SMILE Eye Surgery Success Rate: What You Need to Know

SMILE Eye Surgery Success Rate

AUTHOR

Dr. Advaith Sai Alampur

Ophthalmologist/ Eye Surgeon  13+ Years Exp

MBBS, MS – Ophthalmology

TREATMENT

SMILE

CALL US 24/7 FOR ANY HELP

9492820777

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Summary

  • High success & safety: Around 80–90% of suitable patients achieve 20/20 vision, and 95–99% reach 20/25 or better, with very low complication rates.

  • Minimally invasive advantage: No corneal flap, a tiny incision, quicker healing, and less risk of dry eye compared to LASIK.

  • Best results with proper screening: Success depends heavily on correct patient selection, healthy corneas, stable prescription, and surgeon experience.

  • Fast, comfortable recovery: Most patients notice clear vision within 1–2 days, with continued refinement over a few weeks.

  • Reliable long-term option: For eligible patients, SMILE offers stable, glasses-free vision with high satisfaction and predictable outcomes.

 

Introduction

If you’re thinking about SMILE eye surgery and wondering, “How successful is it, really?” you’re not alone. I speak to many patients who want crisp vision without glasses but feel anxious about the procedure, outcomes, and what recovery looks like day-to-day. 

My goal here is to walk you through SMILE in plain language, share what the data shows about success rates, explain who does best with it, and help you make a confident, informed decision.

By the end, you’ll understand:


Let’s take it step by step.

What Is SMILE Eye Surgery?

SMILE stands for Small Incision Lenticule Extraction. It’s a laser vision correction procedure designed mainly to treat short-sightedness (myopia) and astigmatism. Think of it as a minimally invasive alternative to LASIK.

Here’s the key difference:

  • LASIK creates a corneal flap, reshapes the cornea with an excimer laser, and then replaces the flap.
  • SMILE uses a femtosecond laser to create a tiny, lens-shaped piece of tissue (a “lenticule”) inside the cornea. The surgeon removes this lenticule through a very small incision (usually 2–4 mm). No flap is created.


Why that matters:

  • Less disruption to the corneal surface
  • Potentially less dry eye after surgery
  • Very small incision that tends to heal quickly
  • Reduced risk of flap-related complications (because there is no flap)


SMILE has been performed globally for over a decade and has regulatory approvals in many regions for correcting myopia and myopic astigmatism within certain ranges.

SMILE Eye Surgery Success Rate: The Numbers


Let’s talk outcomes. When we say “success rate,” we usually mean how many patients achieve:

  • Uncorrected distance visual acuity of 20/20 (6/6) or better
  • Uncorrected distance visual acuity of 20/25 (6/7.5) or better
  • Results close to the intended prescription (accuracy)
  • Stable vision over time
  • Few complications


Based on large studies and real-world clinical data:


In short: if you’re a good candidate, the chances are very high that you’ll get clear, glasses-free distance vision for most daily tasks. Some patients with very high prescriptions may land slightly shy of 20/20 but still see a big improvement. If residual refractive error remains, an enhancement can often refine the result.


⇒How Does SMILE Compare to LASIK?

Both are highly successful. Here’s how they stack up in practical terms:

  • Visual outcomes: SMILE and LASIK are comparable for myopia and myopic astigmatism within approved ranges.
  • Dry eye: SMILE tends to have a slightly lower risk or intensity of postoperative dry eye symptoms due to the smaller incision and fewer corneal nerves being disrupted.
  • Flap-related issues: SMILE has none (no flap). LASIK has a very low but present risk related to the flap.
  • Recovery: Both are quick, but many patients describe SMILE as comfortable with minimal light sensitivity.


If you’ve been told you’re borderline for LASIK because of dry eye risk or corneal thickness, SMILE may be a better fit—though this is assessed case by case.

 

Who Is a Good Candidate for SMILE?

Your personal success rate depends heavily on proper screening. You’ll likely do well with SMILE if:

  • You have myopia (roughly −1.00 to −10.00 D) and astigmatism up to about −3.00 D, depending on local approvals and your corneal measurements.
  • Your corneal thickness is adequate for safe tissue removal.
  • Your corneal shape is healthy and regular (no signs of keratoconus or ectasia risk).
  • Your prescription has been stable for at least 12 months.
  • Your eyes are generally healthy (no active infections, significant scarring, or uncontrolled dry eye).
  • You’re over 18 (often 21+ preferred) and not pregnant or breastfeeding at the time of surgery.


If you have very high hyperopia (long-sightedness) or mixed astigmatism outside approved ranges, SMILE may not be suitable. Alternatives include LASIK, PRK (surface ablation), or phakic IOLs, depending on your eye profile.

