30 Important Questions About SMILE Pro

Get answers to 30 important SMILE Pro questions, including cost, recovery, safety, eligibility, results, and LASIK comparison in 2026.

If you are considering laser vision correction, you have likely encountered a sea of acronyms: LASIK, PRK, Contoura, and now, SMILE Pro.

As a refractive surgeon with over 10 years of experience, I find that my patients in Hyderabad arrive with many questions, driven by meticulous online research. They want to understand not just the "what," but the "why" and "how."

This guide is designed to answer the 30 most critical questions I hear about SMILE Pro, providing the scientific clarity you need to make an informed decision.

We will cover everything from the basic science and its comparison with other procedures to eligibility, the surgical experience, recovery, and cost.

In this article

The Basics: What is SMILE Pro?

Let's begin by demystifying the technology itself. Understanding the fundamentals is the first step towards feeling confident about your choice.

What exactly is SMILE Pro, and how does it differ from the original ReLEx SMILE?

SMILE stands for SMall Incision Lenticule Extraction. SMILE Pro is the third generation of this procedure, representing a significant technological leap over its predecessor, ReLEx SMILE.

Both procedures work on the same principle: a femtosecond laser carves a precise, disc-shaped piece of tissue (the lenticule) inside the cornea.

The thickness and shape of this lenticule are customised to your exact refractive error. I then remove this lenticule through a tiny incision. This process reshapes the cornea, correcting your vision.

The "Pro" in SMILE Pro comes from the advanced machine used: the ZEISS Visumax 800. This upgraded laser platform introduces two game-changing enhancements:

1. Speed: It dramatically reduces the laser treatment time.
2. Intelligence: It incorporates sophisticated eye-tracking and centration aids that help the surgeon align the treatment perfectly.

How does the Visumax 800 laser make the "Pro" version faster?

The laser portion of the original SMILE procedure took about 25-30 seconds. While that is already quick, for a patient lying under the laser, every second can feel like an eternity.

The Visumax 800 laser in SMILE Pro has a much faster pulse repetition rate. This allows it to create the lenticule in less than 10 seconds.

This isn't just about patient comfort. A shorter laser time reduces the risk of intraoperative complications, most notably "suction loss," which we will discuss later. It requires less patient cooperation and leads to a smoother, more predictable procedure.

Is SMILE Pro a "bladeless" and "flapless" surgery?

Yes, SMILE Pro is both bladeless and flapless, which are its defining characteristics.

• Bladeless: Like modern LASIK, it uses a high-precision femtosecond laser to make all incisions. No mechanical blades (microkeratomes) are involved, enhancing safety and predictability.
• Flapless: This is where SMILE Pro truly distinguishes itself from LASIK. In LASIK, a circular flap, about 20 mm in circumference, is cut and lifted to expose the underlying cornea for reshaping. SMILE Pro does not require this flap. Instead, the entire procedure is performed through a micro-incision of just 2-4 mm.

How does removing a "lenticule" correct vision without a LASIK flap?

Think of your cornea as a lens. Your refractive error (nearsightedness or astigmatism) is due to this lens being shaped incorrectly, causing light to focus in front of the retina instead of directly on it.

All laser vision correction procedures work by reshaping this lens.

• LASIK does this by ablating (vaporising) tissue from the corneal bed after lifting a flap.

   

• SMILE Pro achieves the same goal through a different method. The femtosecond laser creates the "lenticule" within the intact cornea.

   

  This lenticule is essentially the 'excess' tissue that is causing your refractive error. By removing it, I am changing the overall curvature of your cornea, allowing light to focus correctly on the retina. It’s like performing the correction inside the cornea rather than on its surface.

Why is SMILE Pro often called "keyhole" laser eye surgery?

The term "keyhole surgery" is an analogy borrowed from general surgery (like laparoscopy) to describe a minimally invasive technique.

SMILE Pro earns this name because the entire procedure is performed through a single, tiny incision—as small as 2 mm.

Imagine needing to fix something inside a locked room. LASIK is like opening the door (the flap) to work inside.

SMILE Pro is like working through a small keyhole to achieve the same result without compromising the door's structure. This minimal disruption is the core benefit of the procedure, leading to better corneal biomechanical stability and a lower risk of dry eyes.

