How SMILE works
One laser shapes a thin, lens-shaped disc of tissue (a lenticule) inside the cornea. The surgeon removes it through a small opening, and the cornea's new shape corrects the focus. There is no flap to lift and lay back. The treatment takes ten to fifteen minutes.
Who SMILE suits
Adults with short sight, with or without some astigmatism, whose prescription has held steady for at least a year. In the United States it is approved from age 22 for short sight between -1 and -10 and astigmatism up to 3. People with an active life or a contact sport like that there is no flap to dislodge.
Who should look at something else
- Anyone under 18. Laser eye treatment is for adults, and most clinics want you a little older, once the prescription has settled.
- Anyone whose prescription changed in the last year. Wait until it has held steady.
- Pregnancy and breastfeeding, when hormones can change the prescription. Wait until things have settled.
- Keratoconus, or a cornea the scans show is too thin or irregular for laser.
- Uncontrolled diabetes, or an autoimmune condition or medicine that affects healing, without extra assessment first.
- Long sight. SMILE treats short sight and astigmatism only.
- Very high prescriptions beyond the range above, where an implantable lens may suit better.
Recovery
Sight is blurry at first and improves over days and weeks. Most people are back to normal activities after a day or two. Keep water out of the eyes for a few days, use the drops as prescribed, and have someone drive you home on the day.
The risks, honestly
Glare and halos around lights at night, especially early on. Debris or inflammation where the disc was removed, and rarely infection. Under- or over-correction, which may need glasses, contact lenses or a top-up. Rarely, sight that is worse even with glasses. No laser can make you see better than you already see with your glasses on. It can only take the glasses away.
Where you can have it
SMILE needs a specific laser, and only a few clinics on the island of Ireland have one. Ask at your assessment whether the clinic offers SMILE, and if it doesn't, whether LASIK or LASEK would do the same job for your eyes.
What it costs
About €2,600 per eye, so about €5,200 for both. Tax relief at 20% applies, as for any laser treatment for sight.
Questions people ask
Is SMILE better than LASIK?
It avoids a flap, which matters in contact sports and may help dry eyes. LASIK treats more prescriptions, including long sight, and more clinics offer it.
Can SMILE correct long sight?
No. It treats short sight and astigmatism. Long-sighted eyes are treated with LASIK, LASEK or, later in life, lens replacement.
How long does SMILE take?
About ten to fifteen minutes in the laser room. Plan on a couple of hours at the clinic in all.
Can SMILE be topped up?
Yes, though the top-up is often done with surface treatment rather than a second SMILE. Ask how the clinic handles it and whether it is in the price.