SMILE
Flapless laser correction through a small incision · Gurpal Virdi, MD · San Francisco Bay Area, California
Medically reviewed by Gurpal Virdi, MD, refractive and cataract surgeon and ICL-sizing researcher · Last reviewed: 25 August 2026
How does SMILE work?
In SMILE, a femtosecond laser defines a thin lens-shaped piece of tissue, the lenticule, within the intact cornea. The surgeon then removes that lenticule through a small peripheral incision, and the cornea settles into its new shape. Because no flap is lifted and the incision is a fraction of the length of a LASIK flap edge, more of the cornea's anterior structure and more of its nerve supply are left undisturbed.
SMILE vs LASIK — which is better?
For eyes suited to both, the visual results are comparable. SMILE's advantages are structural: no flap to displace, and less disruption of corneal nerves, which is associated with less post-operative dry eye. LASIK's advantages are practical: faster visual recovery in the first days, a longer track record, and easier enhancement if a touch-up is needed later. Neither dominates, and the honest recommendation depends on your cornea, prescription and priorities rather than on which technology sounds newest.
Am I a candidate for SMILE?
SMILE treats myopia with and without astigmatism within defined ranges, and does not treat hyperopia. As with any corneal laser procedure, adequate corneal thickness, regular topography and a stable prescription are prerequisites. If your prescription falls outside the treatable range or your cornea is too thin, EVO ICL becomes the more appropriate option.
SMILE in the San Francisco Bay Area
I completed ophthalmology residency at the University of Missouri, where I served as chief resident, and refractive surgery fellowship training at Parkhurst NuVision in San Antonio under Dr. Gregory Parkhurst, principal investigator of the FDA EVO ICL trial. I offer SMILE alongside EVO ICL, LASIK, PRK, refractive lens exchange and premium cataract surgery.
For higher prescriptions or thinner corneas that fall outside SMILE's range, EVO ICL is usually the better route.
Common questions
Is SMILE better for dry eye than LASIK? Because SMILE disturbs fewer corneal nerves, it is generally associated with less post-operative dry eye than LASIK, which is a meaningful advantage in eyes already prone to it.
How long is recovery after SMILE? Most people see functionally well the next day, though vision often sharpens over the following week, typically a little more gradually than after LASIK.
Can SMILE treat farsightedness? SMILE is used for nearsightedness with and without astigmatism. Farsightedness is generally addressed with LASIK, PRK or a lens-based procedure.
Can SMILE be enhanced later? Yes, though because there is no flap to lift, an enhancement is usually performed as a surface treatment such as PRK.
Educational information, not medical advice. Discuss your specific eyes with a qualified ophthalmologist.