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Small Incision Lenticule Extraction

Small Incision Lenticule Extraction (SMILE)

The Revolutionary Laser Vision Correction Surgery

Small Incision Lenticule Extraction (SMILE) is a laser vision correction surgery that became popularized for the treatment of myopia and astigmatism since 2016. It is the most recently developed refractive laser eye surgery. It is performed on the cornea (the front surface of the eye), similar to LASIK and PRK, but it has some unique features that might be more suitable for some patients.

Of course, there are many unique features to each type of vision correction surgery and no one solution is best for everyone, or even for the majority of people. For example, neither LASIK nor SMILE are the best option for reading vision if you are over 45. For the best correction of both near and distance vision, the preferred option is Clear (Refractive) Lens Exchange. Here, we compare the advantages and disadvantages of SMILE vs LASIK and PRK.

How SMILE Surgery Works

Dr. Cohen and Dr. Morar

Using a laser, the SMILE procedure cuts a tiny, disc-shaped piece of tissue called a lenticule from within your cornea. This lenticule is then removed from the cornea via a small incision. This process reshapes the cornea, and in turn, corrects and improves the patient’s eyesight. The whole treatment takes less than 15 minutes for each eye.


SMILE has become a popular alternative to LASIK as it is generally considered a less invasive procedure. During LASIK, a circular corneal flap is created, then lifted. A laser is then used to reshape the inner cornea for vision correction. The incision made during SMILE is smaller than the one made during LASIK, and some would even go as far as calling this a flap-less LASIK procedure. This description is not accurate. A flap is created, but not lifted as it is in LASIK surgery. This is the reason that some patients that already suffer from dry eyes may benefit more from SMILE. The risk of dry eyes is low with LASIK, and even lower with SMILE, but still not zero.

SMILE is also less likely to cause complications such as flap-related problems and corneal thinning, as there is minimal disruption of the eye’s structure.

The complete treatment takes less than 15 minutes per eye, and patients usually report little pain, and quick recovery periods.

Lasik Smile



A large flap is made to reshape your cornea

A small incision is made to reshape your cornea

Time it takes to see 20/20

About 1 day

About 1 week

Risk of dry eyes

Very low

Even lower but not zero

Astigmatism treatment



Irregular Astigmatism treatment

Very low

Even lower but not zero

Sharpness of vision

Best (with Contoura)


Use of blade



Long term track record

25 years

7 years

Who is a Good Candidate for SMILE?

SMILE is a safe and effective option for patients who are looking to correct their vision. However, not everyone is a good candidate for SMILE. The ideal candidate for SMILE has the following attributes:

It is important to note that SMILE is not suitable for patients with severe nearsightedness or those with thin corneas. It is also not available for patients who are farsighted or who have high levels of astigmatism or irregular astigmatism. LASIK or PRK surgery may be a better option for these patients.

Am I a Candidate?

Dr. Cohen in the News & Media

Fox News

Dr. Sapna Parikh reports on the very first case of an ICL in New York performed by Dr. Ilan Cohen.

ABC 7 News

The surgeon, Dr. Ilan Cohen talks about “the unique” features of Implantable Collamer® Lens surgery as compared with LASIK.

CBS 2 News
An artificial corneal transplant is a complex surgery that is reserved for patients that have corneal blindness and are not otherwise candidates for a traditional corneal transplant.

What to Expect During and After SMILE Surgery

The SMILE surgery is done as an outpatient operation. To decrease pain during the surgery, the surgeon will apply numbing drops to the patient’s eyes prior to the treatment.

Often, patients will feel pressure on their eyes when the surgeon makes the incision and removes the lenticule. They should not, however, feel any discomfort.

Patients may suffer some pain after the surgery, such as dryness, itching, and sensitivity. They must use eye drops for many weeks and refrain from scratching their eyes or engaging in intense activities. The majority of patients may return to work and regular activities within a few days following the treatment.

What to Expect During and After SMILE Surgery


SMILE is a safe, effective, and minimally invasive laser vision correction surgery. It has some benefits and some drawbacks when compared with LASIK (please see the comparison chart). It is a fast and comfortable procedure that can help patients achieve clearer vision without the need for glasses or contact lenses. If you are interested in SMILE surgery, book an appointment with us today to see if SMILE is a good option for you.

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What other Doctors say about Dr. Cohen

Doctor Testimonial

When looking for a doctor to do my LASIK surgery, I was searching for someone with deep subject matter expertise, who is precise with a high degree of attention to detail, and who enjoyed and was enthusiastic about what they did.

Doctor Testimonial

I met Dr. Cohen through the recommendation of one of my ophthalmology friends when I was looking to get LASIK surgery. I am 20/15 in both eyes and have never had a problem. Thank you Dr. Cohen!

Doctor Testimonial

I chose Dr. Cohen for my cataract surgery with a multifocal lens implant because over the last 20 years of knowing him and referring many of my patients to him, he never made a mistake. I couldn’t be happier with my vision.

Doctor Testimonial

Dr. Ilan Cohen is one of the finest surgeons I could possibly imagine. He has done multiple surgeries, he’s handled incredibly complicated cases. He is one of the finest doctors and I am more than happy to recommend him.

Doctor Testimonial

When it comes to mine or my family’s eyes, Dr. Cohen is my number one choice. Why? Because I have seen his results, and they are far superior than most surgeons in the area. If you want the best results, it’s Dr. Cohen that you have to go to.

Doctor Testimonial

Dr. Cohen is one of the finest surgeons I know. I have seen plenty of his LASIK post op results which have been excellent. I would not hesitate to send any of my family members to him. 

Doctor Testimonial

I have known Dr. Cohen for over 10 years through his reputation and personal interaction. He is one of the best surgeons that I know. When working on a complicated case, I will call Dr. Cohen because his opinion is very important to me.

Doctor Testimonial

I have co-managed hundreds of patients with Dr. Cohen who have had all kinds of refractive surgery. Each procedure is tailored to the patient's particular eye. 

Doctor Testimonial

I have been the director of an ophthalmology surgical center for the last 30 years. I personally know over 100 eye surgeons. If a member of my family needed eye surgery, Dr. Cohen would be the one to perform it.

Doctor Testimonial

I've been an optometrist for 19 years, and I've worked with a number of different surgeons. I think Dr. Ilan Cohen has some of the best hands that I've ever seen.

Doctor Testimonial

When I think of doctor Ilan Cohen, I think of the best. Dr. Cohen and I have been involved in some of the most exciting research projects. Dr. Cohen, in my opinion is one of the best surgeons on this plant.

Patients Testimonials

Refractive Surgery Quiz

At Cohen eye Institute we offer a wide menu of Refractive Surgery. From Lasik to EVO- ICL. This quiz will help us help you tailor your vision to your lifestyle needs.