(Put Real times images and shorts of Dr Avdaith Sai Consulting, Operating on Patients)

Comparison: SMILE Pro vs. Others

Patients often ask me, "Doctor, which procedure is the best?" The answer is always, "The best one for your eyes and lifestyle." Let’s compare SMILE Pro to other common procedures.

SMILE Pro vs. LASIK: Which one is better for high-impact athletes?

For high-impact athletes, police officers, military personnel, or anyone with a physically demanding job, my recommendation is almost always SMILE Pro.

The reason is the flap. In LASIK, the corneal flap never fully heals with the same strength as the original tissue. It is always a potential weak point. A direct, forceful impact to the eye, even years after surgery, can dislodge or damage the flap, leading to serious complications.

In my practice at Envision LASIK Centre, I've consulted with several young men who are passionate about boxing or martial arts.

For them, the flap-related risk of LASIK is a non-starter. SMILE Pro, being flapless, eliminates this concern entirely. The structural integrity of the cornea remains largely intact, making it the safest and most robust option for those who cannot afford to worry about an eye injury.

Can SMILE Pro treat farsightedness (hyperopia), or is it only for nearsightedness?

As of early 2026, SMILE Pro in India is primarily FDA-approved for treating myopia (nearsightedness) and astigmatism. Research and trials for treating hyperopia (farsightedness) with SMILE are ongoing globally, and it is expected to receive approvals in the future.

For now, if you have significant hyperopia, other procedures like Contoura Vision or Femto-LASIK remain the gold standard. During a pre-operative evaluation, we determine the best procedure based on your specific refractive error.

Why is the risk of "Dry Eye" significantly lower with SMILE Pro than with LASIK?

This is one of the most significant advantages of SMILE Pro and a key discussion point in my consultations. The cornea is rich in nerves that help regulate tear production and the blink reflex.

• In a LASIK procedure, creating the 20 mm flap severs a large number of these superficial corneal nerves. While these nerves eventually regenerate, it can take months, and in some patients, the process is incomplete. This nerve disruption is the primary cause of post-LASIK dry eye syndrome.
• In SMILE Pro, the 2-4 mm keyhole incision cuts far fewer nerves—up to 80% fewer than in LASIK. This preserves the natural nerve architecture of the cornea.

I recently treated a 30-year-old software engineer who spent over 12 hours a day on his computer and already suffered from mild screen-related dry eyes. He was worried that surgery would make it worse.

We chose SMILE Pro precisely for this reason. Post-operatively, he experienced minimal dryness that resolved within a few weeks, allowing him to work comfortably without the constant need for lubricating drops that can sometimes follow LASIK.

SMILE Pro vs. Contoura Vision: Which offers better night vision results?

Both SMILE Pro and Contoura Vision are excellent modern procedures known for producing high-quality vision.

• Contoura Vision is a topography-guided LASIK procedure. It creates a highly detailed map of the cornea, measuring over 22,000 points, to correct microscopic surface irregularities. This can lead to exceptional "super-vision" (better than 20/20) and is particularly effective at reducing pre-existing night vision issues like glare, halos, and starbursts.
• SMILE Pro uses a highly precise laser system (Visumax 800) that is also known for producing excellent night vision quality. Because the procedure is so gentle and the optics are smooth, most patients report very clear night vision.

The choice often depends on the individual eye. If a patient's primary concern is pre-existing higher-order aberrations causing poor night vision, Contoura might have a slight edge.

However, for a patient with a high prescription and concerns about dry eyes or corneal strength, SMILE Pro is often the superior choice. The quality of vision with both is generally outstanding and a significant improvement over glasses or contacts.

If I have thin corneas, am I a better candidate for SMILE Pro or PRK?

This is an area where a detailed corneal evaluation is critical. For patients with borderline or thin corneas, LASIK is often ruled out because creating a flap would leave the remaining corneal bed too weak. The choice then comes down to SMILE Pro vs. PRK (Photorefractive Keratectomy).

