When can I not get SMILE?

What is SMILE?

SMILE or, Small Incision Lenticule Extraction, is the newest advancement in the laser eye surgery and vision correction industry. SMILE is an improvement on the already well established and at its creation, revolutionary, laser eye surgeries LASIK and LASEK. 

SMILE is also a type of laser eye surgery. During SMILE surgery the Doctor uses a special type of laser called a femtosecond laser, to create a small, lens shaped piece of tissue within the cornea. This tissue is called a lenticule. The lenticule is responsible for producing curvature and thickness in the cornea. The Doctor will then use the same laser and make a small (usually around 4mm) sized, arc-shaped incision in the surface of the cornea. Once this is done the surgeon will remove the lenticule through the incision. This will then allow patients to refract light better onto the retina, which improves vision!

Why SMILE is preferred?

SMILE vision correction is preferred for a host of reasons. Firstly, SMILE is the least invasive procedure among the laser vision correction options. The reason is that only a small incision is made in the cornea, compared to entire removal of the cornea flap with LASEK. 

Due to the incision being smaller and less invasive, the turnaround time until you are fully recovered is also way less. Meaning you can get back to normal activities sooner as well as being able to see better almost right away. 

Lastly, SMILE is also reported to cause the least amount of discomfort with most people stating that they did not feel any pain or discomfort during or after the procedure. A welcome change for people who heard that LASEK can be slightly uncomfortable a few days after the surgery. 

Who can NOT get SMILE

Now we will look at some of the downsides of SMILE, specifically who is NOT eligible for SMILE. Two main groups of people who can unfortunately not get SMILE are patients with hyperopia and severe astigmatism.


Hyperopia or farsightedness, is a very common vision condition which is characterized by a person only being able to see objects that are far away. Objects that are nearby or relatively close might appear blurry. Hyperopia decreases your eye’s ability to focus. 


As of now clinics rarely use SMILE for the treatment of farsightedness. 

Here is an extract from CRSTEurope, explaining why: “An alternative approach to treating hyperopia using the lenticule extraction technique was first investigated in 2010. Although technically more difficult than myopic lenticule extraction, the investigators concluded that hyperopic lenticule extraction was feasible and merited further research. The results of the initial study, published 2 years later, were promising, but some eyes experienced similar problems to hyperopic LASIK, with a loss of corrected distance visual acuity and a significant degree of regression. It was surmised that the regression was most probably due to the treatment’s small transition zone size (<2.0 mm).”


Astigmatism is a condition by which an imperfection in the curvature of the eye causes objects far and near to appear blurry. And in the case of severe astigmatism, objects at almost any distance away from the eyes appear blurry. Astigmatism occurs when either the front surface (cornea) or the lens inside the eye have mismatched curves.  


This is not always the case, but in very rare situations the clinic might deem it safe for you to undergo SMILE surgery to treat severe astigmatism. The reason is that SMILE is still a relatively new procedure and not enough research has been done on the general application of SMILE surgery for normal astigmatism. 

Published by B&VIIT EYE CENTER

B&VIIT Eye Center is an ultra-modern, Korea's representative ophthalmic clinic that has successfully accomplished vision correction surgeries on over 500,000 eyes for 27 years.

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