SMILE Pro Laser Eye Surgery Guide

ROQUE Refractive Surgery • Article 023 • Current SMILE Pro master guide

Comprehensive patient guide to SMILE Pro laser eye surgery on the ZEISS VISUMAX 800, including suitability, treatment experience, comparisons, possible complications, recovery, costs and consultation planning in the Philippines.

If you are tired of glasses fogging up, frequently wearing contact lenses or struggling to see clearly at distance, it is reasonable to explore laser eye surgery. But the first question is whether your eyes are suitable—not whether the latest laser can treat you. This guide helps you understand the operation before booking an evaluation.

Ready to investigate candidacy? Book a SMILE Pro consultation.

Quick navigation

• What is SMILE Pro?
• SMILE Pro versus original SMILE
• Evidence: what is proven?
• Who may qualify?
• What happens at screening?
• How surgery works
• SMILE Pro videos
• Recovery and return to activities
• Risks and warning signs
• SMILE Pro vs LASIK, PRK, PRESBYOND and ICL
• Philippine costs and value
• Enhancements and long-term expectations
• Frequently asked questions

What exactly is SMILE Pro?

The cornea is the transparent dome over the iris and pupil. In myopia, light focuses too far in front of the retina, making distant objects look blurry. SMILE Pro changes corneal focusing power by removing a specifically shaped disc of tissue—the lenticule—from inside the cornea. It does not create a broad flap as LASIK does.

ZEISS uses the brand name SMILE pro for the treatment workflow on the VISUMAX 800. Some clinical papers describe this type of treatment using the broader term keratorefractive lenticule extraction (KLEx). In patient language, both refer to the small-incision lenticule extraction family; exact platform settings, indications and availability must be confirmed.

SMILE Pro is a procedure, not a cure for every blurry-vision problem. It does not treat cataracts, retinal disease, glaucoma or age-related loss of near focus.

How is a lenticule different from a LASIK flap?

A lenticule is the tissue removed from within the cornea to change its shape. A LASIK flap is a broad hinged layer lifted so another laser can treat tissue underneath. In SMILE Pro, a small opening is used to reach the lenticule while the anterior corneal cap remains largely in place.

SMILE Pro vs SMILE: what actually changed?

Laser time is not total surgery time. The eyes must still be positioned; suction established; the lenticule separated and removed; and recovery care completed. These trial averages are not personal treatment-time promises.

ZEISS technical materials describe computer-assisted centration and cyclotorsion adjustment. These are surgeon-guidance features—not a substitute for good fixation, centration decisions or clinical skill.

What does the latest comparative research actually show?

The strongest current summary we identified is a 2026 systematic review and meta-analysis that combined nine nonrandomized comparative studies and 1,692 eyes. Follow-up was short, approximately one to six months. It found that several standard measures—including postoperative uncorrected distance visual acuity and spherical equivalent—were not statistically different between the platforms, while certain astigmatism-related outcomes favored VISUMAX 800. The researchers explicitly called for larger, longer prospective studies.

A 2025 paired-eye study of 30 patients used VISUMAX 800 in one eye and VisuMax 500 in the other. The newer system reduced docking and surgical workflow time; patients generally preferred the VISUMAX 800 experience. Standard vision, refractive and optical measurements at three months were not significantly different.

A separate 2025 comparison and a 2026 retrospective study reported faster lenticule scans and potentially favorable centration or astigmatic measures with VISUMAX 800, although such findings need more follow-up and replication.

Who is a candidate for SMILE Pro?

An appropriate candidate is usually an adult whose prescription has remained stable and whose cornea, ocular surface and overall eye health make the intended treatment reasonably safe. Many candidates have myopia, with or without myopic astigmatism.

What surgeons look for

• Repeatable refraction and a stable eye grade.
• Healthy corneal shape on topography and tomography.
• A sufficiently thick cornea with adequate postoperative structural reserve.
• Healthy tear film and managed dry eye or eyelid disease.
• Absence of active ocular infection or inflammation.
• Retina and other eye findings compatible with refractive surgery.
• Realistic expectations about night vision, healing, glasses and age-related near vision.

