As a brief holiday break in early October approaches, more office workers and students are preparing for vision-correction surgery. What those preparing for surgery are most curious about is the outcome.
Concerns about whether the procedure is safe and whether it might actually cause discomfort afterward are just as significant as concerns about whether vision will recover.
The leading vision-correction methods are SMILE and SMILE Pro, which use lasers to correct the cornea's refractive power, and lens implantation surgery using an Implantable Collamer Lens (ICL), a specialized lens matched to the patient's prescription. Both procedures have become widely used worldwide and offer excellent safety and vision-correction outcomes.
At my ophthalmology clinic, we directly surveyed patients one year after each procedure to assess their actual satisfaction. The findings were presented at the 2025 American Society of Cataract and Refractive Surgery (ASCRS).
SMILE and SMILE Pro use a femtosecond laser to correct refractive power while preserving the corneal surface, without creating a corneal flap. They cause little corneal damage, are painless, and allow rapid visual recovery, making them the most popular options. ICL involves inserting a specialized lens between the crystalline lens and the iris. It produces excellent results for patients with thin corneas or severe myopia and astigmatism.
The study included 324 patients: 227 who underwent SMILE and 97 who received ICL. Their myopia ranged from -0.5 to -18.0 diopters. All met the surgical criteria for corneal thickness, ocular depth, and refractive status, and their average age was 27. One year after surgery, a questionnaire assessed the severity and duration of five major discomfort symptoms: hazy vision, spread-out vision, glare, light halos, and dry eye.
Overall satisfaction was very high in both groups. While 97.4% of SMILE patients, 99% of ICL patients said they were satisfied with the surgery. However, the patterns of discomfort differed. Glare and light halos were more common among ICL patients and lasted longer than they did after SMILE. Conversely, dry-eye symptoms occurred more frequently and lasted longer among SMILE patients. There was no significant difference between the two procedures in hazy vision or spread-out vision. In both groups, most discomfort symptoms naturally improved over time, and any remaining symptoms were not severe.
For patients with myopia and astigmatism who want relief from the inconvenience of glasses and contact lenses, choosing the right vision-correction method requires more than considering corneal thickness and vision measurements. They should also receive a thorough explanation of the discomfort they may experience after surgery before making a decision. Astigmatism is another important variable. When astigmatism is present, the amount of corneal tissue removed may increase by 20% to 30%, so it must be checked before surgery. Moderate astigmatism can be corrected along with myopia through SMILE, but severe astigmatism may be treated more safely by combining astigmatism-correction surgery with lens implantation or by reducing the astigmatism first and correcting the myopia through a staged procedure.
If you are considering vision-correction surgery, it is advisable to look beyond numerical eligibility, consider the expected discomfort as well, and make a decision after a thorough consultation with a specialist.
Expert advice: Kim Bu-gi, director of Onnuri Smile Eye Clinic
This article has been translated by GripLabs Mingo AI.
