SMILE (SMall Incision Lenticule Extraction) reshapes the cornea (the clear front part of the eye) using a laser to help it better focus light. Unlike LASIK or PRK, it treats a deeper layer of the cornea and only minimally disrupts the surface. This means the procedure is extremely comfortable with a very fast visual recovery and almost no restrictions after the procedure. SMILE is sometimes called LALEX (Laser-Assisted Lenticule EXtraction).
Here is an overview of the process but it’s important to know the specifics of your surgical plan may vary.
SMILE (Small Incision Lenticule Extraction) is a minimally invasive laser vision correction procedure that corrects nearsightedness and astigmatism. Instead of treating the surface like LASIK or PRK, SMILE uses a different kind of laser to create a thin, lens-shaped piece of cornea (called a lenticule) which is then removed through a tiny opening. This reshapes the cornea to focus light properly to improve vision.
SMILE is ideal for people with nearsightedness (up to –10.00 D) and astigmatism (up to –3.00 D), who are around 18 or older with stable prescriptions and healthy corneas. It’s especially beneficial for people with mild dry eye or those in contact sports. We will evaluate your eyes carefully to determine if SMILE is right for you.
SMILE takes about 15 minutes for both eyes, with the laser part lasting under 30 seconds. Recovery is very quick with most people noticing clearer vision by the next morning and can resume normal activities like driving or working within a day.
Yes! Enhancements or polishing are possible if a small prescription remains or vision changes over time. We have the knowledge and skillset to enhance SMILE in a very comfortable way and can avoid PRK in most cases.
Most people are 20/20 or better without glasses or contacts after SMILE. However, as you age, the natural lens inside your eye stiffens, a process called presbyopia or lens dysfunction, which affects near vision. This is unrelated to SMILE and happens to everyone, even those who never needed glasses before. This usually happens around the mid-40s and is why many people start to need readers or bifocals around this time. Don’t worry! There are plenty of ways to keep you out of glasses at any age!
SMILE can treat nearsightedness up to –10.00 D and astigmatism up to –3.00 D. It’s not currently approved for farsightedness or presbyopia is the United States, though clinical trials are ongoing. Patients should have a stable prescription for at least one year and no significant eye diseases like keratoconus. We offer plenty of other treatments for keratoconus!
SMILE is extremely safe. Risks generally include temporary dryness, mild glare, or in very rare circumstances residual prescription that needs to be retreated. Serious issues that threaten vision are vanishingly rare. Because the cornea is minimally affected, ongoing dry eye problems are etremely rare.
SMILE costs a few thousand dollars per eye, like LASIK. Like other vision correction surgeries, it’s considered an elective procedure and not covered by insurance. We offer flexible payment plans, HSA/FSA options, and financing to make it more accessible and vision correction pays for itself after a few short years compared to the ongoing expense of contact lenses or glasses!
Most patients notice sharper vision within a few hours, and the majority are able to drive the next morning. You can return to most activities almost immediately and resume exercise or makeup the day after the procedure.
Yes! Modern SMILE technology effectively treats up to 3 diopters of astigmatism, providing smooth and stable visual outcomes.
Symptoms of dry eye is very rare with SMILE. Most patients experience minimal dryness that improves within a week or two. Some may notice temporary glare or halos at night initially, but these typically fade as the cornea stabilizes and the brain adapts.
SMILE provides long-term, stable results, similar to LASIK. The change to the cornea is permanent, though your eyes will still age naturally over time. Vision remains clear for decades, with very low rates of needing a touch up or enhancement. If your prescription changes later, enhancement options remain available. When the eyes naturally reach the age of needing readers or bifocals there are plenty of ways to keep you out of these too!
SMILE is rarely performed after LASIK or PRK, but it’s an excellent option before those procedures or for some patients that don’t qualify for LASIK. For patients who’ve already had laser vision correction, EVO ICL, LASIK, or PRK may be better secondary options.
No. Having SMILE won’t complicate future cataract surgery. When the time comes, your surgeon will use updated measurements and formulas to select the correct lens implant. SMILE does not increase the risk of cataracts or interfere with advanced IOL technology.
After the procedure, you will have drops to take for a week. There are essentially no restrictions after SMILE and you will be able to get back to normal activities the day after the procedure! We will see you one day, one week, and one month after surgery.
We take all the measurements we need for any vision correction procedure at your consultation. It’s important to stay out of soft contact lenses for at least five (5) days and three (3) weeks for rigid contact lenses. If you have special contact lenses, let us know when you schedule your consultation. We can operate on the same day as your consultation with proper planning.
We take great care to make sure there is no discomfort at any point of the procedure. We use one laser for the entire procedure and carefully remove the section of cornea. The light may go dim at several parts of the procedure. It typically takes under 15 minutes for both eyes.
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