Who should be cautious or may not qualify?

• People with suspected keratoconus, ectasia risk or abnormal corneal mapping.
• Unstable prescription or uncertain measurement reliability.
• Severe untreated dry eye or active ocular-surface inflammation.
• Significant cataract or other disease that better explains reduced vision.
• Conditions affecting wound healing, including certain systemic illnesses or medication exposures.
• Pregnant or breastfeeding patients, for whom elective refractive surgery is typically deferred.
• Patients whose corneal tissue budget is inadequate for the intended correction.

A patient who is unsuitable for SMILE Pro may still be a candidate for another procedure—or may be better advised not to undergo elective surgery.

Does SMILE Pro treat farsightedness?

ZEISS describes hyperopic (farsighted) treatment in some international product materials. That does not establish a Philippine indication or confirm availability at our clinic. The surgeon must verify the local authorization and installed software before offering any specific correction. This page focuses on established discussions of myopia and myopic astigmatism, not an unverified claim of local hyperopic availability.

What happens during a SMILE Pro consultation and screening?

Screening determines whether any operation is appropriate and helps compare available methods. Depending on your clinical findings, your assessment may include:

1. Discussion of your vision, job, hobbies, night driving and goals.
2. Measurement of unaided and corrected eyesight, refraction and prescription stability.
3. Corneal topography or tomography and corneal-thickness testing.
4. Tear-film and eyelid evaluation, including meibomian gland function where indicated.
5. Slit-lamp examination, intraocular pressure and pupil evaluation when indicated.
6. Retinal examination, with dilation or other imaging when appropriate.
7. A review of alternatives, complications, expected recovery and costs.

Contact-lens wearers: lenses can temporarily alter corneal measurements. Ask ROQUE Eye Clinic for your personalized lens-free interval before scheduling screening; it varies by lens type and corneal stability. Do not assume one fixed interval applies to everyone.

For a printable preparation checklist, see SMILE Pro screening instructions.

How is SMILE Pro performed?

1. Before the procedure. The surgical team confirms the correct patient, eye, prescription, treatment plan and consent; your surgeon explains the process.
2. Numbing and positioning. Anesthetic eye drops are applied, and a small eyelid holder keeps the eye open.
3. Docking and alignment. The surgeon aligns the laser interface; you will be instructed to look toward a fixation target while suction stabilizes the eye.
4. Laser treatment. VISUMAX 800 creates the internal lenticule and small incision using femtosecond laser pulses.
5. Tissue removal. The surgeon gently separates and extracts the lenticule.
6. Assessment and discharge. The team checks the operated eye, reviews the medication plan and confirms follow-up.

The laser cutting itself is short, but preparation, docking, tissue separation and checks take additional time. Patients may feel pressure or a foreign-body sensation; responses vary. Follow the treating surgeon’s instructions if you become anxious, move unexpectedly or notice anything unusual.

Read SMILE Pro surgery-day instructions for a patient checklist before your appointment.

SMILE Pro procedure and explanation videos

Watch the clinic’s educational videos using the BeTheme Tabs element below. Surgical footage is for understanding the steps and may not be suitable for sensitive viewers. Actual surgical plans and recovery vary.

Recovery: what will I see and feel?

Many patients notice functional improvement relatively soon after SMILE Pro, but recovery is not identical for every eye. Early blur, watering, light sensitivity, irritation and fluctuating sharpness can be expected. Some patients see clearly within days; others take longer to feel visually stable, especially during screen work or night driving.

These are descriptions, not promised milestones. You must follow the surgeon’s written activity restrictions. Recovery after SMILE Pro is not a reason to skip postoperative visits.

Can I go to work or use my phone the next day?

