Booking SMILE eye surgery: what to confirm before you choose it

What SMILE is, in one paragraph

SMILE stands for small incision lenticule extraction. Instead of folding back a flap, a femtosecond laser shapes a thin disc of tissue, called a lenticule, inside the cornea. The surgeon then removes that disc through a small opening, which changes the cornea's shape. The American Academy of Ophthalmology describes the laser step as taking around 30 seconds and the whole procedure roughly 10 to 15 minutes (AAO, 2020).

You do not need to understand the optics to book it well. You do need to confirm five practical things with the clinic before you put down a deposit.

1. Is your prescription inside the range?

SMILE was designed to correct short-sightedness, and that is still its core use. AAO's EyeWiki entry records US approval for spherical myopia in 2016, extended to myopia with astigmatism in October 2018, and reports no FDA approval for farsightedness (AAO EyeWiki, 2026). The same entry lists the US criteria in terms of maximum prescription, astigmatism and a minimum age of 22.

Clinics in Colombia work under their own country's approvals and with whatever version of the platform they own, so their range may be different from the US label. That is precisely why you should ask, in writing, with your current prescription in front of them:

• "Given these numbers, would you consider me for SMILE, or would you more likely recommend something else?"
• "Does my astigmatism fall within what you treat with SMILE?"
• "Is there anything in my history that would rule it out?"

If you are farsighted, or approaching the age where reading glasses appear, raise it at this stage. It may point you to a different conversation entirely.

2. Does the clinic actually have the equipment?

LASIK can be performed on several laser platforms. SMILE needs a specific kind of femtosecond laser with the software to cut a lenticule. Not every refractive clinic owns one. Before you plan around SMILE, ask the coordinator to name the laser the clinic would use, and whether the surgeon who will operate on you performs SMILE routinely or only occasionally.

This is a fair booking question, not a clinical one. You are confirming that the product you are paying for is the product you will receive. If the answer is vague, treat it the same way you would treat a vague answer about anything else on the quote.

3. How would an enhancement work?

This is the question most SMILE patients never think to ask, and it matters more for a travelling patient than for a local one.

With LASIK, a later touch-up typically involves lifting the existing flap and applying more laser. SMILE leaves no flap to lift. EyeWiki notes that re-treatment after SMILE may require PRK, and that software to convert the SMILE cap into a flap exists but is not approved in the US (AAO EyeWiki, 2026). PRK has a slower early recovery than LASIK, which affects how long a return trip would need to be.

So ask the clinic three things:

1. If I needed a touch-up after SMILE, which technique would you use?
2. Is it covered by the enhancement policy, and for how long?
3. Could it be done by an ophthalmologist near my home, and would you share my records for that?

None of the answers should put you off SMILE on their own. They simply let you price the worst realistic case into the decision.

4. What does the first week look like?

AAO's patient page on SMILE says to expect blurry vision immediately afterwards, gradual improvement over days to weeks, a return to most normal activities within a day or two, and keeping water out of the eyes for a few days (AAO, 2020). Someone needs to take you home on surgery day.

For trip planning, that means the post-op shape of a SMILE booking looks broadly similar to a LASIK booking rather than a PRK one. The details still come from your surgeon: how many check-ups they want before you leave, and when they are comfortable with you flying. Do not assume a SMILE trip can be shorter than a LASIK trip unless the clinic tells you so.

5. Are you choosing SMILE for the right reasons?

People ask for SMILE for several reasons. Some are solid, and some are worth a second look.

Reasons worth discussing with the surgeon

• Concern about dry eye. EyeWiki reports that dry eye symptoms are generally less frequent after SMILE than after LASIK, linked to the smaller incision affecting fewer corneal nerves. That is a population-level finding, not a promise for your eyes, and dry eye can still occur after any laser procedure. If dry eye is your worry, tell the surgeon and let them weigh it.
• A lifestyle where a flap could be knocked. A flapless procedure removes that particular concern. PRK also does, which is why the surgeon may present both.

Reasons to look at again

• "It's the newest." New is not the same as right for your cornea or your prescription.
• "There's no recovery." There is. It may be quick, but you still have post-op drops, check-ups and restrictions.
• "A friend had it." Your friend's prescription and corneal thickness are not yours.

The FDA's general advice on choosing a refractive procedure applies just as much to SMILE: compare risks and benefits across procedures and surgeons, do not choose on cost alone, and be wary of anything presented as guaranteed (FDA, 2018).

What the consult will check

Even with a strong pre-screen, the final yes or no for SMILE comes after the in-person exam. AAO lists what the ophthalmologist looks at to decide eligibility: retesting your vision to confirm it has not changed, checking for other eye problems that surgery could worsen, measuring corneal thickness and mapping the corneal surface, and measuring pupil size (AAO, 2020).

Each of those can move the recommendation. A prescription that shifted since your last glasses, a cornea that maps irregularly, or a dry-eye finding can all lead the surgeon to suggest a different approach, or none. The same AAO page also sets expectations: SMILE lets most people handle everyday tasks without glasses or contacts, but some may still need glasses for things like reading or night driving.

Two booking habits follow from this. First, stop contact lenses on the schedule the clinic gives you, so the retest of your vision is meaningful. Second, arrive with a written list of what you would want to happen if SMILE is ruled out: switch to another laser procedure on the same trip, or go home and think about it. Deciding that calmly in advance is far easier than deciding it dilated in the consult chair.

Booking a SMILE date without boxing yourself in

The safest way to book is to request SMILE while leaving room for the surgeon to recommend something else. In practice:

• Say in your inquiry that SMILE is your preference but that you are open to the surgeon's recommendation.
• Send your full prescription history, any previous topography, and your contact lens type, so the clinic can make an early judgement.
• Get a quote that lists SMILE, LASIK and PRK, with the enhancement policy for each.
• Book a trip length and a flight that would still work if the surgeon chose PRK on the day.
• Confirm the surgeon's SMILE experience in writing before travelling, not in the consult room.

If you are not sure SMILE is even the right starting question, our guide on what to send with your inquiry will get you a recommendation based on your records rather than on a procedure name.