Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 05/25/21 1:42 PM
SMILE has such a good name. We don’t do SMILE at Hunter Vision because I don’t think it’s as good as LASIK yet. But it has such a great name! It’s an acronym for SMall Incision Lenticule Extraction, so you can see why they went with SMILE instead of the longer, more specific and grosser-sounding name.
Small incision lenticule extraction works by using only a femtosecond laser. That’s the same laser that we use to create the flap for LASIK. A femtosecond laser works by creating really tiny gas bubbles to separate layers of the cornea. With SMILE, instead of just one pass, there are two of them to separate out a thin layer. That layer gets removed (through the SMall Incision from the acronym) and overall flattens the cornea.
Does it work? Yes. It does work! But in my opinion, the technology is at a “LASIK in 2005” kind of level. LASIK worked great in 2005, it’s just had time to evolve and become even better since then. So, for me, it’s not that SMILE isn’t good, it’s just that we have something better… something that’s at a “LASIK in 2021” kind of level.
I’m rooting for it to keep getting better, though. Because SMILE is such a perfect name. The moment I feel like the accuracy and quality of the procedure matches LASIK, I’ll be on board the SMILE train.