Some people resume desk tasks early, but reading and screen comfort depend on the quality of vision and tear film. Rest when tired, blink often and use prescribed lubrication. If your work involves dust, chemical exposure, heavy activity or precision driving, discuss a safe return date before surgery.

When can I drive?

Do not drive on surgery day. Resume only after your eye-care team has cleared you and vision meets legal and practical driving requirements. Feeling confident alone is not a substitute for adequate vision.

For the full safety checklist, see SMILE Pro postoperative instructions.

SMILE Pro risks, complications and warning signs

SMILE Pro is elective eye surgery. All patients must understand what can go wrong even when an operation is carefully performed.

Usually temporary side effects

• Blur, fluctuating focus or a mild foreign-body sensation
• Dry eyes, reflex tearing or burning
• Glare, halos, starbursts and light sensitivity
• One eye settling faster than the other

Complications requiring assessment

• Residual prescription or regression: glasses or later enhancement may be considered.
• Intraoperative suction loss: may require an altered or postponed treatment plan.
• Difficult lenticule dissection, tearing or a retained fragment: uncommon surgical challenges that may need additional management.
• Inflammation or infection: sometimes vision-threatening without timely treatment.
• Corneal ectasia: a rare progressive change in corneal shape that careful screening aims to minimize, not eliminate.
• Persistent quality-of-vision symptoms: night-vision disturbance, dry eye, reduced contrast or visual dissatisfaction.
• Rare loss of best-corrected vision: a serious possible outcome even though uncommon.

Can SMILE Pro cause dry eye?

Yes. Some studies suggest advantages over LASIK on certain early ocular-surface measures, but both procedures can cause or aggravate dryness. Treating pre-existing dry eye and meibomian gland problems before elective surgery is important.

Is 20/20 guaranteed?

No. Vision results vary, and even clear chart vision does not guarantee perfect contrast, night driving or comfort. You may still need glasses for specific activities.

SMILE Pro vs LASIK, PRK, PRESBYOND and ICL

What looks best on a brochure may not be safest for your cornea. The correct procedure is the one that passes clinical screening and suits your actual visual needs. A person with high myopia and an inadequate corneal tissue budget may need to discuss ICL. A person with ocular surface problems may need treatment before any elective laser procedure.

SMILE Pro cost in the Philippines: what should patients ask?

The ROQUE Eye Clinic published Costs page lists the current refractive surgery fees and distinguishes one-eye from both-eye prices. Check that page for the latest amount rather than relying on a copied price in an older blog article. Published fees can change and may not include every screening test or other service.

When comparing quotations, ask whether they include: clinical consultation; corneal imaging and dry-eye tests; procedure and facility fees; medications and eye protection; scheduled follow-up; and any enhancement terms or exclusions.

The cheapest quotation is not automatically the best value. More importantly, even a technically excellent operation is poor value if the patient is not a safe candidate.

Does a SMILE Pro consultation mean I must undergo surgery?

No. Screening is a decision-making process. We may recommend SMILE Pro, another approach, further treatment before surgery, more testing or no surgery at all.

What if I still have an eye grade after SMILE Pro?

Undercorrection, overcorrection, regression or ocular-surface changes can lead to persistent blur. The first step is to identify the cause, verify stability and check corneal safety—not to rush into a second procedure.

Depending on the eye, selected enhancement approaches may include PRK or a surgeon-planned CIRCLE cap-to-flap conversion followed by excimer laser treatment. Other cases may be managed with glasses, contact lenses, dry-eye treatment or observation. No enhancement is guaranteed or universally appropriate.

Will my correction last forever?

The removed corneal tissue does not grow back as it was. However, eyes can continue to change with age. Presbyopia, cataracts and other unrelated conditions can affect vision later. Discuss near-vision plans before deciding on distance correction, particularly from the 40s onward.

