Frequently Asked Questions

SMILE stands for Small Incision Lenticule Extraction and reduces or eliminates the need for eyeglasses or contact lenses. In 2016, the FDA-approved the SMILE laser vision correction procedure to treat patients with nearsightedness and in 2018, the FDA approved the VisuMax laser used for SMILE for the treatment of nearsightedness and astigmatism, enabling a larger number of patients to be treated with SMILE too

While the procedure was approved in the US in 2016, it has been available in other countries since at least 2006 with more than 5 million procedures performed worldwide. According to the American Refractive Surgery Council, over 600 clinical studies have shown that the SMILE is equally safe and effective as LASIK, with similar long term outcomes.

https://pubmed.ncbi.nlm.nih.gov/30061116/

SMILE is a very attractive laser vision correction option because it is minimally invasive.

• The opening in the front surface of the eye known as the cornea is very small, less than 4 millimeters in length. This may enable the cornea to maintain more of its strength and resist traumatic injuries.
• The cornea or front surface of the eye remains mostly untouched.
• There may be a reduced chance of dry eyes after surgery because few nerves may be affected by surgery.1
• The recovery is very quick.
• And most patients return to their normal daily activities the very next day.
• Often recommended for people with active lifestyles and those who engage in contact sports such as basketball, wrestling, rugby, martial arts. Because there is no flap, there is less risk of complications from direct contact to the eye.

To find out if SMILE laser eye surgery is right for your eyes, schedule a consultation with us at Clearview Eye and Laser Medical Center. We will do a thorough exam,discuss your medical history, lifestyle and goals. Together, we will determine the best options for you to achieve a reduction or freedom from glasses and/or contact lenses.

• Alexandre Denoyer, Elise Landman, Liem Trinh, Jean-Francois Faure , Francois Auclin , Christophe Baudouin. Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule extraction versus LASIK . Ophthalmology. 2015 Apr;122(4):669-76.

It is generally thought that SMILE may cause less dryness than LASIK. A recent study by Drs. Manche and Ma presented the results of a one year study comparing the changes in corneal sensitivity and self-reported dry eye in eyes that had either wavefront-guided femtosecond LASIK or SMILE. Patients were examined at one month, three months, six months and one year after surgery.

While in the first six months, SMILE patients exhibited less changes to corneal sensitivity, by 12 months, there were no significant differences.

Additionally, by 12 months, there were significant improvements in dry eyes, to levels better than at surgery for both types of surgery. The reporting of dry eyes was not significantly different for the two groups at all points after surgery.

In conclusion, there is no significant difference in dry eye and corneal sensitivity between LASIK and SMILE. Although early, corneal sensation may be affected more in LASIK than SMILE. Dryness improves over time after both surgeries to levels better than before surgery!

https://www.aao.org/eyenet/academy-live/detail/corneal-sensitivity-dry-eye-symptoms-smile-lasik

During your complimentary consultation, we will examine and measure your eyes. We will:

• Check the overall health of your eyes.
• Test your vision, measure your current glasses and measure your glass prescription to make sure that your vision is stable. We want to ensure that your vision has not changed as well as measure how high your nearsightedness is and the amount of your astigmatism. These must fall into certain parameters to be a good candidate.
• Check for other eye problems that could affect your surgery and recovery or that aSMILE procedure could worsen.
• We will also easure and take a topographic map of the front surface of your eye known as the cornea. We will check the thickness of your cornea and take precise measurements of the cornea's inner and outer surface. These measurements are necessary for the software programs that the laser uses during your surgery to reshape your cornea.
• Measure your pupil size.

Additionally, we will discuss your general health, any chronic health issues, the health of your eyes, any history of eye surgery or issues, your lifestyle and your goals and expectations. Then we will determine if SMILE laser vision correction is the best procedure for you to achieve the best possible vision for your eyes and lifestyle.

Before beginning, the laser is programmed with the measurements taken during your comprehensive consultation.

Your eyes will be numbed with eye drops and you will be given a mild sedative..

Then Dr. Feldman will place an eyelid holder on your eye to keep you from blinking during the procedure.

Step 1: Create a thin disc of corneal tissue
The Visumax femtosecond laser uses small gas bubbles to create a thin disc of tissue within the layers of the cornea without disturbing the surface of the cornea. The shape of the disc is like the shape of a contact lens -- it is thicker in the center and thinner at the edge.  The disc is called a lenticule. 

Step 2: Remove the thin disc of tissue
The laser creates a small opening -- approximately 4 mm in the length in surface of the cornea.. whose purpose is to remove the lenticule.

Step 3: Vision correction is achieved
The disc removal allows for a change in the shape of the cornea to improve vision. 
The whole procedure takes about 15 minutes.