SMILE Pro LASIK Side Effects: How Much Should They Worry You? Cost, Reviews and Methods

Worried that SMILE Pro LASIK side effects, like gritty dry eyes or halos around headlights, could still be with you long after your time in Seoul is over?

Read this before you plan surgery around a short stay.

You'll know which side effects are common and how long they usually last, what reviews get right and wrong, how the methods compare, and what decides the cost, so you can tell which approach suits your eyes and your budget.

Hello, I'm Dr. Lee Ki-il, Medical Director and ophthalmologist at OLIM Eye Clinic in Gangnam.

Before any surgery here, your eyes go through about 60 tests, including corneal shape and thickness on an OCULUS Pentacam and tear-film testing on an OCULUS Keratograph 5M. My SMILE surgery is the 5th-generation system on the SCHWIND ATOS, through a 2mm incision. I review your results and explain them to you in person.

I wrote this because many people judge the risk by the name printed on the laser, when most of the risk comes from which eye goes under it.

The common side effects of SMILE-type surgery are temporary: dryness, glare and halos at night, and vision that stays soft for the first day or two. Serious complications are uncommon, and careful screening before surgery is the main way to lower them.

If dryness is the part that worries you, send a photo of your current glasses or contact-lens prescription on WhatsApp, along with the one question you'd ask first, for example whether eyes that feel gritty in contacts by mid-afternoon change the plan.

SMILE Pro is a laser name; the surgery is lenticule extraction

SMILE Pro is the name one laser manufacturer gives its newer platform, and it's mostly marketed on a shorter laser time. The operation underneath is the same family as SMILE: the laser shapes a thin disc of tissue, called a lenticule, inside the cornea, and the surgeon removes it through a small opening. Reinstein and colleagues describe this technique and its history in detail in their 2014 review in *Eye and Vision*.

I don't use that platform. My SMILE is done on the SCHWIND ATOS, a 5th-generation system that corrects myopia and astigmatism without a corneal flap, with real-time 7D eye tracking and low energy set to your cornea. I mention this so you read the rest correctly: the side effects below belong to the procedure, and they apply to SMILE Pro, to my SMILE, and to other lenticule-extraction lasers alike.

A shorter laser time means fewer seconds of holding your gaze on a light. On its own, it doesn't change how your cornea heals over the following weeks.

Which SMILE Pro LASIK side effects are common in the first weeks?

Most people get at least one of these, and most of them fade.

Dryness. The nerves in the front of the cornea help tell your eyes to make tears. Any laser correction cuts some of them. Because SMILE works through a small opening instead of a large flap, more of those nerves stay intact, which the Reinstein review discusses as one reason dry eye tends to be milder than after LASIK. Milder still isn't none. Many people use lubricating drops for several weeks, and for some it takes a few months to settle.

Glare, halos and starbursts at night. Headlights and streetlamps can look ringed or spiky early on. This usually improves over weeks to months as the cornea settles. It tends to be more noticeable with larger pupils or a higher correction, and a small number of people keep some of it longer.

Soft vision for the first day or two. The US Food and Drug Administration's guidance on what to expect after laser surgery notes hazy or blurry vision right after the operation, along with burning or itching, and tells you not to rub your eyes. With SMILE, the layer where the lenticule was removed needs a little time to clear, so many people see well enough for daily life within a few days while sharpness keeps improving.

Red spots on the white of the eye. The suction ring that holds the eye steady can leave small bleeds under the surface. They look alarming in the mirror, don't affect vision, and usually fade within a couple of weeks.

Can the rare complications be avoided, or only treated?

Some can be largely avoided by choosing the right eye. Others can only be watched for and treated.

• Ectasia. The cornea weakens and starts to bulge, which blurs vision over time. The risk is higher when the cornea is thin for the correction needed or shows early signs of keratoconus. This is why the Pentacam map matters so much: it analyzes corneal topography, thickness and shape to detect abnormal corneas such as keratoconus before surgery.
• Under- or over-correction, and regression. Your eye may end up slightly short of or past the target, or drift back over the years. A second treatment is often possible after SMILE, though it's usually done with a different technique from the first one.
• Suction loss during the laser. If the eye moves enough to break suction, the surgeon stops. Depending on the stage, the treatment may be finished another way or rescheduled.
• Inflammation or infection in the corneal layer. These are uncommon and usually treated with drops, which is one reason the checkups in the first days aren't optional.
• Incomplete lenticule removal. If a fragment is left behind, it can cause irregular astigmatism.

Say you're 24, on a working-holiday visa in Seoul, around -3.50 with a little astigmatism, and your eyes already feel gritty in contacts by mid-afternoon. Before I'd talk about SMILE with you, I'd want to see the tear-film results as much as the prescription. If the oil glands along your eyelids turn out to be blocked, it can make sense to treat that first, and we have LipiFlow and IPL for exactly that cause of dry eye.

If that sounds like your eyes, send a photo of your last eye-exam report or prescription on WhatsApp together with the dates you'll be in Seoul, and ask whether dryness in contacts changes which method makes sense for you.

How do SMILE side effects compare with LASIK and LASEK?

