SMILE in Toulon — Small Incision Lenticule Extraction

SMILE (formerly Relex SMILE) is the most recent corneal refractive surgery technique. A single laser — the femtosecond — cuts a thin lenticule directly within the thickness of the cornea, changing its curvature. This lenticule is then extracted through a 3 mm micro-incision, versus 20 mm for the LASIK flap. SMILE is seen as an evolution of LASIK: visual recovery is just as fast, but the risk of dry eye is lower and there are no flap-related complications. It corrects myopia and astigmatism, and recently hyperopia (hyperopic SMILE).

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SMILE: the essentials

Principle: a femtosecond laser cuts and you extract a corneal lenticule through a 3 mm incision
Corrects: myopia (to about -10), astigmatism, recently hyperopia
Single laser: no flap, fewer dry-eye issues than LASIK
Anaesthesia: local drops — painless
Procedure time: about 15 minutes
Recovery: 24 to 48 hours
Dr Bourdon’s fees: €2,950 both eyes (SMILE), €3,050 (hyperopic SMILE)

How does SMILE work?

Under the femtosecond laser, a painless suction stabiliser is placed on the eye.
The laser cuts a lenticule within the thickness of the cornea in about 10 seconds; a veil forms from the periphery to the centre.
The same is done on the other eye.
Under sterile conditions, the surgeon extracts the lenticule through a 3 mm micro-incision.

Recovery and aftercare

Visual recovery is fast — usually 24 to 48 hours — with little or no pain. Because there is no flap and fewer corneal nerves are cut, dry eye is less common than after LASIK. Antibiotic and anti-inflammatory drops are used for 2 to 4 weeks and artificial tears as needed. Avoid rubbing the eyes and water immersion for the first weeks.

Advantages and limits

Advantages: minimally invasive (3 mm incision), fast recovery, less dry eye, no flap complications.
Limits: needs a thick enough cornea, touch-up slightly less straightforward than after LASIK, presbyopia correction only partial.

Other techniques: PRK · LASIK · Phakic ICL implant · PreLex

Frequently asked questions about SMILE

How is SMILE different from LASIK?

SMILE uses a single femtosecond laser and a small 3 mm incision, with no corneal flap. Recovery is similarly fast, but dry eye is less frequent and flap-related complications do not exist.

Is SMILE painful?

No. The procedure is performed under drop anaesthesia. You may feel brief pressure during the suction step. Afterwards there is little discomfort and vision is usually clear within 24 to 48 hours.

Can SMILE correct astigmatism and hyperopia?

SMILE corrects myopia and astigmatism reliably, and more recently hyperopia (hyperopic SMILE). Presbyopia correction is only partial.

When can I go back to work after SMILE?

Usually within 24 hours, once the surgeon confirms your vision at the follow-up visit.

How much does SMILE cost in Toulon?

Dr Bourdon’s fee is €2,950 for both eyes (SMILE) and €3,050 (hyperopic SMILE), post-operative consultations included. Many insurers reimburse part of the cost.

Sources

Article written and reviewed by Dr Hugo Bourdon, ophthalmic surgeon at the Clinique Saint-Michel ELSAN and the Centre Iris – Institut Toulonnais d’Ophtalmologie (281 rue Jean Jaurès, Toulon).