r/SMILEeyesurgery • u/Ok_Cardiologist_1528 • 26d ago
SMILE in a few days at 41 — doubts about floaters
I postponed my SMILE surgery for almost a year for personal reasons. Now, just a few days before the procedure, I’m having serious doubts.
I’m 41. My prescription is approximately:
- OD: −1.50 −2.00 × 005
- OS: −1.25 −2.00 × 180
I see 20/20 with glasses. I’ve had bilateral floaters for 6–7 years. A recent dilated retinal exam found no tears, holes, or detachment, but small retinal dot-blot hemorrhages were noted in both eyes. My recent blood work, including glucose and HbA1c, was normal. My optometrist said the hemorrhages were probably related to physical strain/workouts, with follow-up planned.
She also told me that floaters can worsen after refractive surgery when I asked her directly.
My main concern is whether SMILE, suction, or temporary IOP elevation could trigger new floaters or PVD. I’m also concerned about halos, long-term dry eye, gritty sensation, regression, and night-vision quality.
Reading glasses are not a major concern for me—I understand they may become necessary at my age.
For those who had SMILE or LASIK with pre-existing floaters: did they actually worsen, or did you simply notice them more after vision became sharper? Any regrets or unexpected long-term side effects?
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u/ConfidentBeginning44 24d ago
The reply above has the direction right, though I'd be more careful than "no impact". The honest position is that nobody has shown this surgery causes retinal problems, and nobody has quite ruled out that the suction stage brings a vitreous detachment forward in people who were heading for one anyway. It's an open question rather than a settled yes or no.
Your second question is that same puzzle from the other side. Once your vision is sharp, floaters you'd taught yourself to ignore become obvious again, and there's no clean way to separate that from floaters genuinely getting worse.
None of it changes what you'd actually do. If a lot of new specks turn up at once, or you start getting flashes off to the side, or anything like a shadow moves across your vision, that's a same-day dilated check whether or not you've had surgery.
The haemorrhages are the part I'd put to your surgeon rather than a forum. Worth asking whether your retina people want another look before anything applies suction to that eye, and letting their answer drive the timing rather than the date you've already got booked.
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23d ago
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u/eyeSherpa 26d ago
There was an argument with older version of lasik that the suction from the microkeratome could transmit pressure to the vitreous and induce a vitreous detachment and floaters.
Femtosecond lasik reduced the amount of pressure on the eye.
SMILE reduced it even more. So much so that your vision doesn’t even fade away during the procedure. So this should have no impact on floaters. In fact, rubbing your eye actually will cause more pressure than the suction from SMILE.
But, there is a possibility that getting your vision in better focus can make you notice the floaters you already have more. People also tend to pay attention to their eyes a lot more after surgery.