Factors That Influence SMILE Surgery Success

Several variables affect your individual outcome:

  • Prescription strength: Higher myopia or astigmatism can be corrected, but accuracy can slightly taper at the extremes.

     

  • Corneal thickness and biomechanics: Thicker, healthy corneas are more flexible for planning and leave more residual tissue, which supports long-term stability.

     

  • Corneal shape: Subtle irregularities or early signs of ectasia risk reduce suitability and long-term safety.

     

  • Pupil size: Very large pupils in low light can contribute to halos or glare, although modern planning reduces this risk.

     

  • Tear film quality: A healthy tear film improves measurements, healing, and visual quality.

     

  • Age: Younger adults often heal quicker but still need accurate screening for stability. Over 40? You may still be a candidate, but we’ll talk about presbyopia (near-vision changes) and whether monovision or blended vision strategies make sense.

     

  • Surgeon experience and technology: Outcomes are better in centres that perform SMILE regularly with modern laser platforms and robust pre-op screening.

     

  • Following instructions: Using drops as prescribed, avoiding eye rubbing, and attending follow-ups all matter.


What Results Should You Expect After SMILE Surgery?

Most patients notice sharper vision within the first day, and vision typically continues to improve over the first week or two. Fine details and night vision often keep refining for several weeks.

Typical timeline:

  • Day 1: Clearer vision, mild grittiness, light sensitivity for some.
  • Week 1: Vision stabilising; many patients are comfortable to drive if cleared.
  • 1–3 months: Vision settles; halos/glare (if present) usually diminish.
  • 3–6 months: Final refinement; any residual dryness tends to settle.


Remember, each eye heals slightly differently. It’s normal for one eye to feel ahead of the other for a short time.

Potential Risks and How Common They Are

No surgery is risk-free, but serious complications with SMILE are rare. Here’s what we discuss in clinic, along with what you might realistically expect:

  • Dry eye symptoms: Usually milder and less frequent than LASIK, but still possible. Most cases improve within weeks to months with lubricating drops.

     

  • Night visual symptoms: Halos, glare, or starbursts can occur, especially early on. These often fade with healing; persistent symptoms are uncommon, and strategies like optimised optical zone sizing help reduce risk.

     

  • Under- or over-correction: A small number of patients may need an enhancement to fine-tune vision. Enhancements are safe and effective when planned appropriately.

     

  • Inflammation or infection: Very rare, but we take it seriously. Using prescribed antibiotic and steroid drops and keeping follow-up appointments minimises this risk.

     

  • Epithelial ingrowth or interface issues: Much less common in SMILE than in flap-based procedures, but careful surgical technique is key.

     

  • Corneal ectasia (progressive thinning/weakening): Extremely rare with proper screening and surgical planning. This is a major reason we take pre-op scans so seriously.

     

  • Transient haze or microstriae: Uncommon and usually self-limited.

     

  • Residual astigmatism: Possible, especially with higher pre-op astigmatism; often mild and correctable.


Bottom line: When you’re a good candidate and the procedure is done in an experienced centre, the risk of serious problems is very low, and satisfaction rates are high.

SMILE Success Rate for Different Prescriptions

  • Low to moderate myopia (e.g., −1.00 to −6.00 D): Highest predictability. 20/20 or better rates tend to be at the upper end of published ranges.

     

  • Higher myopia (e.g., −6.00 to −10.00 D): Still very good results; a slightly higher chance of mild residual error. Many still reach 20/20, but some land at 20/25. Enhancement can help if needed.

     

  • Myopic astigmatism (up to ~−3.00 D): SMILE handles this well, though the more astigmatism corrected, the more crucial centration and planning become.


If your numbers sit outside these windows, we’ll discuss other options to achieve your goals safely.

How to Maximise Your Personal SMILE Surgery Success Rate?

There’s a lot you can do to set yourself up for a smooth procedure and clear vision.

⇒Pre-op:

  • Keep your lenses out: Stop soft contact lenses for at least 1 week (toric/rigid lenses may need longer) before your assessment and surgery as advised.

     

  • Treat dryness: If your eyes feel dry, start preservative-free lubricants and consider omega-3s after discussing with your clinician. A healthy tear film improves measurements.

     

  • Share your history: Tell your surgeon about any autoimmune conditions, medications (like isotretinoin), or eye issues.

     

  • Stabilise expectations: Understand realistic outcomes for your prescription and eye anatomy.

     

⇒Day of surgery:

  • Arrive rested: Good hydration and a light meal can help you feel steady.

     

  • Follow instructions: Don’t use makeup, perfume, or creams around your eyes that day.

