Are you nearsighted, have astigmatism—or a bit of both—and has the idea of getting rid of your glasses or contact lenses been on your mind for a while? Have you heard of SMILE, the laser procedure considered a serious alternative to LASIK, but you’re wondering whether it’s really worth it, what to expect, how the procedure works, and what—if anything—will change in your daily life? We’ll cover all the basics here so you can move forward with your plan with complete confidence.
SMILE: A Controlled Revolution in Refractive Surgery
SMILE (Small Incision Lenticule Extraction) is the latest generation of laser refractive surgery. In practical terms, this technology is currently intended primarily for people with myopia and certain types of astigmatism who wish to permanently correct their vision without undergoing the creation of the well-known “stromal flap” used in LASIK. And that is the method’s key advantage: a minimally invasive procedure thanks to a very small incision—less than 3 mm—and a very rapid recovery of vision, with virtually no discomfort.
Unlike PRK, which requires removal of the epithelium (the surface of the cornea), or LASIK, which creates a “flap,” SMILE uses only a high-precision femtosecond laser—the very same technology that has been used in eye surgery for over 30 years. The result? A less invasive procedure, less dry eye, and less long-term mechanical weakening.
Why SMILE, and for whom? Key Indications to Remember
The SMILE It is primarily intended for people with myopia (a condition that impairs distance vision) and astigmatism (blurred or distorted vision at both near and far distances). Do you wear your glasses all the time? Do your contact lenses irritate your eyes or cause dryness? Are you active, athletic, or lead a lifestyle that exposes you to impacts? SMILE may be an excellent technical alternative, but it’s not for everyone. It is reserved for patients who:
- Ideally between the ages of 20 and 60, with stable vision correction for more than one year; ;
- Who are seeking refractive surgery to correct their nearsightedness (up to -10 diopters) or astigmatism (up to approximately 5 diopters); ;
- Provided the cornea is sufficiently thick and has a “smooth” surface (detailed topography and precise examinations are always performed beforehand);
- Free of progressive eye conditions or contraindications (such as keratoconus, corneal inflammation, or uncontrolled autoimmune disease).
Is your situation unique? Only a surgeon specializing in refractive surgery can assess the feasibility of SMILE and, if necessary, suggest other options (LASIK, PRK, intraocular implants, etc.).
How a SMILE procedure works: every step, from arrival to recovery
Preoperative Evaluation
First and foremost, a comprehensive evaluation is required: topography, biometrics, measurement of the prescription, and screening for contraindications. This is also an opportunity to discuss your daily life, your professional activities, and your specific expectations. You’ll be asked to stop wearing soft contact lenses 3 days beforehand, or 15 days for rigid lenses, to allow the cornea to return to its natural shape. One last thing before the procedure: make sure to have someone accompany you, since you won’t be able to drive for a while.
D-Day: A Step-by-Step Guide
You’ll arrive fresh and ready: no makeup, no lotion, and no perfume. Local anesthesia is administered in the form of eye drops (no injections). The procedure itself takes an average of 15 minutes per eye, which is the time needed to set up and program the laser and perform the extraction:
- The femtosecond laser carves a lenticule (a sort of mini-disc) into the cornea in just a few seconds;
- Through a micro-incision (<3 mm), the lenticule is manually removed by the surgeon;
- No “flap,” no cut-out flaps—that’s the main difference from LASIK.
The operated eye is then rinsed and protected, and you are taken to the recovery room to be monitored.
Postoperative Recovery
You’ll leave with a prescription for eye drops (antibiotics, anti-inflammatories, artificial tears) and instructions to rest for the rest of the day. The recovery of vision is remarkable: most patients regain clear vision as early as the next day. Sometimes it may take 48 hours to achieve optimal vision—please be patient if you still see some halos during the first few days.
Everything is designed to facilitate recovery: close postoperative follow-up, personalized advice, and vigilance for minor warning signs (unusual pain, decreased vision, marked redness). See the information on the Patients Page to find all the practical tips.
