Unveiling the Reality of SMILE Eye Surgery: Risks and Considerations

Unveiling the Reality of SMILE Eye Surgery: Risks and Considerations

In the quest for perfect vision, medical science has consistently outdone itself, presenting us with groundbreaking innovations. And one such advancement is Small Incision Lenticule Extraction (SMILE) eye surgery. Despite its many advantages, like all surgeries, SMILE eye surgery comes with its set of risks. In this blog, we delve into these potential complications, providing a comprehensive understanding of what you should consider before opting for this vision correction procedure.

Understanding SMILE Eye Surgery

Understanding SMILE Eye SurgerySmall Incision Lenticule Extraction (SMILE) is a modern, minimally invasive refractive eye surgery. It is used to correct myopia (nearsightedness) and, in some cases, astigmatism. Gaining popularity for its efficacy and shorter recovery period, SMILE surgery employs a unique approach that differentiates it from traditional procedures like LASIK and PRK.

The process commences with the use of a femtosecond laser. That crafts a tiny, lens-shaped piece of tissue, or a lenticular, within the cornea. This lenticular is then extracted through a small incision, reshaping the cornea to improve it’s focusing capability. Notably, SMILE surgery doesn’t involve creating a corneal flap. That leads to fewer disruptions to corneal nerves and potentially reduces the risk of dry eye syndrome. After the procedure, healing begins immediately. Even, with significant vision improvement typically observed within a few days.

What Are Some SMILE Eye Surgery Risks?

Like any surgical procedure, SMILE eye surgery comes with potential risks and complications. While it’s generally considered safe and effective, some patients may experience certain side effects. Here are the top seven SMILE eye surgery risks:

Dry Eyes

The eye’s cornea is rich in nerves that play a significant role in stimulating tear production, hence maintaining a healthy tear film. During the SMILE procedure, despite causing less disruption than LASIK, some corneal nerves are inevitably severed. And that can impact tear production. This might lead to dry eye symptoms such as a feeling of dryness, burning, grittiness, or as if something is in the eye. While these symptoms are usually temporary and resolve as the nerves regenerate, Then, they can be managed with artificial tears and other treatments if necessary.

Under-correction or Overcorrection

In some cases, the reshaping of the cornea during the SMILE procedure might not be enough (under-correction) or might be too much (overcorrection). This could result in not achieving the expected visual acuity or introducing a new refractive error. In such scenarios, patients might still need to wear glasses or contact lenses after surgery. However, enhancements or touch-up procedures can often address under-corrections or overcorrections. Although these additional treatments may not be possible immediately and will need to be planned carefully.

Visual Aberrations

Visual AberrationsVisual disturbances, such as halos (circular flares or rings of light around a light source), starbursts (rays of light extending out from a light source), and glare (intense brightness that can be discomforting), are potential risks following SMILE surgery. These symptoms are typically more prominent in low-light or night-time conditions, and while they usually decrease over time as the eye heals, they may persist in some patients.

Infection or Inflammation

Infections after SMILE surgery are extremely rare but can occur. The risk of infection can be minimized by strictly adhering to post-operative instructions, which include using prescribed antibiotic eye drops and avoiding activities that could expose the eyes to contaminated water (like swimming) or dust. Inflammation is a normal part of the healing process but in rare cases can become excessive and require additional treatment.

Corneal Haze

Corneal haze refers to a condition where the cornea becomes cloudy or opaque due to the growth of excess collagen (a healing response of the body). This can occur as the cornea heals after SMILE surgery, potentially leading to blurred vision. It’s generally a transient effect and is usually resolved with the help of steroid eye drops. The surgeon will monitor this during follow-up appointments.

