SMILE technology

The SMILE procedure is known in medicine as a minimally invasive method of laser eye surgery for the treatment of near-sightedness, astigmatism or the combination of these two visual defects. 

The SMILE method

The SMILE method, where SMILE stands for small incision lenticule extraction, involves using a high-precision femtosecond laser to shape the cornea. This laser prepares a small lens, also known as the 'lenticule', within the intact cornea. On average, this process takes barely 30 seconds. The surgeon then removes the lenticule by making a small incision in the front part of the eye, giving the cornea a new shape and correcting the visual defect. 

A femtosecond laser is a laser that emits light pulses of a duration within the femtosecond range. A femtosecond is an unimaginable short unit of time: femto is a unit prefix and one femtosecond is equal to 10-15 seconds. Written out, one femtosecond looks like this: 0.000,000,000,000,001 seconds. 

For medicine, this means that, with a femtosecond laser, it is possible to work with extreme precision, which is a decisive advantage in the case of a tissue as sensitive as the human cornea with a thickness of about 0.5 mm. 

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The SMILE method uses a single laser (i.e. the patient does not have to switch between several lasers during the procedure), which emits numerous short pulses extremely rapidly. On the one hand, the laser produces a thin layer below the surface of the eye and, on the other hand, creates a tiny opening on the surface of the eye. 

Use of a femtosecond laser: This laser is programmed to glide gently through the upper layers of the cornea to the tissue layer where the lenticule is prepared. Neither the outer layer of the cornea is removed, nor is more than a single, tiny incision necessary on the surface of the eye. In addition, important corneal nerves that stimulate the lacrimal (tear) glands are less affected, which is why the eye continues to be supplied with sufficient moisture. 

Who is it suitable for?

Patients suffering from astigmatism and/or near-sightedness should first talk to their ophthalmologist about laser eye surgery and other alternative treatment methods. 

The ophthalmologist will then carry out some tests in order to ultimately be able to tell the patient whether his/her refractive error can be corrected using the SMILE procedure. 

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Before undergoing the SMILE procedure, patients should pay attention to the following: 

  • Do not wear hard contact lenses for at least four weeks prior to surgery 
  • Do not wear soft contact lenses for at least one week before surgery 
  • Do not apply any make-up, perfume or body lotion on the day of the procedure 
  • Arrange for someone to collect you, as you are not allowed to drive your own car after the operation (you may also not be permitted to do so on the next few days after surgery)  

The procedure takes place on an outpatient basis and lasts an average of 20 minutes for both eyes. 

  1. Anaesthetisation of the eye with anaesthetic eye drops 
  2. Immobilisation of the eye using a Goldmann lens connected to the laser and carefully affixed to the eye 
  3. As soon as the eye is immobile, the laser creates a 2–4 mm small, arched access through the cornea 
  4. Inside the cornea, the laser now forms a thin lenticule (= a lens-shaped piece of tissue), which is then removed by the surgeon through the small access point.

Removing the lenticule changes the shape of the cornea and rectifies the visual defect. 


To allow the treated eye/eyes to heal optimally, patients should not rub their eye(s), allow themselves plenty of rest or avoid overexerting themselves. 

For the first few postoperative days, the patient will be given a plaster to prevent accidental scratching of the eye. In addition, the eyes may feel a little irritated in the first few days after the procedure, but they usually recover quickly from it. Vision usually improves immediately, but in some rare cases it may take a few days for the patient to regain full vision. As a general rule, it is advisable to refrain from outdoor and strenuous activities for about one week after the operation. 

Follow-up examinations usually take place one day after the operation, seven days, one month and three months after operation.

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