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SMILE eye surgery- 5 Important Aspects

SMILE eye surgery is a microprecision 30 second procedure irrespective of the treatment required. It is innovative twist to lasik eye surgery. As you may recall Lasik and Superlasik use mechanical devices or lasers to cut a plane in the cornea. What you may not be aware of that before lasers were deployed to improve vision, a procedure called ALK or Automated Lamellar Keratectomy existed. Here two different settings in a mechanical keratome cut a  disc proportionate to the amount of vision correction required. This was not very accurate but that’s the same principle being used in SMILE eye surgery. Full form of SMILE is Small Lenticular Extraction.

Just like ALK it removes tissue from a deeper part of the cornea than lasik. This layer of cornea is less dense and contributes less to the strength of the cornea. Theoretically, therefore more tissue could be removed from this deeper layer than the front of the cornea.

The laser platform used in SMILE eye surgery is Visumax. It has been developed by Carl Zeiss, from Germany.  Carl Ziess is well known in the ophthalmic community. They have produced advanced diagnostic equipment for decades. Slit lamps and topographers have set the industry standard. This laser can make flaps of different sizes. This is a femtosecond laser. That means it can be used with Visx laser to do lasik eye surgery. Normally  femtosecond lasers like intralase generate one cleavage plane. Visumax laser has the ability to produce one or two cleave planes. The tissue between the two cleavage planes  is removed. This is essence is SMILE Lasik eye surgery or small lenticular extraction procedure.

IS SMILE Lasik eye surgery an option for you?

Like Lasik eye surgery SMILE also requires a thorough evaluation. It may be a little forgiving but still has to respect the fundamentals of safe Corneal Refractive Surgery. Therefore, a stability in refraction is essential. A pachymetry distribution map in conjunction with color corneal topography is analyzed for safety of corneal intervention. A pentacam with computerized analysis is also helpful. Of course, absence of cataracts, glaucoma, maculopathy and other eye disease is required.

Who Can do SMILE Eye Surgery?

Only the very best lasik eye surgeons certified in SMILE eye surgery by Zeiss. This requires having done 50 lasik with the visumax laser. You see, this is a breakthrough technology which is painless. It require cooperation between surgeon and patient, without holding the eye with high pressure which causes pain, redness and visual disturbance. That’s why Zeiss insists on a strict training protocol.

SMILE Eye Procedure vs PRK And LASIK



Surface ablation just below the epithelium

​Reshaping done below epithelium and a portion of corneal stroma

A disc of corneal stroma is removed


Excimer laser like Allegretto or Visx reshapes the cornea

Excimer laser and a microkeratome or Femtosecond laser like intralaser employed

Only one femtoseocnd laser the Visumax used


​One plane treatment

​One plane treatment

Two plane treatment designs the outline of the lenticule

Gentle Treatment

Side Effects

Patient discomfort commons

​Risks of flap complication

​No flap complications

Smile Eye Surgery Los Angeles
Smile Eye Surgery with lenticule being removed

Smile eye surgery vs lasik

In lasik eye surgery a flap is created and the upper part of the cornea which provides most of the corneal tensile strength is ablated or removed. In SMILE eye surgery there is no flap. A 4 mm laser made corneal opening allows a laser cut disc of tissue to be removed.

Smile eye surgery success rate

This is a very successful procedure. OVer the last 15 years international experience helped improve the procedure – instruments used, laser and surgical skills. Today it rivals lasik eye surgery in outcomes. That means, there is over a 98 % chance of being 20/20.

Smile eye surgery near me

We make it convenient for you by having multiple screening and followup offices. These are located in Oxnard, Moorpar, Westlake Village, Sherman Oaks and Inglewood. The SMILE procedure is performed at Beverly Hills Laser suite.

Smile eye surgery pros and cons

Its a safe short duration procedure with great outcomes. Its great for higher treatments as amount of tissue removed is the same and from posterior cornea. Sometimes the healing can be delayed.

Potential Side Effects of Smile Eye Surgery

Smile surgery is one of the safest procedures in medicine. Still it is a surgery, and no surgical intervention is free from side effects. Lets discuss some of them and options on how to rectify them.

  1. Undercorrection and over correction: These can be refined with further laser correction. We provide this service at no extra charge.
  2. Visual disturbance like glare: These are common early after the procedure but fade away over time.
  3. Imperfect vision: When the interface is washed after SMILE to remove debris, there can be some irregular edema. This can result in imperfect vision which resolves over days but rarely weeks.
  4. Pain in eye: If nerves are stimulated there can be transient sharp painful episodes, much like occurs rarely after Lasik.
  5. Corneal Instability> even though SMILE is considered safer than lasik eye procedure, like lasik it can lead to corneal instability. Therefore we do a careful study of the cornea. We are luck Dr. Rajesh Khanna, our SMILE surgeon is a trained corneal expert with over two decades of experience.

Smile eye surgery gone wrong

During the procedure of SMILE eye surgery a patient has to be stable and concentrate on a green flashing light. Patient find the procedure comfortable and short that they rarely move. It can happen though an overtly anxious patient may squeeze eye while the laser is working. In such cases if the treatment has been less than 10 percent the patient interface can be areapplied and procedure restarted. It will start from the same spot it was left off at.

On the other hand if the treatment had reached more than 10 percent it would not be safe to restart. Therefore in such cases the procedure could be converted to a lasik with a flap.

Before and after smile laser surgery