How to make a productive consultation

• Bring your most recent eyeglass prescription and older prescriptions if available.
• Tell your surgeon whether you use soft, rigid or specialty contact lenses.
• Mention all eye diagnoses, medications, allergies, surgeries and systemic conditions.
• Explain night-driving needs, hobbies, working environment and reading requirements.
• Ask directly: “If I were your family member, what clinical finding would make you advise against surgery?”

SMILE Pro FAQs

1. Is SMILE Pro the same as LASIK?

No. Both can correct refractive error, but SMILE Pro removes an internal lenticule through a small incision while LASIK uses a corneal flap and excimer laser ablation.

2. Is SMILE Pro better than original SMILE?

The newer system improves laser scan speed and offers workflow assistance. Comparative short-term studies have not consistently shown superior standard distance vision for every patient.

3. Is the laser painless?

Numbing drops are used. Patients may notice pressure, touching or discomfort. You should tell the surgical team if you have significant pain or difficulty following instructions.

4. Does the laser take only ten seconds?

About 9–10 seconds was the lenticule creation phase in selected studies; it is not the full surgical or clinic appointment duration.

5. Can SMILE Pro treat astigmatism?

It can treat suitable myopic astigmatism, depending on approved indications, measurements and available settings. Screening determines the individual plan.

6. Can SMILE Pro treat hyperopia?

Some international ZEISS materials discuss hyperopic applications. Philippine authorization and clinic availability must be confirmed, so we do not promise hyperopic SMILE Pro on this page.

7. How old must I be?

Age thresholds depend on regulatory indications and patient factors. Stable refraction, eye health and visual maturity matter; the treating surgeon will confirm eligibility.

8. Does SMILE Pro cure dry eye?

No. Dry eye is possible after surgery and may require treatment before and after the procedure.

9. Will I need reading glasses?

Possibly. Standard distance correction does not prevent presbyopia.

10. When can I return to work?

Many people resume lighter activities fairly quickly, but the timing depends on vision, comfort, job hazards and your doctor's advice.

11. When can I swim or wear eye makeup?

Ask for the written postoperative restrictions provided by your surgeon. Avoid applying a generic internet schedule to your particular case.

12. Can SMILE Pro cause complications?

Yes. Uncommon problems can be serious. Careful screening, operative technique and follow-up reduce risk but do not eliminate it.

13. Is SMILE Pro suitable for very high myopia?

Not always. The corneal tissue budget, treatment range and retina must be assessed; ICL may be a more appropriate alternative for selected patients.

14. Can I undergo SMILE Pro after prior LASIK or SMILE?

Previous corneal surgery changes safety calculations. Do not assume another lenticule extraction is an option; obtain specialist evaluation.

15. Where can I book an assessment?

Use the official ROQUE Eye Clinic Book Consultation page. Appointments can be sought at St. Luke's Medical Center Global City or Asian Hospital and Medical Center. The actual laser surgery site is confirmed separately.

Clinical references

Sources support the clinical information above. Regulatory indications and product features can differ by country.

1. American Academy of Ophthalmology. Refractive Surgery Preferred Practice Pattern (2024)
2. American Academy of Ophthalmology. SMILE patient information (2022)
3. US FDA. VisuMax SMILE patient information booklet
4. ZEISS. VISUMAX 800 technical and treatment description
5. ZEISS. SMILE pro patient information
6. Ganesh, Brar & Swamy. Paired-eye VISUMAX 800 vs 500 study. J Refract Surg (2025)
7. Kim & Chung. VISUMAX 800 vs 500 clinical outcomes. Scientific Reports (2025)
8. Sekundo et al. Multicenter six-month VISUMAX 800 outcomes. J Refract Surg (2025)
9. Li & Li. VISUMAX 800 vs 500 meta-analysis, 1,692 eyes. Front Med (2026)
10. Yang et al. Comparative optical quality study. Front Med (2026)

Prepared October 29, 2026. This information does not establish eligibility, guarantee results, or replace the physician’s personalized advice. Regulatory indications and product features may vary by jurisdiction.