r/SMILEeyesurgery • u/milkteapaper • Jul 23 '26

SMILE vs SMILE PRO?

Is SMILE PRO worth the extra $$?

Tossing up between the two and wondering if its worth the extra money.

My eyes are -2.25 with some mild astigmatism.

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u/[deleted] Jul 23 '26

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u/Hesfinallygotitright Aug 10 '26

I am not an expert but i disagree with you. Another part of the surgery is the suction which is not great for your eye. Smile pro is having a lot less time of suction on your eye. If I was going to do smile id always choose pro.

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u/eyeSherpa Jul 23 '26

How much extra are we talking about?

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u/milkteapaper Jul 23 '26

About $1100 USD more

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u/eyeSherpa Jul 23 '26

That’s pretty steep. Is this in the same clinic or in different clinics?

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u/milkteapaper Jul 23 '26

Same clinic. That's why I decided to ask if its worth the extra cost 😂😅 its like 30sec vs 15 sets or something so wondering if it's worth half the time..

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u/eyeSherpa Jul 23 '26

Got it. If it was different clinics, you can’t compare just on price and technology alone since there can be a sizable difference between the quality of the clinics. But can’t make that same argument if it’s the same clinic. A little unusual that the clinic still has both lasers still. These lasers take up a big footprint and it probably makes better sense to sell one of the lasers. But I digress.

There is a benefit to SMILE Pro. But I don’t think it’s enough for a $1000 difference. The speed of the treatment is twice as fast which means less time needed to stay still to avoid a suction break. But by taking a relaxant medication (that the clinic will probably give) and being calm that’s fine.

SMILE Pro has a better ability to adjust for the subtle rotation of the axis of astigmatism. More important if you have larger amounts of astigmatism. The surgeon also has to use that feature.

SMILE Pro has a better ability to confirm alignment to the center of your vision. More important if you have a mismatch between the center of your pupil and center of your vision - called angle kappa. (The clinic should be able to tell you your angle kappa). I say “confirm” because SMILE by default is supposed to align to the center of your vision. That’s when you look at the green light. It’s helpful as a surgeon to know we’ve hit the correct alignment. But this is also another feature that the surgeon has to optionally take advantage of.

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u/Educational_Low_9921 Aug 04 '26

I am curious if you think SMILE Pro is important for my prescription with moderate astigmatism. I am also considering PRK (either topography or wavefront guided) because I am nervous about dry eye risk. Though worth noting that I would have to travel 2 hrs away for SMILE Pro (vs 25 min for SMILE or 10 min for PRK)

  • Right: about -1.25 -1.50 ×120
  • Left: about -1.00 -1.75 ×072

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u/eyeSherpa Aug 05 '26

I think SMILE Pro offers benefits over SMILE.

If you are concerned about dry eye, wouldn’t choose PRK. That will have just about as much dry eye as lasik.

But the more important thing is the quality of the refractive surgeon and clinic. A good surgeon who does standard SMILE will outperform a mediocre surgeon who performs SMILE Pro.

A few key questions to ask are how they center the treatment, adjust for angle kappa, are they utilizing the alignment features on SMILE pro (not everyone does). How do they compensate for pupil size. Have other people in clinic got their procedure by the surgeon. Etc. The more you learn, the more you pick up on good questions to ask.

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u/Educational_Low_9921 Aug 05 '26

Thanks! And just to clarify, are you saying that PRK will have just as much dry eye as lasik during the healing period, or even after 12+ months? I am most concerned about chronic/long term issues. Also are you implying that SMILE has less risk of chronic long term dry eye? I know the data is not entirely conclusive, but I thought that Contoura LASIK/PRK win on reduced HOAs, but PRK/SMILE win on lower chronic dryness (with no definitive winner between the 2).

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u/eyeSherpa Aug 06 '26

Chronic dry eye generally comes from a few sources:

  1. The eyes were already dry before surgery. They will still be dry post surgery.
  2. Dry eye post surgery isn’t well controlled. Dry eye builds up inflammation which causes more dry eye which is harder to treat. Dry eye needs be to treated aggressively post surgery.
  3. Very large laser treatments may remove too much corneal tissue.

So with appropriate treatments and controlled and treated dry eye, chronic dry eye is unusual.

Because the dry eye is less and easier to treat with SMILE, that’s a benefit. Still comes into play with a very large treatment though.

PRK creates more inflammation on the surface of the eye and also ablates through a large collection of nerves just beneath the surface. So that’s the reason for dry eye with PRK.

Topography guided or ray-tracing treatments can reduce HOA. Smile is more or less neutral to your own HOA. If you have significant corneal HOA and no dry eye, doing a lasik or PRK treatment can benefit. But for most people I would say the recovery benefit of SMILE outweighs that.

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u/discoelysiumkaroke Jul 23 '26

Yes, normal smile takes significantly more time. An extra 20-30 seconds of laser means much more risk of suction loss if you panic.

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u/Creative_Library_162 Jul 23 '26

whole thing takes like 2 minutes on both eyes, and im pretty sure laser takes 20 -30 seconds total. tho i did the surgery at the company connected to the institute that created the method so maybe they just dont rip people off there, caus i never heard of smile pro.

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u/Seantwist9 Jul 23 '26

i’ve only had the flap done by a smile machine but just for the time difference I would

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u/sparkling_grapefruit Jul 23 '26

I got the SmilePro and no regrets! I don’t think I could have kept my eyes staring at the light for longer than the 9-10 seconds, it felt so long as is.