Q1. What is SMILE?

SMILE is short for Small Incision Lenticule Extraction. It is a procedure that uses only one type of laser - the Femtosecond laser for the whole procedure, in contrast to Femto-LASIK which uses 2 different lasers – the Femtosecond laser to create the flap and the Excimer laser.

The SMILE Femtosecond laser is able to penetrate the surface of the cornea (the front part of the eye) without making any cut, and focus on the deeper part of the cornea to carve out a shape called the lenticule.

A small incision is also made at one side of the cornea to allow access to this lenticule and the surgeon is able to remove the lenticule from the cornea. Once the lenticule is removed, the overall shape of the cornea is altered and the prescription/power of the eye will be changed.

Q2. What are the benefits of SMILE over LASIK?

In SMILE, there is no corneal flap, unlike LASIK. When there is no flap, there is no worry about flap complications. Eg: the flap moving or dislodging (which can occur in LASIK).

By not cutting a flap, we keep the cornea much stronger compared to LASIK, this is especially relevant to those with higher powers or thinner corneas, as the tensile integrity of the cornea is reduced with the creation of a flap.

The third advantage is the preservation of the corneal nerves. In the process of cutting the flap during a LASIK procedure, we also cut a lot of the nerves, and these nerves help reduce post op dryness.

So in summary, by not having a flap, you get a stronger post operative cornea, lesser dry eyes, and no flap complications.

Also, for patient’s comfort – because only a small incision is made in SMILE, the patient experiences lesser post op irritation and pain as compared to LASIK, where a big flap incision is made.

Q3. Is SMILE better than LASIK?

In certain safety aspects, it is – no flap means no flap complications, and it maintains more corneal strength post op, compared to LASIK. It is also more comfortable, the patient experiences lesser dry eyes (because more corneal nerves are preserved) and less pain after the operation.

Vision-wise, results are similar to LASIK. LASIK has been around for a long time, and is a mature technology and procedure giving good and satisfying visual results.

Q4. How long has SMILE been made available to the public?

SMILE has been practiced in Europe and other parts of the world for over 5 years. In Malaysia, SMILE was made available to the public by OPTIMAX in August 2013.