• PRK is a surface-based procedure. It does not involve a flap or lenticule. The topmost layer of the cornea (epithelium) is removed, and the excimer laser is applied directly to the surface. It preserves the maximum amount of corneal tissue, making it very safe for thin corneas. However, the recovery is longer and more uncomfortable as the epithelium needs to heal.
• SMILE Pro also preserves corneal strength because it's flapless. It can often be performed on corneas that are too thin for LASIK.

The decision is based on a specific measurement: the residual stromal bed (RSB). This is the amount of corneal tissue left untouched after the procedure. We have strict safety guidelines for this.

In my practice, if a patient's cornea is thin but thick enough to safely accommodate a SMILE Pro lenticule extraction while leaving a healthy RSB, I recommend SMILE Pro for its faster recovery and greater comfort. If the cornea is exceptionally thin, PRK remains the safest option.

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Eligibility & Candidacy

Not everyone is a perfect candidate for SMILE Pro. A thorough screening at our Hyderabad centre is essential to ensure safety and optimal outcomes.

What is the maximum power (diopters) SMILE Pro can correct?

SMILE Pro is approved to correct:

• Myopia (nearsightedness): Up to -10.0 Diopters (D)
• Astigmatism: Up to -5.0 Diopters (D)

These are the official limits, but as a surgeon, I apply my clinical judgment. For a patient with a very high prescription, say -9.5 D, I will meticulously evaluate their corneal thickness, topography, and age. The goal is not just to correct the power but to ensure long-term corneal stability.

Can SMILE Pro fix astigmatism, and what is the limit?

Yes, SMILE Pro is very effective at correcting astigmatism (or "cylindrical power"). The lenticule created by the laser is shaped asymmetrically to compensate for the irregular, oval shape of an astigmatic cornea. It can correct astigmatism up to -5.0 D. The Visumax 800's advanced centration and axis alignment tools are particularly helpful in ensuring the treatment is perfectly placed to neutralize the astigmatism.

Why do I need to be at least 18 years old with a stable prescription for SMILE Pro?

Vision correction surgery reshapes the cornea permanently. We need to perform this on a "stable" platform.

• Age: The eye continues to grow and change throughout the teenage years. Performing surgery before the eye has fully matured could lead to an inaccurate result, with the refractive error returning as the eye continues to change. The age of 18 is generally considered the minimum, though many surgeons, including myself, prefer patients to be at least 20-21.
• Stable Prescription: A stable prescription means your glasses or contact lens power has not changed by more than 0.5 D in the past year. This indicates that your eyes have stopped changing, and the results of the surgery will be long-lasting. Performing surgery on an unstable prescription is like trying to tailor a suit for someone who is still growing.

Is SMILE Pro safe for patients with a history of mild dry eyes?

Yes, in fact, SMILE Pro is often the preferred procedure for patients with pre-existing mild to moderate dry eyes. As discussed, its nerve-sparing technique makes it far less likely to exacerbate the condition compared to LASIK.

At Envision LASIK Centre, if a patient presents with signs of dry eye during their evaluation, we first work to manage and treat the condition. This might involve optimising their lid hygiene, prescribing specific lubricating drops, or other therapies. Once their ocular surface is healthy, we can proceed with SMILE Pro, confident that we are minimising the risk of post-operative discomfort.

Can I get SMILE Pro if I am pregnant or breastfeeding?

No. Hormonal fluctuations during pregnancy and breastfeeding can affect the fluid balance in the body, which can temporarily alter the shape of the cornea and your refractive error.

Performing surgery during this time could lead to an inaccurate correction. Furthermore, the medicated eye drops used before and after surgery could potentially be absorbed and affect the baby.

We advise waiting at least 3-6 months after you have finished breastfeeding to ensure your hormones and prescription have stabilised before considering surgery.

The Procedure Experience

The idea of eye surgery can be daunting, but SMILE Pro is a remarkably quick and smooth experience. Let's walk through what happens on the day.

Is the SMILE Pro procedure painful, or will I be sedated?

The procedure itself is not painful. Before we begin, we administer topical anaesthetic eye drops that completely numb the surface of your eye. You will not feel any pain or sharpness.

You might feel a light pressure sensation on your eye for a few seconds during the laser part, but that's it.

