SMILE (Small Incision Lenticule Extraction) represents the next generation of laser vision correction. Unlike LASIK, SMILE requires no flap - the entire procedure happens inside the cornea through a tiny 2-4mm keyhole incision. The result is a stronger, more structurally intact cornea and faster recovery from dry eye.
Dr Naren Shetty at Narayana Nethralaya now offers SMILE Pro - the latest evolution using the ZEISS VISUMAX 800 platform, making the procedure 4x faster and even more precise than the original SMILE.
No Flap
Structurally stronger cornea post-surgery
< 10 sec
SMILE Pro laser treatment time per eye
2-4mm
Tiny keyhole incision - no blade
24 hrs
Return to normal activities
How SMILE Works - Inside the Cornea
SMILE is an all-femtosecond laser procedure. There is no excimer laser, no blade, and no flap. Understanding the procedure helps set realistic expectations.
Pre-operative evaluation
Comprehensive corneal topography, pachymetry, and refraction. The laser treatment plan is calculated based on your exact prescription and corneal shape.
Anaesthetic eye drops
Numbing drops are applied. The procedure is painless. No injections, no sedation required.
Lenticule creation (femtosecond laser)
The VISUMAX femtosecond laser creates a disc-shaped piece of corneal tissue (lenticule) entirely within the cornea. The laser also creates a tiny 2-4mm incision. In SMILE Pro, this takes under 10 seconds per eye.
Lenticule removal
The surgeon gently dissects and removes the lenticule through the small incision using microsurgical instruments. The removal of this disc reshapes the cornea, correcting myopia and/or astigmatism.
Natural healing - no flap to reposition
The small incision heals naturally. There is no flap to displace - ever. This is why SMILE is preferred for contact sports, martial arts, and physically active patients.
Post-operative review
Reviewed at 1 day, 1 week, and 1 month. Vision clears over 24-72 hours. Dry eye symptoms are significantly milder than with LASIK.
SMILE vs SMILE Pro - What's the Difference?
| Feature | Original SMILE | SMILE Pro (VISUMAX 800) |
|---|---|---|
| Laser platform | VISUMAX 500 | VISUMAX 800 |
| Treatment speed | ~25-30 sec per eye | < 10 sec per eye |
| Suction time | Longer | Significantly shorter |
| Patient discomfort | Minimal | Even less (faster suction) |
| Lenticule precision | High | Higher (advanced optics) |
| Eye tracking | Standard | Enhanced real-time tracking |
| Availability in India | Widespread | Select centres (incl. NN) |
Narayana Nethralaya offers SMILE Pro with the ZEISS VISUMAX 800 - one of the few centres in India to have this next-generation platform.
Why Patients Choose SMILE
No Flap - Stronger Cornea
SMILE preserves more corneal biomechanical integrity. No flap means no risk of flap displacement - ever. Ideal for active lifestyles and contact sports.
Less Dry Eye
SMILE severs fewer corneal nerves than LASIK, resulting in significantly less post-operative dry eye. Most patients report minimal dryness.
Ultra-Fast with SMILE Pro
The VISUMAX 800 completes the laser phase in under 10 seconds per eye - reducing suction time and improving patient comfort and compliance.
All-in-One Laser
Only one laser is used throughout. There is no separate excimer laser step, no flap creation machine, and no repositioning. Fewer instruments, fewer variables.
Ideal for Active Patients
No flap to displace means SMILE is the preferred choice for military personnel, martial artists, swimmers, and anyone at risk of eye trauma.
Treat Higher Prescriptions
SMILE can correct myopia up to -10D and astigmatism up to 5D - making it suitable for patients with moderate-to-high prescriptions.
Are You a SMILE Candidate?
✅ Good Candidate If:
- • Age 18+ with stable prescription ≥1 year
- • Myopia: -1D to -10D
- • Astigmatism up to 5D (myopic)
- • Adequate corneal thickness
- • Active lifestyle or contact sports
- • Prone to dry eye (SMILE causes less dryness)
- • Preference for flapless procedure
⚠️ SMILE May Not Be Suitable If:
- • Hyperopia (SMILE does not treat far-sightedness)
- • Keratoconus or irregular cornea
- • Very thin cornea
- • Severe dry eye disease
- • Mixed astigmatism
- • Very low myopia (under -1D) - LASIK may be better
- • Need for maximum contrast/HOA correction (consider Contoura)
Recovery Timeline
Day 1
Vision functional
Mild blurring, light sensitivity, and watering. Rest recommended. Most patients can see well enough to navigate independently.
Day 2-3
Rapid improvement
Vision improves quickly. Return to desk work and light activity possible. Avoid rubbing eyes.
Week 1
Follow-up review
Vision check and slit lamp exam. Medicated drops continued.
Week 2-4
Normal activity resumes
Avoid swimming for 4 weeks. Light gym is usually permitted from week 1. Contact sports from 4 weeks.
Month 3
Full stabilisation
Final vision outcome assessed. Dry eye symptoms (if any) fully resolved for most patients.
Cost of SMILE Surgery in Bangalore (2025)
| Procedure | Platform | Cost (per eye) |
|---|---|---|
| SMILE | ZEISS VISUMAX 500 | ₹55,000 - ₹70,000 |
| SMILE Pro | ZEISS VISUMAX 800 | ₹65,000 - ₹85,000 |
* Includes pre-operative evaluation, procedure, and post-operative care. Final pricing confirmed at consultation.
Frequently Asked Questions - SMILE
Is SMILE painful?+
No. Anaesthetic drops numb the eye completely. The suction phase (under 10 seconds with SMILE Pro) may cause mild pressure sensation - not pain.
Can SMILE treat hyperopia (far-sightedness)?+
No. SMILE is currently approved for myopia and myopic astigmatism only. Patients with hyperopia should consider LASIK or Contoura Vision.
Can SMILE be re-treated if needed?+
Enhancement after SMILE is more complex than after LASIK. Options include LASIK on top of SMILE (LASIK Touch-up), PRK, or a second SMILE in suitable cases. Dr Naren Shetty will advise accordingly.
How is SMILE different from LASIK?+
LASIK creates a flap; SMILE does not. SMILE uses only one laser (femtosecond) vs LASIK's two (femtosecond + excimer). SMILE causes less dry eye and preserves more corneal strength. LASIK offers more treatment options including hyperopia and topography-guided treatment.
When can I return to work after SMILE?+
Most desk workers return within 24-48 hours. Those in physically demanding roles may need 1 week.
Is SMILE Pro available at Narayana Nethralaya?+
Yes. Narayana Nethralaya is equipped with the ZEISS VISUMAX 800 for SMILE Pro - one of the few centres in India offering this platform.