Difficulty with Night Vision

This issue often manifests as difficulty seeing or distinguishing objects in low light, sometimes accompanied by the appearance of halos or glares around lights. This problem arises due to the changes in the way light enters. And is focused on the eye post-surgery. Typically, these symptoms are temporary and improve over a period of several weeks to months as the eye adapts to its new shape. However, in rare cases, the problem could persist. It’s worth noting that any pre-existing night vision issues may potentially be exacerbated by surgery. That is why a thorough pre-operative examination and discussion with your eye surgeon is crucial.

Rare Severe Complications

Rare Severe ComplicationsFinally, this complication is more likely to occur if the procedure is performed on a patient with thin corneas or undiagnosed corneal disease. Another rare but serious complication could be cap tears or incomplete lenticule removal. During the SMILE procedure, the surgeon creates a small ‘cap’ on the cornea under which the lenticular is formed.

If this cap tears, it can complicate the procedure. Similarly, if part of the lenticular is left behind, it could interfere with vision. In these instances, additional surgical intervention may be necessary. These potential complications underscore the importance of having a detailed and comprehensive pre-surgical consultation. This will ensure you’re a suitable candidate for the procedure.

While these risks exist, it’s important to remember that complications are relatively rare and many are treatable. It’s also essential to have a thorough consultation with a knowledgeable and experienced surgeon.

How To Minimize The SMILE Eye Surgery Risks?

While SMILE eye surgery is generally considered safe and effective, there are some steps that patients and surgeons can take to minimize potential risks:

  1. Thorough Pre-Operative Assessment: Prior to surgery, a comprehensive eye examination should be conducted. This will help identify any existing eye conditions or anomalies that could increase surgical risks. Measurements such as corneal thickness, pupil size, and the level of refractive error will be crucial to determine your suitability for the procedure.
  2. Choosing an Experienced Surgeon: The skill and experience of your surgeon are fundamental to a successful outcome. A well-trained, experienced surgeon can ensure the procedure is performed correctly and manage any complications if they arise. Be sure to ask about your surgeon’s qualifications and experience with SMILE surgery.
  3. Strict Adherence to Post-Operative Care Instructions: Following surgery, you will receive instructions for care to help ensure proper healing and prevent infections. This may include the use of prescribed eye drops, and avoiding rubbing your eyes. And refraining from certain activities, such as swimming or vigorous exercise, for a period of time.
  4. Regular Follow-Up Visits: Post-operative check-ups are important for monitoring the healing process and ensuring that any potential complications are identified and managed promptly. Do not skip these appointments even if you feel your eyes are healing well.
  5. Proper Hydration and Nutrition: Staying well-hydrated and maintaining a balanced diet can aid the healing process. Certain vitamins and nutrients are particularly beneficial for eye health, such as vitamin A and omega-3 fatty acids.
  6. Avoidance of Eye Strain: Avoid activities that can strain your eyes, such as excessive screen time or reading in low light, during the recovery period. This can help your eyes heal more effectively.

Remember, while these steps can help minimize risks, they cannot completely eliminate them. It’s essential to have a detailed discussion with your surgeon about the potential risks and benefits.


As we conclude our deep dive into the realm of SMILE eye surgery, it’s clear that this innovative procedure, with its precision and minimally invasive approach, has reshaped the landscape of refractive surgeries. It offers the prospect of clear, glasses-free vision with a swift recovery time. However, as with any surgical intervention, it carries potential risks, albeit relatively rare ones.

Always remember, the decision to undergo SMILE eye surgery, or any surgical procedure for that matter, should not be taken lightly. Comprehensive discussions with your eye care professional are critical to helping you weigh the potential benefits and risks. Ensuring that you make an informed decision based on your specific circumstances and needs will set the foundation for a successful outcome.

Eye surgery is a safe 10-minute procedure to help you get rid of glasses. EyeMantra offers the most advanced eye surgery options including PRKFemto LasikSMILE surgeryStandard lasikICL and Contoura vision. If you have any questions on Lasik surgery in DelhiLasik surgery cost and Lasik procedure, call us at 9711116605 or email at [email protected].

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