SMILE Pro Procedure: What Actually Happens, Step by Step

SMILE Pro, stage by stage

Use the stage buttons to move through the timeline, or show all stages at once. On a phone, all stages appear in sequence.

1. 01
   Preparation

   Before the day of treatment

   Contact lenses are usually left out for a period beforehand, and the clinic will give you specific instructions about drops, makeup and medication.

   Contact lenses press on the cornea and change its shape, which distorts the measurements used to plan your treatment. That is why clinics ask you to stop wearing them for a set period first. The required period differs between soft, toric and rigid lenses, so follow the instruction your clinic gives rather than a general rule from the internet.

   Practical points

   • Bring your previous prescriptions or spectacle records if you can: they are useful evidence of how stable your refraction has been.
   • Tell the clinic about every medication you take, including anything bought over the counter, and about any supplements.
   • Arrange transport home. You will not be driving yourself.
   • Ask whether anyone needs to stay with you afterwards, and for how long.

   Worth asking

   • Exactly how long must I leave my contact lenses out, for my lens type?
   • Which of my medications, if any, do you want me to pause?
   • What should I have at home ready for the first evening?
2. 02
   Assessment

   The consultation and eye examination

   A comprehensive assessment maps your refraction, corneal shape and thickness, ocular surface and overall eye health. Suitability is decided here.

   This appointment is the most important part of the whole process. It is where the measurements that determine whether surgery is safe and appropriate for you are taken. A clinic that offers to skip or compress this step in order to book a treatment date is telling you something about how it operates.

   Practical points

   • Expect the assessment to take substantially longer than a routine eye test. Ask how long to allow.
   • Corneal topography, pachymetry, refraction, tear film assessment and a dilated examination are the core components. Ask which of these are included.
   • You may be given dilating drops, which blur your near vision and make bright light uncomfortable for several hours. Plan around that rather than driving afterwards.
   • Ask for your measurements in writing. This is your data, and you will want it later.

   Worth asking

   • What are my corneal thickness and topography results, in numbers?
   • What is the tear film assessment showing, and does anything need treating first?
   • Would you operate on your own eye with these measurements?
   • What would make you decide not to operate?
3. 03
   Planning

   Eye measurements and treatment planning

   Your refraction and corneal data are used to calculate the lenticule shape and the treatment parameters for each eye.

   Refraction is not always identical from one visit to the next, and the ocular surface affects the reading. Some surgeons repeat measurements to confirm they are consistent before planning treatment. This is a sign of care, not indecision.

   Practical points

   • If your refraction differs between visits, ask whether it should be repeated before treatment is planned.
   • If your ocular surface needs treatment first, that may add time before surgery. That sequencing is usually deliberate.

   Worth asking

   • Were my measurements consistent between visits?
   • Is there any reason to repeat or confirm anything before we proceed?
4. 04
   Day of treatment

   Arrival and preparation

   Anaesthetic drops are instilled, the eye is cleaned and prepared, and any final checks are made before you enter the treatment room.

   Topical drops are used rather than injections. You will be awake and able to follow instructions throughout, which is part of the point: the surgeon needs your cooperation to keep the eye positioned.

   Commonly reported by patients

   Most people describe the anaesthetic drops as mildly stinging for a moment, then nothing.

   Practical points

   • Wear comfortable clothing and no eye makeup, perfume or lotion around the eyes.
   • Leave jewellery and anything you do not need at home.
   • Expect a final confirmation of your details and your consent before treatment. Read it, even if you have read it before.

   Worth asking

   • Who will be in the room, and who is actually operating?
   • What happens if I need to stop part way through?
5. 05
   Treatment

   The laser phase and lenticule removal

   The femtosecond laser creates the lenticule and the incision. The surgeon then separates and removes the lenticule, usually taking only a short time per eye.

   A suction device holds the eye steady against the laser interface while the laser works. Then the surgeon uses fine instruments to separate and withdraw the lenticule through the small incision. There is more than one way to do that step, and surgeons differ in which they prefer.

   Commonly reported by patients

   Patients commonly report pressure and a suction sensation, awareness of lights, and a strong urge to look away. Pain is usually not reported during the laser phase because of the anaesthetic drops. Vision is typically blurred and watery immediately afterwards.

