SMILE Refractive Surgery: A Comprehensive Guide for Patients

Refractive eye surgeries have revolutionized vision correction, allowing millions to see clearly without glasses or contact lenses. One of the latest advancements in this field is Small Incision Lenticule Extraction (SMILE), a minimally invasive laser procedure designed to correct myopia (nearsightedness) and astigmatism.

If you are considering SMILE surgery, it is essential to understand its benefits, risks, and how it compares to other procedures such as LASIK and PRK. This detailed guide will help you make an informed decision about whether SMILE is the right choice for your vision correction needs.

What is SMILE Eye Surgery?

SMILE is a laser vision correction procedure that uses a femtosecond laser to reshape the cornea and correct refractive errors. Unlike LASIK, which involves creating a corneal flap, SMILE works by creating a small lenticule (a thin, lens-shaped layer of corneal tissue) within the cornea. This lenticule is then removed through a tiny incision, allowing the cornea to reshape and correct the patient’s vision.

How Does SMILE Work?

The procedure involves the following steps:

1. Numbing the Eye: Local anesthetic eye drops are applied to ensure the patient feels no pain during the procedure.

2. Lenticule Creation: A femtosecond laser creates a small lenticule within the cornea in less than 30 seconds.

3. Lenticule Extraction: The surgeon removes the lenticule through a 2-4mm incision, reshaping the cornea to correct vision.

4. Healing Begins: Since no flap is created, the cornea remains mostly intact, promoting a faster healing process and reduced complications.

SMILE is an outpatient procedure that typically takes 10-15 minutes per eye and provides long-term vision correction with minimal discomfort.

Who is a Candidate for SMILE Surgery?

SMILE is an excellent option for many patients but is not suitable for everyone. You may be a good candidate if you:

✔️ Are over 18 years old

✔️ Have stable vision for at least one year

✔️ Have mild to moderate myopia (-1.00D to -10.00D)

✔️ Have mild astigmatism (up to -3.00D)

✔️ Have sufficient corneal thickness

✔️ Do not have any active eye diseases, such as keratoconus or severe dry eyes

✔️ Are not pregnant or breastfeeding

If you have hyperopia (farsightedness) or severe astigmatism, SMILE may not be the best option for you, and your eye surgeon might recommend LASIK or PRK instead.

Benefits of SMILE Surgery

1. Minimally Invasive

Unlike LASIK, which requires a 20mm corneal flap, SMILE only needs a small 2-4mm incision. This reduces the risk of flap-related complications and preserves more of the corneal structure.

2. Faster Healing & Less Dry Eye

Since SMILE preserves more corneal nerves, the risk of post-surgery dry eye is lower compared to LASIK. Most patients experience minimal discomfort and can resume normal activities within a few days.

3. Enhanced Corneal Strength

By avoiding a large corneal flap, SMILE maintains better biomechanical strength, reducing the risk of corneal weakening (ectasia) over time.

4. Less Risk of Flap Complications

Flap issues such as dislocation or wrinkling (which can occur in LASIK) are eliminated since no flap is created in SMILE surgery.

5. High Precision & Predictability

SMILE uses advanced femtosecond laser technology, ensuring precise tissue removal and excellent visual outcomes. Most patients achieve 20/20 vision or better after surgery.

6. Suitable for Active Lifestyles

Because SMILE does not create a flap, it is ideal for athletes and individuals involved in contact sports or physically demanding jobs where eye trauma might be a risk.

Risks & Potential Side Effects of SMILE Surgery

While SMILE is a safe and effective procedure, all surgeries carry some risks. Here are some potential complications associated with SMILE:

1. Temporary Visual Disturbances

Patients may experience hazy vision, glare, halos, or starbursts around lights, especially at night. These symptoms usually improve within a few weeks to months.

2. Undercorrection or Overcorrection

In some cases, the vision correction may not be perfect, requiring an enhancement procedure or the continued use of low-power glasses. Unlike LASIK, SMILE has limited options for retreatment.

3. Mild Dry Eye Syndrome

Although less common than with LASIK, some patients may experience temporary dryness and irritation after surgery. This typically resolves with artificial tears within a few months.

4. Infection or Inflammation

As with any eye surgery, there is a small risk of infection or inflammation. Using prescribed antibiotic and anti-inflammatory drops as directed can help minimize this risk.

5. Interface Issues

In rare cases, retained lenticule fragments or improper healing may lead to corneal haze or irregular astigmatism,requiring additional treatment.

6. Slightly Longer Recovery Compared to LASIK

Although SMILE heals quickly, visual recovery may take a few days longer compared to LASIK, where improvements are often immediate.

How Does SMILE Compare to LASIK and PRK?

Each procedure has its pros and cons, and the best choice depends on your corneal thickness, lifestyle, and specific vision needs. Consulting an experienced eye surgeon can help determine which surgery suits you best.

What to Expect Before, During, and After SMILE Surgery

Before Surgery

• Your eye doctor will perform a comprehensive eye exam to assess your vision, corneal thickness, and eye health.

• You should stop wearing contact lenses a few days to weeks before surgery (your doctor will advise based on your case).

• Arrange for transportation on the day of surgery, as you won’t be able to drive immediately afterward.

During Surgery

• The procedure takes about 10-15 minutes per eye.

• You will be awake but given numbing drops to ensure a painless experience.

• You may feel mild pressure but no sharp pain.

After Surgery

• Expect mild discomfort or blurry vision for the first 24-48 hours.

• Avoid rubbing your eyes and follow all post-operative care instructions.

• Most patients can return to work and regular activities within 3-5 days.

• Full vision stabilization may take a few weeks to months.

Is SMILE Surgery Right for You?

SMILE is an excellent option for many patients, offering a minimally invasive alternative to LASIK with fewer complications and a fast recovery time. However, it may not be suitable for individuals with severe refractive errors, thin corneas, or unstable vision.

A detailed consultation with a qualified eye surgeon is essential to determine if SMILE is the best choice for your eyes.

For a personalized consultation and expert advice, visit RETINA & EYECARE CENTRE and take the first step toward freedom from glasses today!