Results and Expectations Following SMILE: What Will—and What Won't—Change
Accuracy and Stability of the Correction
Since its introduction in 2010, SMILE has delivered reliable and long-lasting results: more than 95% of nearsighted patients who have undergone the procedure achieve perfect or near-perfect distance vision (10/10) without correction. What about astigmatism alone? The results are also very satisfactory, provided that the surgical parameters are properly adjusted. Tests and studies confirm that the correction remains stable over time—which is precisely the advantage of removing the lenticule without superficial ablation.
However, SMILE is a customized treatment that is not suitable for all forms of astigmatism or for other conditions such as presbyopia or hyperopia. It is best to discuss this openly during the evaluation to clear up any confusion.
Comfort and Functional Recovery
Patients say it themselves: the difference compared to LASIK or PRK is clear in terms of how they feel after the procedure. There is no outright pain, and comfort is restored immediately. Dry eyes, which are quite common after other types of surgery, are reduced in this procedure (lasting on average only 2 to 4 weeks and are generally tolerable). For athletes or those at risk of eye trauma, the biomechanical strength of the cornea is also a major advantage.
By the numbers: Nearly 98 % of SMILE patients are able to return to work within 48 hours, and the vast majority are using eye drops very little, if at all, after a few weeks.
Safety: Adverse Effects and Rare Complications
No surgery is completely risk-free—this is a fact that the clinic fully acknowledges. When performed correctly and under proper supervision, SMILE has some of the lowest complication rates in modern refractive surgery (< 2 % of serious complications, which are almost always reversible). Key points to note:
- A slight risk of infection or inflammation (keratitis), which is fully managed through follow-up protocols and adherence to prescriptions;
- Occasionally, a tear or incomplete removal of the lenticule: these situations are rare, are often prevented by the surgical team’s experience, and can be managed without long-term complications;
- The risk of undercorrection or overcorrection: adjustments can be made, either through laser retreatment or, in rare cases, by using another secondary method.
Want to talk about it? Don't be shy about sharing all your fears on the first date (make an appointment).
SMILE, LASIK, or PRK: How Do You Choose?
A Medical Choice, Not a Matter of Fashion
There are three main recognized techniques in refractive surgery for correcting myopia and astigmatism: PKR, LASIK, and SMILE. All are offered following a detailed evaluation. LASIK offers the most personalized correction and the fastest recovery, but requires the creation of a flap. PKR, on the other hand, is suitable for thin corneas. SMILE is positioned as a state-of-the-art alternative for those seeking biomechanical strength and a minimized risk of dry eye.
Your eye care history, your prescription, and your lifestyle—it all matters. Above all, don’t assume that SMILE will “necessarily be better”: only a personalized, in-person consultation can help you make the right decision. Find a comparison of the techniques at our dedicated page.
Fees, Reimbursement, and Practical Steps
The price of a SMILE procedure in Lyon ranges around 1300 to 1500 euros per eye – that is between 2600 and 3000 euros for both eyes. This difference compared to other lasers is explained by the use of advanced technology and rare equipment, such as the laser femtosecond VisuMax 800, a state-of-the-art tool for cutting with unmatched precision. Some mutual insurance plans offer partial or full coverage: be sure to inquire in advance (see pricing details).
In practice: prepare and optimize your recovery after SMILE
Actions to take before and after the operation
- Stop wearing contact lenses well in advance to ensure the accuracy of the assessment.
- Come makeup-free, without jewelry or perfume.
- Arrange to be accompanied home; do not drive on the day of the procedure.
- Follow the eye drop prescription after the procedure, avoid rubbing your eyes, and refrain from intense sports and makeup for several days.
- Schedule attentive post-operative follow-up to anticipate any symptoms.
Conclusion: SMILE, a technological promise with attentive care
Choosing the SMILE procedure means betting on cutting-edge, highly refined technology for those who want to gain visual independence without compromising comfort or safety. At Néovision, support and personalized care are at the heart of the process: every patient is managed from the first contact to the final recovery, with all the perspective, rigor, and warmth you should expect from a center dedicated to refractive surgery.
Looking for more information? Ready to take the step towards your first appointment? Check out all our solutions for nearsightedness or astigmatism, or come meet us in consultation: a tailor-made project often begins with a first question!
