Femtosecond laser assessment during SMILE laser treatment

SMILE
Laser Treatment

Correcting myopia and astigmatism with a flapless, small-incision femtosecond laser method; particularly advantageous for a dry-eye tendency and an active life.

About SMILE Laser

SMILE (Small Incision Lenticule Extraction) is a modern, flapless, small-incision laser eye treatment method that aims to reduce dependence on glasses and lenses. It is used to correct myopia and the astigmatism that accompanies it.

In this method, a thin disc of tissue (a lenticule) is created inside the cornea with a femtosecond laser and removed through a very small incision of about 2–4 mm. The refractive power of the cornea is thereby changed and vision becomes clearer. Unlike LASIK, no large corneal flap is created; this largely preserves the surface integrity of the cornea.

SMILE is part of the family of laser eye treatments. For a comparison with other methods (LASIK, No-Touch) you can review our Laser Eye Treatments and LASIK Eye Surgery pages.

Who Is SMILE Suitable For?

After a suitability assessment, SMILE may be preferred for the following people:

  • Myopia and astigmatism: In people with myopia (and astigmatism) within certain ranges and a stable prescription.
  • Those with a dry-eye tendency: In those seeking an advantage for dry eye thanks to its flapless, small-incision nature.
  • Active life / sport: In people who do contact sports or are at risk of trauma, for whom flap safety matters.
  • Suitable corneal thickness: In candidates with an adequate, regular corneal structure and suitable topography.
  • Over 18 with a stable prescription: In people in a suitable age range whose prescription has not changed for at least a year.

Suitability is determined with corneal topography, thickness measurement and a detailed eye examination. Not every eye may be suitable for SMILE.

The SMILE Procedure and Comparison

SMILE is a short procedure performed in a single session:

  • Suitability assessment: Corneal topography and thickness, prescription stability and eye health are assessed.
  • Creating the lenticule: A thin disc of tissue (the lenticule) is prepared inside the cornea with a femtosecond laser.
  • Removal through a small incision: The lenticule is removed through an incision of about 2–4 mm; no large flap is created.
  • Difference from LASIK and PRK: In LASIK a corneal flap is created and in PRK a surface treatment is performed; SMILE is flapless and small-incision.

Which laser method is suitable is specific to each person; the decision is made according to examination findings.

The SMILE Procedure

Flapless Laser

SMILE Steps

SMILE laser icon

A flapless method in which a lenticule prepared with a femtosecond laser is removed through a small incision.

1
Suitability

Assessment

Corneal topography and thickness are assessed.

2
Lenticule

Laser

A lenticule is created inside the cornea with a femtosecond laser.

3
Removal

Small Incision

The lenticule is removed through a 2–4 mm incision.

Flapless, Small Incision

Advantage

Comfort & Comparison

Comparison icon

Thanks to its flapless structure, an advantage for dry eye and a fast return to active life.

1
Comparison

LASIK/PRK

Suitability for the method is assessed together.

2
Fast recovery

Comfort

Recovery is fast thanks to the small incision.

3
Follow-up

Monitoring

Vision stabilisation is monitored at check-ups.

Fast and Comfortable

Is SMILE right for you?

The most suitable laser method is decided together based on your corneal structure and prescription.

Book an Examination

Benefits & Aftercare

Benefits of SMILE

With its flapless, small-incision structure, SMILE is a comfortable and safe refractive method.

  • Flapless, small-incision application
  • Advantage for dry eye
  • Suitability for an active life and sport

Aftercare

Following simple advice after the procedure supports recovery and the result.

  • Not rubbing the eye in the first days
  • Regular use of the recommended drops
  • Attending check-up examinations

Frequently Asked Questions

In LASIK a flap is created in the cornea and the tissue beneath it is shaped with laser. In SMILE no flap is created; a thin disc of tissue (the lenticule) prepared inside the cornea is removed through a small incision of about 2–4 mm. Being flapless preserves the surface integrity of the cornea and provides an advantage for dry eye.
SMILE is particularly effective in myopia and the astigmatism that accompanies it. It may not be suitable in some situations, such as high hyperopia. Suitability is determined with a detailed examination and corneal measurements.
The procedure is performed with anaesthetic drops and is usually painless; it takes only a few minutes per eye. Afterwards there may be mild stinging and watering for a few hours.
Thanks to the small incision, recovery is fast; most people return to daily life within a few days. Vision improves markedly in the first days and becomes clearer and stabilises over the following weeks.
Temporary dryness can occur with any laser method; however, the flapless, small-incision structure of SMILE affects the corneal nerves less and is therefore considered advantageous for dry eye. Temporary dryness is managed with drops.
In suitable candidates and when the prescription is stable, the results are permanent. However, near vision (presbyopia) that develops at older ages is a separate condition and SMILE does not prevent it. The details are assessed at examination.