SMILE (small incision lenticule extraction) is a laser eye surgery that treats astigmatism and nearsightedness. SMILE may mean that you don’t need to wear glasses or contact lenses anymore. You do have to meet certain criteria to be eligible for the surgery.
SMILE is a minimally invasive surgery. Its name gives an idea of what happens. The laser creates a lenticule and a tiny incision — less than 4 millimeters long — into your eye to remove your lenticule. Lenticules are disc-shaped pieces carved into your cornea by the laser. (The shape of the tissue is like an M&M®.) Removing the piece of tissue is what changes the shape of your cornea.
They may recommend SMILE eye surgery over other types of corrective surgeries if you have a higher prescription or issues with dry eyes. People who are candidates for SMILE eye surgery:
Your eye care provider may not recommend SMILE eye surgery if you:
Throughout the world, surgeons have done 5 million SMILE eye surgeries. The procedure became available in the U.S. in 2016, but had approval elsewhere about 10 years before that.
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In a pre-surgery appointment, your surgeon will examine your eyes to confirm you don’t have any other eye diseases or conditions that mean you shouldn’t have SMILE surgery. They’ll map out plans to remove the lenticule from your eye. For example, they’ll measure your cornea’s curvature and thickness.
Your provider will let you know how to prepare for surgery.
You should have an adult friend or family member with you to drive you home on the day of your surgery, too.
Your surgeon will numb your eye. They’ll use a femtosecond laser for the surgery.
The laser will create a small disc of tissue from your eye that looks much like a soft contact lens. It will be thicker in the middle and thinner along the edges. This disc is the lenticule.
Your surgeon will use the laser to make a small cut into your eye so they can remove the lenticule. By doing this, the surgeon changes the shape of your cornea and improves your vision.
Your eye doesn’t need stitches and will heal in about one or two days.
The SMILE surgery itself takes only minutes for each eye. The laser part only takes about 30 seconds.
After SMILE surgery, your friend or family member can take you home. You shouldn’t do anything strenuous that day. You’ll probably want to rest.
Your vision will get better over a matter of days or weeks. It may even be better right away. You’ll likely be able to return to your normal routine after one or two days. But you should be careful to avoid water in your eyes for a few days.
People have corrective surgeries because they want to get rid of their contact lenses or glasses. If you have SMILE eye surgery, you’ll be able to see better and be less dependent on glasses or contact lenses.
SMILE may be better than LASIK eye surgery for people who:
SMILE surgery offers a chance for less tissue and nerve damage, quicker healing and less inflammation than other types of corrective eye surgeries. SMILE surgery is painless, too.
One study of people who had SMILE surgery found that 99% of them had at least 20/40 vision six months after the surgery. The same study showed that 88% had 20/20 vision when they came in for their six-month check-up.
Any surgery comes with risks or the chance of complications. Even though SMILE surgery is very safe and effective, you may have issues:
You should be able to resume regular activities in a few days, but you’ll still need to avoid getting water in your eyes for at least that long. Your vision may seem better even at first. It will continue to improve in the coming days and weeks.
In addition, you should:
Your surgeon will give you instructions after your procedure. These instructions will tell you when you need to call. But typically, you should call your provider or get emergency help if:
Both SMILE eye surgery and LASIK eye surgery are very safe procedures. SMILE may have an advantage because it is less invasive than LASIK. There’s also less chance of nerve or tissue damage.
The SMILE procedure is a little newer than other eye surgeries. There may be fewer surgeons familiar with doing SMILE surgery than LASIK or photorefractive keratectomy (PRK). There may also be fewer research studies on SMILE surgery.
A note from Cleveland Clinic
Many people who wear contact lenses or glasses decide they don’t want to wear them any longer. Your eye care provider is your partner in sight. Ask them if they would recommend any type of corrective surgery, like SMILE eye surgery. They’ll direct you to the safest option for you. If you have SMILE surgery, be sure to do what your surgeon tells you so you have the best results.
Last reviewed by a Cleveland Clinic medical professional on 06/15/2023.
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