SMILE eye surgery (Small Incision Lenticule Extraction) is one of the most advanced laser vision correction techniques available today. It offers a minimally invasive alternative to LASIK and PRK, especially for those with myopia (nearsightedness) and astigmatism.
In this article, we’ll walk you through exactly how SMILE eye surgery works—step by step—to help you understand what to expect before, during, and after the procedure.
What Makes SMILE Different?
Unlike LASIK, which involves creating a corneal flap, SMILE reshapes the cornea by removing a small, lens-shaped piece of tissue (called a lenticule) through a tiny incision. This technique results in a more comfortable recovery, fewer dry eye symptoms, and no flap-related complications.
Step-by-Step Overview of the SMILE Procedure
1. Initial Consultation and Eye Evaluation
Before the procedure, your ophthalmologist will conduct a thorough eye exam to determine if you’re a suitable candidate. This includes:
- Measuring your corneal thickness
- Assessing your pupil size
- Mapping your corneal curvature (corneal topography)
- Evaluating your prescription stability
- Checking for dry eye or other underlying conditions
If you qualify, you’ll receive instructions on how to prepare for the surgery (e.g., stop wearing contact lenses before the appointment).
2. Day of the Procedure: Preparation
On the day of surgery:
- You’ll be asked to avoid makeup, lotion, or perfume.
- You’ll receive numbing eye drops to prevent discomfort during the procedure.
- You’ll be taken to the laser suite, where the entire procedure takes about 10–15 minutes for both eyes.
3. Laser Creation of the Lenticule
Using a femtosecond laser, the surgeon performs the following steps:
- Step 1: Lenticule Creation
The laser creates a precise, lens-shaped piece of tissue (the lenticule) inside the stromal layer of the cornea. This tissue mirrors the shape needed to correct your vision. - Step 2: Incision Creation
A small incision—usually about 2–4 mm—is made on the surface of the cornea. This is much smaller than the flap required in LASIK.
This laser portion is entirely bladeless, controlled by advanced software to ensure accuracy and safety.
4. Lenticule Extraction
Once the laser has completed the cutting process:
- The surgeon uses specialized tools to gently open the incision.
- The lenticule is carefully removed through the incision.
- Removal of this tissue changes the shape of the cornea, which corrects how light is focused onto the retina, improving your vision.
The entire process in each eye typically takes only 2–3 minutes.
5. Post-Procedure Recovery
After the lenticule is removed:
- There’s no need for stitches—the small incision heals naturally.
- You’ll rest for a few minutes before being discharged with detailed aftercare instructions.
- A follow-up appointment will be scheduled for the next day.
What Happens After the Surgery?
Immediate Post-Op Period
- Mild tearing, gritty sensation, or light sensitivity may occur.
- Vision may be slightly blurry but usually stabilizes within 24–48 hours.
1 Week
- Most patients can resume work, light exercise, and daily activities.
- Avoid swimming, eye makeup, and rubbing your eyes during the first week.
1 Month and Beyond
- Vision continues to improve and stabilize.
- Long-term results are highly predictable, with most patients achieving 20/20 vision or better.
Advantages of SMILE’s Step-by-Step Approach
Each stage of the SMILE procedure is designed to maximize comfort, safety, and visual outcomes:
- No flap means fewer complications
- Smaller incision reduces nerve damage (less dry eye)
- Fast procedure and fast recovery
- Preserves corneal biomechanical strength more effectively than LASIK
Final Thoughts
Understanding how SMILE eye surgery works step by step can help ease any anxiety you may have about laser vision correction. The combination of precision, minimal invasiveness, and a quick recovery makes SMILE an excellent option for many patients.
Always consult with a qualified refractive surgeon to see if SMILE is the right fit for your eyes and lifestyle.
