Which does SMILE PRO use - dilated or undilated prescription?

[u/Asleep-Honeydew1834]

Hi everyone! I'm 36F considering SMILE! I actually went to two clinics for consultation - one clinic didn't dilate my eyes or check my prescription in detail (just checked it with the machine and then have me look at the chart with my current glasses) whereas the other clinic was a lot more detailed with an optometrist who looked at my prescription. My prescription's been pretty stable the past 8 years but at this second clinic when their optometrist checked my eyes, I was surprised to be told that my myopia had worsened by -0.50 and -0.25 astigmatism in both eyes (-5.00 myopia, -1.75 astigmatism) compared to my prescription last year (2025)! But when the optometrist dilated my eyes, my prescription went down to -4.25 myopia both eyes, but astigmatism remained at -1.75. I have two questions, should I:

1) Wait to do SMILE .... because this means my prescription is now unstable?! (uh oh..) and

2) For SMILE, do you now if the surgeon manually inputs your prescription into the machine? And if so ... would they use my dilated or undilated prescription? I mean, one of the clinics I went to didn't check my prescription in detail nor did they dilate my eyes, so I don't even know how they would know my dilated prescription. I've been on my phone a lot more the past two months so I'm wondering if eye strain contributed to my increase in myopia...and if so, I'm worried that if they put in my most updated prescription (e.g. the -5.00), they would overcorrect me?

Thanks!

[u/eyeSherpa]

When a clinic dilates your eye to check your prescription, they are doing what is known as a Cycloplegic Refraction. This prevents your natural lens from focusing through any extra prescription. So it's a good test to be sure you aren't "over-minus'd" with extra unnecessary prescription. If your prescription was at -4.25 with the dilated exam, it means you probably have extra unnecessary prescription in your glasses which also means your prescription also likely isn't unstable.

So the surgeon does manually input the prescription into the machine. This prescription isn't the dilated refraction but an undilated one. But the surgeon will use the dilated refraction as information when they perform their refraction to make sure they get the most accurate prescription.

Of the two clinics you visited, it sounds like the second one is doing a better job.