We do not use general anaesthesia or heavy sedation. You are awake and aware throughout the short procedure. If you are particularly anxious, we can provide a mild oral sedative to help you relax.

What happens if I accidentally blink or move my eye during the 10-second laser pulse?

This is a very common fear, but the technology is designed to account for it.

1. Blinking: A small, gentle instrument called a speculum is used to hold your eyelids open. It prevents you from blinking automatically. It's not uncomfortable, and you won't even have to think about it.
2. Eye Movement: The Visumax 800 laser in SMILE Pro has a fast, sophisticated eye-tracking system. It monitors the position of your eye hundreds of times per second. If you make a small movement, the laser adjusts its position instantly. If you make a large, sudden movement, the laser will automatically pause. Once your eye is repositioned, the procedure resumes exactly where it left off.

Do I need to treat both eyes on the same day?

Yes, in nearly all cases, we treat both eyes on the same day. This is known as bilateral surgery. The procedure is so quick and the recovery is so rapid that it is far more convenient for the patient to have it all done at once. You experience the recovery and visual improvement in both eyes simultaneously.

How long will I actually be inside the operating room?

While you might be at our Hyderabad centre for a couple of hours for preparation and post-op checks, your time in the operating room itself is very short.

For a bilateral SMILE Pro procedure, you will typically be on the operating bed for about 10-15 minutes in total. The laser application is under 10 seconds per eye, and the manual removal of the lenticule takes another minute or two per eye.

What is "suction loss," and how does the Visumax 800 prevent it?

During the laser part of the procedure, a curved contact glass lightly touches and holds your eye steady using gentle suction. "Suction loss" occurs if this contact is broken before the laser has finished creating the lenticule, often due to a sudden eye movement or squeeze. In older generations of lasers where the process took 30 seconds, this was a more significant concern.

The Visumax 800 minimises this risk in two ways:

1. Speed: By completing the laser treatment in under 10 seconds, the window of opportunity for suction loss to occur is drastically reduced.
2. Gentle Suction: The system uses a very low-pressure suction that is more comfortable for the patient and less likely to be broken by an involuntary squeeze.

Recovery & Results

The visual recovery after SMILE Pro is impressively fast, but it's important to understand the healing timeline.

How soon can I return to work or look at a screen after SMILE Pro?

Most of my patients are functional and able to return to work, including computer use, within 24-48 hours. Immediately after the procedure, your vision will be a bit foggy or misty, as if you're looking through a steamy bathroom mirror. This is normal and is due to microscopic swelling in the cornea.

I recently treated a financial analyst who had the procedure on a Friday. He rested over the weekend, and by Monday morning, his vision was clear enough to read spreadsheets comfortably.

While you can use screens, it's crucial to follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds, and use your lubricating drops frequently to prevent dryness.

When can I resume wearing eye makeup and swimming?

To prevent infection and irritation, we have strict guidelines for this:

• Eye Makeup: You should avoid all eye makeup (mascara, eyeliner, eyeshadow) for at least one week.
• Swimming: You must avoid swimming pools, hot tubs, lakes, and the ocean for at least two weeks. These bodies of water can harbour bacteria that could cause a serious eye infection.
• Head Shower: You can take a careful head shower after 2-3 days, ensuring you keep soap and water out of your eyes.

Is it normal to see "halos" or "starbursts" around lights immediately after surgery?

Yes, it is very common and normal to experience some glare, halos, or starbursts around lights, especially at night, during the first few days or weeks after surgery.

This is part of the healing process and is caused by the light scattering from the interface where the lenticule was removed and from minimal corneal swelling.

For the vast majority of patients, these symptoms gradually diminish and resolve as the eye heals completely over the next few weeks.

How long does it take for vision to stabilize completely (20/20 result)?

While you will notice a dramatic improvement in your vision within the first 24 hours, the final, crisp 20/20 (or 6/6) vision can take some time to fine-tune.

• First Week: Vision is typically good but may fluctuate slightly.
• First Month: Vision becomes much more stable and clear. Most patients are seeing 90-100% of their final result by this point.
• 1-3 Months: The vision continues to sharpen as the last bit of internal healing takes place.

It's a process of neural adaptation as well. Your brain has spent years accustomed to interpreting a blurry image (or an image through glasses/contacts) and now needs to adjust to a new, clear one.

