What is SMILE® Pro?
SMILE (Small Incision Lenticule Extraction) is a minimally invasive procedure where a laser creates a lenticule (or disc shape) inside the cornea, which is removed through a tiny incision. This reshapes the cornea to optimise focus and sharpen vision.
The cornea is made up of five layers, but SMILE ® Pro surgery focuses on the central layer, known as the stroma. During surgery, a computer-guided laser creates a precise lens-shaped disc (known as a lenticule) in the stroma. The shape of the lenticule is customised to correct the specific shape of your cornea. The laser then makes a tiny keyhole incision, and the lenticule is removed. When the process is complete, the cornea is shaped to optimise focus and sharpen vision long term.
How does SMILE® Pro work?
Comfort and Ease
The laser portion of the procedure is quick it’s all over in under 10 seconds. The technology is also designed to ensure it’s a comfortable procedure. Although everyone is different, recovery is quick – most people will be feeling good the next day.
Key Facts about SMILE® Pro
Precision is enhanced through femtosecond laser technology. The laser procedure requires less time.
Minimally invasive technique (2mm incision) promotes rapid healing and reduces the risk of inflammation and infection.
Suitable for patients with myopia up to 1000 degrees and astigmatism below 500 degrees.
Preserves corneal integrity with no risk of corneal displacement.
Low risk of corneal nerve damage. More suitable for patients with dry eye syndrome compared to traditional Lasik.
Vision recovers rapidly, with noticeable improvement within days.
SMILE ® Pro Treatment Steps
1. Non-binding, personal consultation
During the preoperative examination stage, you will undergo a complete and comprehensive eye examination. We will assess whether you are a suitable candidate for SMILE® Pro through this eye check and, based on the results, discuss a personalized surgical plan.
Before the comprehensive eye examination, you should avoid wearing soft contact lenses for at least one week or rigid gas permeable lenses for at least two weeks, as long-term wear can alter the shape of the cornea.
2. Comprehensive preliminary examination
On the day of surgery, it is recommended that you wear comfortable clothing and avoid driving yourself to our center. You may arrange for a family member or friend to accompany you, take a taxi, or use public transportation.
You may eat and drink normally, but must refrain from smoking.
On the day of the procedure, avoid using cosmetics such as face creams, lotions, makeup, and perfume, as they may increase the risk of infection or contamination in the surgical area.
3. The SMILE®️ Pro treatment
This is a day surgery, with both eyes taking approximately 20 minutes. The doctor will verify your personal information and then apply anesthetic eye drops to numb the cornea. An eyelid speculum will be used to prevent blinking during the procedure, while the other eye will be covered.
The doctor will use the VisuMax femtosecond laser to create a lenticule inside your cornea. During this process, a contact lens will be used to stabilize the eye. You will see a bright spot but will experience minimal discomfort. The doctor will then make a small incision of no more than three millimeters to remove the lenticule through this opening. The incision will close naturally and does not require sutures.
After the surgery, the wound will heal naturally without the need for stitches.
4. After the SMILE®️ Pro treatment
After the surgery, you should avoid rubbing your eyes, continue using the prescribed antibiotic eye drops as instructed, and use artificial tears as needed.
You may experience a foreign body sensation in your eyes after the procedure, but this feeling will gradually subside within a few hours. Using the prescribed eye drops can effectively alleviate any discomfort.
Typically, you can return to work within two to three days. However, you should wait approximately one month before resuming contact sports and water-based activities to reduce the risk of infection.
Follow-up appointments will be scheduled one day, one week, and one month after the surgery. Refrain from driving until your vision has stabilized. As each individual’s eye condition varies, please discuss any concerns with our ophthalmologist.
How does it work?
Refractive correction has usually involved the surgeon first cutting a flap, which was then folded back to remove corneal tissue point by point. SMILE® Pro now enables laser vision correction without a corneal flap and thus minimally invasive.
1. Creation of the lenticle and the incision
The first step with the VisuMax is to create a refractive lenticule and a small incision of no more than two to three millimeters in the intact cornea, which can be done almost independently of the surrounding conditions and corneal condition.
2. Removal of the lenticle
In the second step, the lenticle is removed through the created incision. Since no flap is cut, this is only a minimal intervention in the biomechanics of the cornea.
3. Rehabilitation
Removal of the lenticle changes the cornea to achieve the desired refractive change.
SMILE® Pro FAQs
What kind of technology is SMILE® Pro?
A femto-laser is an infrared light laser that treats tissue such as the cornea not only very precisely, but also with much less heat than other lasers. This proves to be a decisive advantage, especially in eye surgery. The femtosecond laser works on the basis of ultra-short light pulses. These last only fractions of a billionth of a second; their spot size is only 1/100 mm.
What equipment does EuroEyes use for SMILE® Pro?
