro expands the treatable range to include myopia up to -10 diopters, astigmatism up to -5 diopters, and hyperopia up to +7 diopters.
- Studies show that 91% of eyes with moderate to high astigmatism achieved 20/20 vision with SMILE Pro—3% higher than traditional SMILE.
- 91% of eyes had postoperative astigmatism of 0.75 diopters or less, a 5% improvement over SMILE.
- SMILE Pro’s advanced alignment tools make it safer and more effective for patients with complex prescriptions.
Lower Complication Rates
Large clinical studies report no significant intra- or post-operative complications with SMILE Pro, and a suction loss rate as low as 0.13%—much lower than the 0.8–4.4% seen with SMILE.
Enhanced Patient Experience and Comfort
Less Anxiety and Discomfort
The shorter, more automated procedure means patients spend less time under the laser and experience less pressure on the eye.
- Most SMILE Pro patients see clearly within 24 hours, compared to 3–4 days with traditional SMILE.
- The faster process reduces anxiety, especially for those worried about holding still or focusing on a fixation light for long periods.
Faster Recovery and Return to Activities
With less tissue disruption and a smaller incision, SMILE Pro patients often return to normal activities—work, sports, driving—much sooner than those who undergo traditional SMILE.
Technology Comparison: VisuMax 500 vs. VisuMax 800
| Feature | SMILE (VisuMax 500) | SMILE Pro (VisuMax 800) |
| Laser pulse rate | 500 kHz | 2 MHz |
| Laser time per eye | 22 seconds | 8–10 seconds |
| Centration tools | Manual | Automated (CentraLign) |
| Cyclotorsion control | Manual | Automated (OcuLign) |
| User interface | Standard | Enhanced, AI-assisted |
| Treatment range | Myopia, astigmatism | Myopia, astigmatism, hyperopia |
| Incision size | 2–4 mm | 2–4 mm (finer, more precise) |
Real-World Results: What the Research Shows?
- 96–99% of SMILE Pro patients achieve 20/20 vision or better within three months.
- No eyes lost more than one line of best-corrected vision in large studies.
- No significant intra- or post-operative complications reported.
- Better outcomes for high myopia and astigmatism, with more consistent correction and fewer enhancements needed.
Who Benefits Most from SMILE Pro’s Safety Features?
- Patients with high astigmatism or complex prescriptions
- Those who experience anxiety during surgery
- Athletes and active individuals who need rapid recovery and minimal downtime
- Anyone looking for the most advanced and precise vision correction technology
Key Takeaways and Next Steps
SMILE Pro is a safer, smarter evolution of SMILE, offering faster, more precise, and more comfortable vision correction with fewer complications and better outcomes, especially for complex cases.
If you’re considering laser eye surgery, talk to your ophthalmologist about SMILE Pro and whether it’s the right fit for your eyes and lifestyle. With its advanced technology and proven safety, SMILE Pro sets a new benchmark for refractive surgery, helping you see the world more clearly and confidently than ever before.
Frequently Asked Questions
Is SMILE Pro FDA-approved?
Yes, SMILE Pro and the VisuMax 800 laser are FDA-approved and recognised by regulatory agencies worldwide for safety and effectiveness.
Does SMILE Pro cost more than SMILE?
Typically, yes, due to the advanced technology and faster recovery, but many patients and surgeons consider the added safety and comfort worth it.
Is SMILE Pro capable of correcting a wider range of vision problems?
Yes, SMILE Pro can correct myopia, astigmatism, and hyperopia, whereas traditional SMILE is only used for myopia and astigmatism.
Is SMILE Pro better for dry eye?
Yes, the smaller, more precise incision and flapless technique help preserve corneal nerves, reducing the risk of dry eye after surgery.
