SMILE Eye Surgery
Small Incision Lenticule Extraction
No flap. A small opening. A cornea largely left as it was.
At UELC, SMILE® is performed as SMILE® pro on the ZEISS VisuMax® 800 femtosecond laser, the current generation of the procedure: the laser creates the lenticule in about 10 seconds per eye. SMILE® is one of the three procedures in UltraView FREEDOM®, the laser vision correction program at U Eye Laser Cosmetic (UELC), alongside LASIK and PRK. It corrects near-sightedness and astigmatism by reshaping the cornea from the inside, through an opening of two to three millimetres.
Reshaping the cornea
from the inside.
SMILE stands for Small Incision Lenticule Extraction. In a near-sighted eye, light focuses in front of the retina rather than on it. The cornea, the clear front window of the eye, is where the correction is made: SMILE changes its curve by removing a thin, lens-shaped piece of tissue from inside the cornea, rather than by working on its surface.
A femtosecond laser shapes a thin disc of tissue, called a lenticule, inside the cornea, without opening the surface.
The same laser makes a small opening at the edge of the treated zone, about two to three millimetres wide.
Your surgeon lifts the lenticule out through that opening. No flap is created and no stitches are needed.
The cornea settles into a flatter shape, and light now focuses on the retina rather than in front of it.
Because no flap is created and the outer skin of the cornea stays largely intact, more of the cornea’s structure is preserved and fewer of its surface nerves are disturbed. For many patients that means a lower chance of dry eye after surgery than with LASIK. SMILE is the newest of the three UltraView FREEDOM® procedures, and at UELC it sits beside LASIK and PRK as an equal option rather than an upgrade.
The procedure that suits one cornea may be wrong for the next. That is why the decision belongs to an assessment, not to a search result.
Who SMILE tends to suit.
SMILE is used for near-sightedness (myopia), including higher prescriptions, and for astigmatism. The range of prescriptions it can treat is similar to LASIK’s. Whether it is the right procedure for your eyes is decided by measurements, not by preference.
Over 40 and mainly frustrated by reading vision? SMILE does not treat presbyopia, which has its own options — explore Vision After 40 → And if laser surgery is not right for your eyes, you are not at a dead end. Lens-based correction works with the eye’s own lens rather than its surface: refractive lens exchange is one route, and our colleagues at Uptown Eye Specialists assess patients whose eyes call for a lens-based approach.
How SMILE differs from
LASIK and PRK.
All three reshape the same part of the eye toward the same goal; they differ in how they reach the layer that is reshaped. LASIK lifts a thin hinged flap, reshapes the tissue beneath with an excimer laser, and lays the flap back: the fastest early recovery, but the flap is a permanent change. PRK removes the surface skin so the laser can reshape the surface directly; the skin regrows over three to five days, so the first week is sorer, but there is no flap. SMILE sits between them: no flap, a surface that stays largely intact, and a range of prescriptions similar to LASIK.
| SMILE | LASIK | PRK | |
|---|---|---|---|
| Flap | None (2–3 mm opening) | Thin hinged flap | None (surface layer removed) |
| Time to functional vision | Same day – 24 hrs | Same day – 24 hrs | 3 – 5 days |
| Early comfort | Minimal discomfort | Minimal discomfort | Sore for 3 – 5 days |
| Post-op dry-eye incidence | Lowest | Common, usually temporary | Common, usually temporary |
| Suited to thin corneas | Sometimes | Less often | Well suited |
| Contact-sport lifestyles | Well suited | With care | Well suited |
| Enhancement, if ever needed | Possible, primarily with PRK | Possible | Possible |
These are trade-offs, not rankings, and the right one for you is decided by measurable facts about your eyes. Our article SMILE vs LASIK vs PRK goes through the comparison in more depth.
Dry eye screening comes first.
A dry or unstable tear film can distort the measurements that guide the laser and make early recovery less comfortable. Before any UltraView FREEDOM® procedure, your ocular surface is evaluated and, if needed, treated and stabilized at the U Dry Eye Institute (UDEI). We treat this as a clinical requirement, not an afterthought, because it protects your result.
From consultation
to clear vision.
We map the shape and thickness of your cornea, measure your prescription in several ways, check the health of the rest of the eye and assess your tear film. Contact lens wearers leave their lenses out for a period beforehand so the cornea returns to its natural shape; we tell you how long. The consultation ends with an honest answer, which may be SMILE, LASIK, PRK, “not yet” or “not this”.
What we measure: corneal thickness and shape; the type, size and stability of your prescription; your tear film; pupil size in dim light; general health; and your work, sport and goals.
SMILE is done while you are awake, with numbing drops rather than needles or a general anaesthetic. You feel pressure and see changing lights rather than pain. The laser itself takes about 10 seconds per eye, though plan to be at the facility for two to three hours. Arrange for a friend or family member to drive you home.
Afterward: vision is blurry at first and improves noticeably by the end of day one, with mild scratchiness for a few hours. Rest with a protective shield as instructed.
Through the first week you use prescribed drops and follow the post-operative instructions you are given; most people are back to desk work within a few days. Avoid swimming and contact sports for the first month. Vision stabilizes over one to three months and reaches its final form by three to six months.
Follow-up: we see you at your one-week visit and through the first months. If an updated glasses prescription is ever needed, U Optical handles it once your vision has settled.
No procedure can promise a specific result. Your surgeon will share what is realistic for your prescription.
Risks and
limitations.
SMILE is a well-established procedure, and like any surgery it carries risks. We would rather you hear them from us clearly than discover them later.
Book a Free ConsultationA surgeon-led program,
guided by our own findings.
UltraView FREEDOM® is a surgeon-led program. The most surgically suitable procedure is only right if it fits how you live, which is why your assessment weighs your work, sport and goals alongside the measurements. UltraView FREEDOM® sits within U Vision Group, whose surgeons generate their own evidence, including published research from more than 3,000 ReLACS (laser-assisted cataract surgery) cases, and bring the same measure-first discipline to laser vision correction.
Good to know.
Medically reviewed by the Medical Advisory Council at U Vision Group.
Medical disclaimer. This page is for general educational purposes only and is not medical advice. It is not a substitute for an assessment, diagnosis or treatment from a qualified eye care provider. Every patient is different, and the information here may not apply to your situation. Any outcomes described are general and are not a guarantee of results. If you have questions or concerns about your eyes or vision, please speak with a qualified eye care professional or book an assessment with us.
SMILE®, SMILE® pro, ReLEx® and VisuMax® are trademarks of Carl Zeiss Meditec AG. U Eye Laser Cosmetic is an independent clinic and is not affiliated with or endorsed by ZEISS.
Is SMILE right
for your eyes?
Your assessment is a measurement, not a sales pitch. We will tell you honestly whether SMILE, LASIK or PRK suits your eyes, and if none of them does, we will explain your alternatives.