     

  • Breathe: The laser part is very quick. You’ll be guided throughout.

     

⇒Post-op:

    • Use your drops: Antibiotic and anti-inflammatory drops are essential. Don’t skip doses.

       

    • Don’t rub your eyes: Let the small incision heal undisturbed.

       

    • Keep water out: Avoid swimming and hot tubs for at least 1–2 weeks as advised. Careful showering is fine—keep water away from your eyes.

       

    • Protect your eyes: Wear sunglasses outside. Consider eye shields at night if recommended.

       

    • Ease back into activity: Most desk work can resume in 1–2 days. Avoid dusty environments and heavy exercise for a few days. Contact sports usually need a longer pause—ask your surgeon.

       

    • Lubricate: Preservative-free artificial tears can make your vision feel sharper and more comfortable while nerves heal.

       

    • Attend follow-ups: We check healing, vision, and address any concerns early.


How Envision LASIK Centre Increases Your Chances of a Successful SMILE?

At Envision LASIK Centre, Hyderabad, we make sure your SMILE surgery gives the best results. Here’s how we help:

⇒Careful Check-Up: We check your cornea, eye power, tear health, and overall eye condition to see if SMILE is right for you.

⇒Skilled Surgeons & Modern Technology: Our experienced doctors use the latest lasers to make surgery safe, accurate, and smooth.

⇒ Personal Plan for You: Your treatment is made to fit your daily life—driving at night, sports, or working on screens.

⇒ Support During Recovery: We guide you step by step after surgery, with easy instructions, follow-ups, and help until your eyes heal fully.


Book your SMILE check-up today and take the first step toward clear, glasses-free vision.

The bottom line

  • Success is high: About 80–90% of suitable patients reach 20/20 or better. Around 95–99% reach 20/25 or better.

  • Safety is excellent: Serious complications are rare, especially with proper screening and experienced surgeons.

  • Comfort and recovery are strong points: Many patients report less dry eye and rapid return to normal life.

  • The right candidate matters: Pre-op assessment is the biggest driver of a great outcome.


If you’re suitable, SMILE offers a reliable, minimally invasive route to sharp vision with a strong safety profile.


⇒Next Steps

  • Book a comprehensive assessment: Ask for corneal topography, pachymetry (thickness), tear film testing, and pupil size measurement.

  • Bring your questions: Note your visual goals (e.g., night driving, sports, screen work) so your plan is truly personalised.

  • Compare options: If you’re borderline for SMILE, ask about LASIK, PRK, or lens-based options—and the pros and cons for your eyes.

  • Plan your recovery: Clear your schedule for the first day or two, stock up on preservative-free drops, and arrange a lift home from surgery.

Additional FAQs About SMILE Eye Surgery Success & Safety


1.Is SMILE eye surgery 100% successful?

No eye surgery can guarantee 100% success. However, SMILE has a very high success rate, with about 80–90% of patients achieving 20/20 vision or better, and 95–99% achieving 20/25 or better, which is excellent for daily life.

2.How long do SMILE surgery results last?

SMILE results are long-lasting and stable for most patients. Once the eye power is stable before surgery, the correction usually remains stable for many years. Natural age-related changes like presbyopia (near-vision difficulty after 40) can still occur.

3.Can eyesight worsen again after SMILE?

In most cases, no. However:

1.Very young patients may experience natural progression of myopia

2.Hormonal changes or eye conditions can affect vision later

3.A small percentage may need an enhancement, which is usually safe and effective.

4.Is SMILE safer than LASIK?

Both are very safe. SMILE has:

1.No corneal flap

2.Lower risk of flap-related complications

3.Generally less dry eye

This makes SMILE especially appealing for patients with dry eyes or active lifestyles.

5.Who should not undergo SMILE surgery?

SMILE may not be suitable if you have:

1.Thin or irregular corneas

2.Keratoconus or ectasia risk

3.Unstable eye power

4.Severe dry eye or autoimmune conditions

A detailed eye evaluation is essential.

6.Can SMILE correct both eyes on the same day?

Yes. SMILE is usually performed on both eyes in the same session, and the entire laser portion typically takes only a few minutes per eye.


7.Is SMILE better than glasses or contact lenses in the long run?

SMILE does not stop natural eye ageing, but it offers long-term freedom from dependence on glasses or contacts for distance vision, which many patients find life-changing.

AUTHOR

Dr. Advaith Sai Alampur

Ophthalmologist/ Eye Surgeon  13+ Years Exp

MBBS, MS – Ophthalmology

TREATMENT

SMILE

CALL US 24/7 FOR ANY HELP

9492820777

GET IN TOUCH ON

Send Whatsapp
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