Are the results of SMILE Pro permanent, or can my vision "regress"?

For a properly selected candidate with a stable prescription, the results of SMILE Pro are considered permanent. The corneal reshaping does not reverse.

However, the eye is a living biological organ. In a very small percentage of patients, particularly those with very high initial prescriptions, a minor amount of "regression" can occur over time.

This is not the cornea changing back, but a subtle biological healing response.

More commonly, vision changes later in life (in your 40s and beyond) are due to natural aging processes like presbyopia (the need for reading glasses) or cataracts, which are unrelated to the SMILE Pro procedure.

Cost & Logistics

Understanding the financial investment is a practical and important part of the decision-making process.

Why is SMILE Pro generally more expensive than standard LASIK?

The cost difference is primarily due to two factors:

1. Technology: The ZEISS Visumax 800 laser is a highly advanced, state-of-the-art piece of medical equipment that represents a significant capital investment for the clinic.
2. Consumables: There is a per-procedure license fee and a single-use patient interface kit that the manufacturer (ZEISS) charges the clinic for each eye treated. This ensures the highest level of sterility and performance for every patient.

Essentially, you are paying for the most advanced, safest, and gentlest technology currently available for laser vision correction.

Is SMILE Pro covered by health insurance (under "specs removal" clauses)?

In India, most standard health insurance policies consider laser vision correction to be a cosmetic procedure and therefore do not cover it.

However, some corporate policies or premium plans may have clauses that cover "specs removal" if the refractive error is above a certain high diopter (e.g., > -7.0 D). It is always best to check the specific terms and conditions of your personal health insurance policy.

We provide all necessary documentation at Envision LASIK Centre to help you with your claim if you are eligible for reimbursement.

What is the average cost of SMILE Pro in 2026 in Hyderabad, India?

While prices vary between clinics based on the technology, surgeon's experience, and what's included in the package, the average cost for a bilateral SMILE Pro procedure in a top-tier centre in Hyderabad in 2026 is typically in the range of ₹1,20,000 to ₹1,50,000 for both eyes.

Be cautious of centres offering the procedure at a significantly lower cost, as this may indicate the use of older technology or compromises in care standards.

What is included in a SMILE Pro "package"?

A comprehensive and transparent SMILE Pro package, like the one we offer at Envision LASIK Centre, should include:

• A complete pre-operative evaluation and consultation.
• The SMILE Pro procedure itself for both eyes.
• All necessary post-operative medications and eye drops for the initial healing period.
• A set of protective glasses.
• A schedule of follow-up appointments for at least the first 6-12 months.

Ensure you get a clear breakdown of what is covered to avoid any hidden costs.

If I am not happy with the results, can I get a "touch-up" or enhancement later?

In the rare event that there is a significant residual refractive error after the vision has fully stabilized (usually after 3-6 months), an enhancement or "touch-up" procedure may be possible.

Because SMILE Pro does not create a flap, the enhancement cannot be another SMILE procedure. The standard and safest method for a SMILE enhancement is to perform a surface-based procedure like PRK.

This is a highly effective way to fine-tune the vision. Most reputable centres include the cost of a medically necessary enhancement within a certain time frame (e.g., one year) as part of their surgical package.

The need for an enhancement after SMILE Pro is very low, typically less than 1-2% in my experience.

Your Path to Visual Freedom

Choosing to undergo vision correction is a major life decision. As a surgeon, my primary goal is to empower you with detailed, transparent, and scientifically accurate information.

SMILE Pro represents the pinnacle of laser vision correction technology, offering an unparalleled combination of safety, precision, and comfort. Its flapless, minimally invasive nature makes it an ideal choice for the modern, active individual.

If you are tired of the daily hassles of glasses and contact lenses and believe you may be a candidate for SMILE Pro, I invite you to take the next step.

A comprehensive evaluation at our state-of-the-art facility in Hyderabad is the only way to determine your eligibility with certainty and to have all your remaining personal questions answered.

Ready to see the world with a new perspective?

Book a comprehensive SMILE Pro consultation at Envision LASIK Centre in Hyderabad today and let us map out your journey to clear vision.