A specially developed laser system, the VisuMax femtosecond laser from Carl Zeiss, is used for SMILE®️ Pro treatment. This laser has already proven itself in Femto-LASIK procedures with its sophisticated technology, precision and reliability. Through further development, it is now possible for the first time to prepare a lenticule within the intact cornea with millimeter precision, so that larger incisions and a flap can be dispensed with. In this way, the surrounding corneal tissue is spared as much as possible and the visual defect can be corrected in a targeted manner.
In addition to its high precision, a particular advantage of femtosecond technology is that it is highly reproducible and accurately predictable even when high corrections are involved.
In order to avoid unnecessary compression of the cornea, a contact lens is used that is adapted to the individual corneal anatomy and allows a precisely fitting treatment. This also avoids short-term visual loss, which can be caused by excessive intraocular pressure.
In addition to state-of-the-art laser technology, a functionally sophisticated and ergonomically shaped patient couch has also been developed for SMILE®️ Pro, allowing for maximum comfort and the most relaxed position possible during the procedure. During the operation, the patient’s position is continuously monitored and can be automatically readjusted if necessary.
What are the the key differences between SMILE® Pro and Femto-LASIK?
The key differences between SMILE® Pro and Femto-LASIK (femtosecond LASIK) surgery are as follows:
- Flap vs. no flap: Femto LASIK involves creating a corneal flap, whereas SMILE® Pro is a minimally invasive procedure without a flap.
- Recovery: Both surgeries offer fast recovery times, but SMILE® Pro is associated with less dry eye and a slightly quicker return to regular activities for some patients.
- Range of Correction: Femto LASIK is suitable for correcting a wider range of vision problems, including myopia, hyperopia, and astigmatism. SMILE® Pro is primarily focused on treating myopia.
Is SMILE® Pro suitable for patients with dry eye?
In SMILE® Pro, there is no need to create a corneal flap, which better preserves corneal integrity and stability while reducing postoperative complications. Since the cornea remains stable and tear film stability is less affected, SMILE® Pro is also suitable for patients with dry eye syndrome or those who are not suitable candidates for wearing contact lenses.
Is there an age limit for SMILE® Pro surgery?
The minimum age requirement for SMILE® Pro is 18 years old. Your refractive error should have been stable for approximately one year before treatment. If you have any questions, please schedule a consultation immediately so we can carefully examine your vision.
What should I know about the pre-operative examination?
The minimum age requirement for SMILE® Pro surgery is 18 years old. The pre-operative examination for SMILE® Pro takes approximately 1.5 to 2 hours. Before a comprehensive eye examination, you should avoid wearing soft contact lenses for at least one week or hard contact lenses for two weeks.
Is SMILE® Pro painful?
Different people have different pain tolerance levels. SMILE Pro is a minimally invasive procedure. Numbing eye drops will be used before the surgery. Because the incision is extremely small and recovery is fast, there will only be a slight foreign body sensation during the procedure. Usually, by the second day after the surgery, you can see 80-90% of what you saw before using vision aids, and you will recover to almost full vision within 3 days. This data is a general guideline, and the exact results will vary depending on individual circumstances.
After SMILE® Pro, when can I put on makeup again? Can I wear colored contact lenses?
- Makeup: Normal makeup is possible except for eye makeup. It is recommended to wait at least one month before put on eye makeup.
- Contact Lenses: The quality of contact lenses on the market varies greatly. Short-term wear has little impact, but long-term use is not recommended.
After SMILE® Pro, when can I use my phone/computer?
Normal use of mobile phones/computers after surgery is not affected, but you should avoid excessive use of the eyes to affect recovery. Rest is appropriate depending on the condition of both eyes.
After SMILE® Pro, am I allowed to drive? Or travel by high-speed rail/airplane?
- Driving: Driving is not affected after surgery, but safe driving is always advised.
- Air travel/High-speed rail: There are no restrictions on air or high-speed rail travel after surgery, but long-distance travel is recommended to be avoided during the early stages of recovery.
When can I resume exercise/fitness after SMILE® Pro?
Strenuous exercise should be suspended: Please avoid strenuous exercise within one month after surgery to prevent sweat from getting into the eyes and causing infection.
I am over 38 years old. Would you still recommend SMILE® Pro to me?
For individuals who have been troubled by myopia for a long time, the more popular options currently available are SMILE® Pro or ICL implantable contact lenses. While the age at which presbyopia appears varies from person to person, most people begin to experience related symptoms after the age of 40. Therefore, individuals aged 38 and above must also consider the “near future” when choosing a vision correction solution.
Presbyond LBV is a type of Laser Blended Vision method. It can be considered as an option for people aged 38 and above. Presbyond LBV effectively addresses myopia, hyperopia, and astigmatism while simultaneously mitigating the effects of presbyopia. However, it is essential to take a detailed preoperative examination to have a professional assess whether you are a suitable candidate for the procedure.