All three reshape the cornea, so they share dryness and night glare as early effects. Where they differ is in how the cornea is opened and how it heals.

The American Academy of Ophthalmology's EyeWiki entry on LASEK describes the discomfort of the first days and the slower visual recovery that come with treating the surface. My LASEK is Contoura LASEK on the Alcon Wavelight ex500, which ablates following the shape of your own cornea and aims to preserve as much residual cornea as possible, which is why it's an option for high myopia and astigmatism. You can see the 23 devices we use from exam to surgery, and if you're still unsure which method fits, I've written about how your cornea decides between SMILE LASIK in Korea, LASIK and LASEK.

What do reviews get right and wrong about SMILE Pro?

Forum threads and video reviews repeat a few claims. Here's how they hold up medically.

"SMILE barely causes dry eye." Partly true. Dryness is often milder than after LASIK, but it's still the most common complaint in the early weeks.

"The faster laser means fewer side effects." Speed mostly affects how long you hold still. Whether your cornea is suitable and how much correction you need matter far more for healing.

"The halos went away after a month." For many people they fade over weeks to months. For some they take longer, so it's worth asking about your pupil size at the exam.

"If SMILE is off, it can't be fixed." Not accurate. Further correction is often possible, though the approach differs from a LASIK touch-up.

What decides the cost for your eyes?

I won't put a number here, because the number belongs to your eyes. These are the things that move it:

• The method your exam points to: SMILE, LASIK or LASEK.
• Your prescription and astigmatism, since they decide how much tissue is treated and which methods are open to you.
• Dry eye that needs attention first, such as LipiFlow or IPL before surgery.
• How your days fall. For SMILE, the exam and surgery can happen on the same day, which changes how many visits you need.
• Checkups during your stay, and how many you'll fit in before you leave.

To get the figure for your own case, ask on WhatsApp what it would cost, with a photo of your prescription. You can also read more about the clinic on OLIM Eye Clinic's English site.

Who should wait, and what to do if something feels wrong at home

First, the common temporary effects: dryness that settles over weeks to a few months, night glare and halos that usually fade over the same period, and soft vision for the first few days. Healing and results differ from person to person, and the in-person exam decides whether surgery suits you.

As general medicine, these are reasons to wait or choose differently. The FDA's page on when laser correction may not be for you lists several of them.

• A prescription that has changed within the past year
• Pregnancy or breastfeeding, when hormones can shift your prescription
• A thin or irregular cornea, or signs of keratoconus
• Autoimmune disease or other conditions that affect healing, and some medications that slow healing
• Severe dry eye that hasn't been treated yet
• Contact sports where blows to the face are common, which matter more for flap surgery

Once you're home, mild dryness and evening halos usually call for lubricating drops and patience. Sudden loss of vision, pain that's getting worse instead of better, increasing redness, discharge or light sensitivity are different: see an ophthalmologist the same day. The US Centers for Disease Control and Prevention advises medical travelers to carry copies of their medical records home, so ask for your surgery record and your drop schedule before you fly.

One photo of your prescription is enough to start. Send it on WhatsApp with your travel dates and the question you'd most want me to answer, for example how long dryness tends to last for eyes like yours. You can ask before booking anything. When you come in, I examine your eyes, explain the results in person, and we choose together the method that fits.

Frequently asked questions

Is SMILE Pro different from SMILE in terms of side effects?

SMILE Pro is one manufacturer's name for its newer lenticule-extraction platform, mainly known for a shorter laser time. The side effects come from the procedure itself, so dryness, night halos and a soft first day or two apply to both. OLIM performs 5th-generation SMILE on the SCHWIND ATOS.

How long does dry eye last after SMILE?

For many people it improves over several weeks, and for some it takes a few months. It is often milder than after LASIK because fewer corneal nerves are cut, but lubricating drops are commonly needed early on.

Can I go back to sightseeing the day after SMILE?

Many people see well enough for daily life within a few days, but vision is often soft at first and you shouldn't rub your eyes. You also can't drive after surgery, so come with a companion or use public transport, and keep your checkups before planning busy days.

What if my vision isn't sharp enough after SMILE?

A small residual prescription or later regression can happen. A further treatment is often possible after SMILE, usually with a different technique than the first operation, and whether it suits you depends on your cornea at that point.

Should I stop wearing contacts before the exam?

Yes. If you're planning vision correction, stop wearing contact lenses 1 to 2 weeks beforehand so your cornea can return to its natural shape before it is measured.

Sources

1. Small incision lenticule extraction (SMILE) history, fundamentals of a new refractive surgery technique and clinical outcomes (Reinstein DZ, Archer TJ, Gobbe M. Eye Vis 2014;1:3) · Eye and Vision (via PubMed Central)
2. What should I expect during and after surgery? (LASIK) · U.S. Food and Drug Administration
3. When is LASIK not for me? · U.S. Food and Drug Administration
4. LASEK · American Academy of Ophthalmology (EyeWiki)
5. Medical Tourism · U.S. Centers for Disease Control and Prevention

Written with AI assistance from OLIM Eye Clinic Gangnam's published information and the medical sources listed below. This article is general medical information and does not replace a diagnosis. Whether and how to operate is decided after an in-person exam.