   Practical points

   • You will be asked to look at a fixation light and to keep still. Small eye movements are expected and the system accounts for them.
   • Tell the team immediately if you feel anything sharp or painful, rather than waiting for it to finish.
   • Both eyes are often treated in the same session, but this is a clinical decision.

   Worth asking

   • How many of these procedures do you personally perform each month?
   • What is your rate of needing to stop and reschedule a treatment?
6. 06
   Immediately after

   In the recovery area

   You stay in the clinic for a short observation period. Drops are usually started, and you are checked before being allowed to leave.

   The team is looking for anything requiring immediate attention and making sure you have understood the drop schedule. This is a good moment to write down your questions rather than relying on memory later.

   Commonly reported by patients

   Blurred, watery, gritty vision is commonly reported at this point. Some people notice an improvement within the first hour or two; others take longer.

   Practical points

   • Do not rub the eye, however much it itches. Ask what you should do instead if the urge is strong.
   • Make sure you know which drop goes in which eye, how often, and for how long.
   • Keep the written instructions and the clinic’s out of hours contact number somewhere you can find them in the dark.

   Worth asking

   • What number do I call out of hours if something worries me?
   • What symptoms mean I should be seen urgently rather than waiting?
   • Which drops, in what order, and for how long?
7. 07
   Same day

   Going home

   Someone else drives. Most people rest with their eyes closed for a period, and many sleep.

   Resting with the eyes closed in the first hours is the most commonly given advice and the most commonly ignored. Understanding why it helps (it reduces dryness and irritation while the surface settles) makes it easier to follow.

   Commonly reported by patients

   Vision is often described as hazy or foggy in the first hours, with glare and halos around lights. Many people choose to sleep through this period.

   Practical points

   • Arrange for someone else to drive, and not just because of the anaesthetic.
   • Take the drops exactly as instructed, including the ones that sting. They are usually the important ones.
   • Expect to want to keep your eyes closed. Sleep is a legitimate use of the evening.

   Worth asking

   • Should I wake to take drops overnight, or can I sleep through?
8. 08
   First night

   The first night

   Protective shields or goggles are usually worn overnight to stop you rubbing the eye in your sleep.

   Rubbing an eye that has just been operated on is one of the few things a patient can do to genuinely damage the result, which is why the shields exist. They are temporary and they matter.

   Commonly reported by patients

   Glare and halos around lights are commonly reported in the evening. Vision may seem better than expected, or worse, or different in each eye.

   Practical points

   • Wear the protection you were given, even though it is uncomfortable. Set drops in a known place for the night.
   • Do not be alarmed if vision differs between the two eyes. This is common and usually settles.

   Worth asking

   • If my two eyes feel very different tomorrow, at what point should I call?
9. 09
   First week

   The first week

   Vision improves and fluctuates. Follow-up appointments begin. Screens, driving and exercise are governed by your surgeon’s instructions.

   This is the period where expectations and reality most often diverge, because vision is good enough to function but not yet stable. Reading text can be harder than expected in the early days, and screen work can feel tiring.

   Commonly reported by patients

   Fluctuating sharpness during the day, dryness or grittiness, sensitivity to light, and halos or starbursts around lights at night. Usually improving but not linear.

   Practical points

   • Use lubricating drops as instructed. Keep them with you rather than at home.
   • Take breaks from screens. Blink deliberately.
   • Follow the specific guidance you were given on driving, exercise, swimming and makeup rather than a generic rule.

   Worth asking

   • When can I resume my specific sport or activity?
   • What should I do if my vision seems to get worse rather than better?
10. 10
    Follow-up

    Follow-up appointments

    Checks are usually scheduled early, then spread out over the first months as refraction stabilises.

    The early appointments check healing and the ocular surface. The later ones assess where your refraction has actually settled, which is the point at which a residual prescription becomes a meaningful conversation rather than a temporary fluctuation.

    Practical points

    • Ask at the first follow-up what the full schedule looks like, so you can plan around work and travel.
    • Attend even if everything feels fine. Some findings are only visible on examination.
    • If you are moving away or travelling, ask how follow-up will be arranged and who will hold your records.

    Worth asking

    • What is the complete follow-up schedule, and what does it include?
    • What follow-up is included in the price, and what is charged separately?
    • If I am outside the UAE, what are my options?