Somebody covering a woman's eyes from behind

SMILE eye surgery in London

What is SMILE eye surgery?

Small Incision Lenticule Extraction (SMILE) is a type of laser eye surgery to correct refractive errors such as near-sightedness (myopia) and/or astigmatism. The procedure is performed just beneath the corneal surface and unlike Femto-LASIK, there is no need to create a flap on the cornea. Instead, the surgeon operates through a keyhole, which makes the surgery minimally invasive reducing the risk of potential side effects.

Wider suitability and other advantages of SMILE

The Zeiss VISUMAX femtosecond laser used in the SMILE procedure harmlessly pass through the upper layers of the cornea creating the lenticule only at a specific sub-layer inside the cornea without affecting the surrounding tissue.

This means:

  • Some patients with existing eye dryness and those with thinner corneas who may have been turned down for other types of vision correction, could be eligible for this treatment.
  • This is a minimally invasive surgery which allows better corneal stability, as the entire upper layers of the cornea stay virtually unaffected throughout the procedure.
  • Compared to other vision correction techniques, the risk of post-surgery dry eye in SMILE is lower as the corneal nerves stimulating the tear glands are less affected and can keep the eye better lubricated.

Our specialist consultant ophthalmic surgeons can advise on your individual suitability for the SMILE procedure based on your eye tests, examination results, your lifestyle and needs.

How is the SMILE eye surgery performed?

During the procedure, the surgeon uses a special extremely short-pulsed femtosecond laser to create micro-precision single holes (bubbles) in the cornea. They provide an outline of a lenticule, a small lens-shaped piece of corneal tissue that gets removed through a very small incision in the outer part of the eye. This reshapes the cornea and corrects the patient’s vision.

Painless procedure

During SMILE surgery, patients do not feel pain. At the start of the procedure, the treated eye is numbed with the anaesthetic eye drops and a contact glass-like interface is placed gently on the eye to keep it immobilized for the surgery. You may feel slight pressure at this step and when the lenticule is being created. The whole procedure takes just a mere few minutes for both eyes.

After the surgery, there are normally a few hours of mild discomfort – a bit like wearing uncomfortable contact lenses. Having said that, most patients can return to work one day or so after surgery.

Before your SMILE surgery

Prior to the SMILE procedure, we usually advise our patients:

  • Stop wearing hard contact lenses for at least two weeks and soft contact lenses for 3 days before the surgery, as wearing them may interfere with pre-operative diagnostic tests.
  • Don’t wear make-up, perfume, or lotion the day before and on the day of the procedure. These products may leave debris around the eye and eyelashes, which may increase the risk of infection.
  • Arrange to be collected and driven home directly after the surgery as your vision won’t be up to the driving standards straight after the procedure.
After your SMILE surgery

After your surgery you will be provided with the detailed aftercare guidance and it’s important to follow your doctor’s instructions to support your recovery. The key points include:

  • Avoid rubbing the operated eye(s) to minimise the risk of infection. You will be provided with medication to manage any post-operative discomfort.
  • Keep water out of your eyes, even while showering, until you are fully healed.
  • Your doctor may recommend wearing an eye shield to protect the eyeball(s) for few days while sleeping to avoid accidentally scratching the eye(s).
  • Rest and do not overexert yourself with physical activity; do not over strain your eyes by reading or looking at digital screens a lot for the first few days following your eye surgery.

Within a few days after the treatment, patients are normally able to drive, work and participate in sports.

SMILE safety

SMILE is a minimally invasive, generally safe, and effective procedure. Side effects tend to be mild and temporary and may include fluctuating vision, night vision issues and eye discomfort and tiredness. Most minor side effects settle as you recover. Your consultant will discuss them with you before you decide to go ahead with the surgery and help you manage them after the procedure.

Like with other laser vision correction techniques, there is a potential risk of sight problems and residual refractive error such as over- or under correction after SMILE surgery.

Moorfields Private patients are treated at every step by our world-class refractive consultant surgeons who use state-of-the-art equipment that is frequently upgraded to deliver the best results. All Moorfields refractive consultants are specialists in corneal surgery and therefore are able to deal with any rare and unforeseen circumstances.

The SMILE eye surgery is performed in our refractive suite at Moorfields Private, New Cavendish Street, in the heart of London’s medical district.

Vincenzo, Maurino

Written in association with

Mr Vincenzo Maurino

Consultant Ophthalmic Surgeon

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