SMILE Pro: flapless laser vision correction

Who it is for

• Adults with short-sight, with or without astigmatism, whose power has been stable for about a year.
• Eyes with corneas of adequate thickness and regular shape.
• Laser correction is generally deferred during pregnancy and breastfeeding, because the power can shift.

What happens, step by step

1. Before the assessment.If you wear contact lenses, the team tells you how long to leave them out so the corneal readings are accurate.
2. Assessment.Your power is measured, including after dilating drops. The cornea is mapped and its thickness measured. The tear film and the retina are examined.
3. Counselling.You are told whether SMILE Pro, LASIK, ICL, or no procedure is advised, and why.
4. Procedure.Numbing drops are applied. The femtosecond laser shapes a thin lens-shaped piece of tissue inside the cornea, which takes under a minute per eye. The surgeon then removes it through a 2 to 4 mm opening.
5. Going home.You rest briefly and go home with drops and written instructions. Bring someone to accompany you.
6. Reviews.Follow-up visits are scheduled and the dates are written down for you.

Which tests are done, and why

• Corneal topography and tomography.Maps the shape of the cornea, front and back. It is the main check for early keratoconus, in which laser is not advised.
• Corneal thickness.Shows whether enough tissue would remain after the correction your power needs.
• Refraction before and after dilating drops.Confirms your true power, which is the number the laser treats.
• Tear film assessment.Existing dry eye is identified and treated first.
• Dilated retina examination.Short-sighted eyes can have weak areas in the retina that need to be known beforehand.

What you feel

• The assessment tests are painless. Dilating drops sting briefly and blur near vision for a few hours.
• During the laser step the eye is held steady by gentle suction. You feel pressure, and vision blurs or dims for some seconds.
• For about a day afterwards the eyes can water and feel gritty.

Recovery, in days and weeks

• First day.Rest. Vision is often slightly hazy on the first day. Do not rub your eyes.
• First week.Use the drops on schedule. Avoid eye make-up, dust and swimming. Vision usually improves over the first few days.
• First few weeks.Swimming and contact sport are resumed when the surgeon clears you, as written in your instructions.
• First few months.Some dryness and fluctuation of vision can continue for weeks to a few months before settling.

What you are told before you consent

• What the examination and measurements show, in plain language.
• The options for your eye, including waiting or not having the procedure.
• What the procedure is expected to do, and what it cannot do.
• The risks that apply to your eye in particular.
• A written estimate, and whether your insurance policy is likely to apply.
• You do not need to decide on the day of the consultation. Nothing is scheduled without your signed consent.

What affects the cost

• The technique advised for your eyes.
• Your prescription and your corneal measurements.
• Refractive procedures are usually excluded from health insurance.

A written estimate is given after the consultation, once your eyes have been examined.

What to bring

• Your current glasses and older prescriptions, which show how stable your power has been.
• Your contact lens details, if you wear them.
• Earlier eye reports, if any.
• Sunglasses, and someone to accompany you on the assessment day and the procedure day.