SMILE Eye Surgery | Los Angeles
SMILE VS. LASIK
Distinguishing SMILE from LASIK, these two procedures may share certain characteristics, yet they fundamentally differ in their surgical methodologies. The LASIK approach incorporates the utilization of dual lasers. Dr. Hamilton employs the VisuMax femtosecond laser to craft the LASIK flap, accompanied by an excimer laser to modify the corneal shape.
In the context of SMILE eye surgery, Dr. Hamilton harnesses the potential of the VisuMax femtosecond laser to shape a distinct piece of corneal material akin to a contact lens, known as a “lenticule.” Operating at an astonishing rate of 500,000 pulses per second, the laser meticulously defines this lens-shaped entity within the central area of the cornea, marked as the transparent cover at the eye’s forefront. The laser’s precision generates minuscule bubbles, scarcely wider than 1/100th of a human hair’s diameter. The specific configuration of the lenticule is tailored precisely to address the patient’s nearsightedness. Subsequently, the laser constructs a diminutive tunnel, allowing the surgeon to extract the lenticule from the cornea. This extraction instigates a transformation in the cornea’s shape, effectively rectifying the nearsightedness.
Noteworthy is the absence of the need for a flap in the SMILE procedure, which is carried out exclusively using the VisuMax laser. Consequently, the intervention poses minimal disturbance to the eye’s surface, translating into swift recovery times. Moreover, owing to the reduced dimensions of the incision, patients undergoing SMILE tend to experience lesser instances of ocular dryness. Notably, the size of the incision is notably smaller than the flap generated during a typical LASIK procedure.
The relatively minor incision also opens the door for individuals with severe nearsightedness to be considered candidates for SMILE. In contrast to prior LASIK assessments, these individuals might not have met the eligibility criteria due to the intensity of their nearsightedness.
Book Your Free SMILE Consultation Today!
The Benefits of SMILE Eye Surgery
- SMILE eye surgery uses a smaller incision than traditional laser vision correction, resulting in minimal disruption to the surface of the eye.
- Patients may experience less dry eye as compared to LASIK eye surgery.
- The SMILE procedure takes ten minutes or less.
- In some cases, SMILE can be used to correct higher levels of nearsightedness as compared to LASIK Eye surgery.
- Quick recovery: patients are allowed to wear makeup, exercise, and drive the day following the SMILE procedure.
SMILE Eye Surgery
The Benefits of SMILE Eye Surgery
- SMILE eye surgery uses a smaller incision than traditional laser vision correction, resulting in minimal disruption to the surface of the eye.
- Patients may experience less dry eye as compared to LASIK eye surgery.
- The SMILE procedure takes ten minutes or less.
- In some cases, SMILE can be used to correct higher levels of nearsightedness as compared to LASIK Eye surgery.
- Quick recovery: patients are allowed to wear makeup, exercise, and drive the day following the SMILE procedure.
SMILE VS. LASIK
Distinguishing SMILE from LASIK, these two procedures may share certain characteristics, yet they fundamentally differ in their surgical methodologies. The LASIK approach incorporates the utilization of dual lasers. Dr. Hamilton employs the VisuMax femtosecond laser to craft the LASIK flap, accompanied by an excimer laser to modify the corneal shape.
In the context of SMILE eye surgery, Dr. Hamilton harnesses the potential of the VisuMax femtosecond laser to shape a distinct piece of corneal material akin to a contact lens, known as a “lenticule.” Operating at an astonishing rate of 500,000 pulses per second, the laser meticulously defines this lens-shaped entity within the central area of the cornea, marked as the transparent cover at the eye’s forefront. The laser’s precision generates minuscule bubbles, scarcely wider than 1/100th of a human hair’s diameter. The specific configuration of the lenticule is tailored precisely to address the patient’s nearsightedness. Subsequently, the laser constructs a diminutive tunnel, allowing the surgeon to extract the lenticule from the cornea. This extraction instigates a transformation in the cornea’s shape, effectively rectifying the nearsightedness.
Noteworthy is the absence of the need for a flap in the SMILE procedure, which is carried out exclusively using the VisuMax laser. Consequently, the intervention poses minimal disturbance to the eye’s surface, translating into swift recovery times. Moreover, owing to the reduced dimensions of the incision, patients undergoing SMILE tend to experience lesser instances of ocular dryness. Notably, the size of the incision is notably smaller than the flap generated during a typical LASIK procedure.
The relatively minor incision also opens the door for individuals with severe nearsightedness to be considered candidates for SMILE. In contrast to prior LASIK assessments, these individuals might not have met the eligibility criteria due to the intensity of their nearsightedness.
Book Your Free SMILE Consultation Today!
Understanding Recovery Following SMILE Procedure
In the aftermath of SMILE surgery, given the absence of a flap, patients often find themselves able to swiftly reengage in activities such as swimming, contact sports, and even applying makeup as soon as the day following the procedure. Remarkably, a significant portion of SMILE patients note a remarkable 80% enhancement in their vision within mere hours of the surgery. A majority of patients typically achieve full visual restoration within one to two weeks post-surgery, attesting to the expeditious recovery associated with SMILE.
During the recuperation phase after undergoing a procedure like SMILE, prioritizing rest for your eyes while avoiding unnecessary strain is pivotal. This entails taking a hiatus from screen exposure, be it television or tablet screens, for a span of several days at the very least. Dr. Rex Hamilton will provide a regimen of prescribed medications and eye drops that facilitate the recovery process. Following the post-operative instructions diligently is of utmost importance for optimal outcomes with SMILE or any other procedures available at the Hamilton Eye Institute.
Immediate Post-Procedure: Allow for Substantial Rest
Preceding the SMILE surgery, Dr. Hamilton will administer a calming medication to ensure patient comfort. Post-procedure, which typically takes around 8 minutes for both eyes, Dr. Hamilton will prescribe Tylenol PM to facilitate several hours of restful sleep. Although the incision made in SMILE is notably smaller than that of LASIK, it necessitates a period of several hours for proper healing. During this interval, patients may encounter sensitivity to light and a sensation akin to sand or grit within the eye. Utilizing this time for restful sleep is advised. A unique aspect of SMILE, as opposed to LASIK, is that patients do not require protective eyewear while sleeping after the procedure. By the subsequent morning, the eyes usually regain a sense of normalcy.
Day After the Procedure: Embrace Freedom!
Thanks to the absence of a flap, SMILE recipients can confidently embrace activities such as swimming, contact sports, and makeup application as soon as the day following the procedure. It’s noteworthy that many individuals experience a noteworthy 80% amelioration in their vision within mere hours of the procedure. Although vision may exhibit a slight haziness on the first post-operative day, this seldom poses any restrictions. Typically, this haziness gradually dissipates over the ensuing 7-10 days, with visual clarity improving each passing day. Aligning with the directives provided post-surgery, particularly regarding the use of prescribed eye drops, is crucial for expediting visual recovery. This dedicated approach will significantly contribute to the rapid restoration of optimal vision.
Tired of glasses and contacts and ready to see a whole new world?
Schedule your SMILE consultation today!
Dr. Rex Hamilton M.D.


ZEISS VisuMax
World Class Cutting Edge Technology
With the VisuMax® femtosecond laser, ZEISS is shaping the world of refractive surgery. This ground-breaking laser system employs high-performance femtosecond laser technology and is characterized by its cutting precision, speed and gentle treatment technique. The ZEISS VisuMax is thus the ideal platform for therapeutic and refractive laser applications such as Lenticule Extraction with SMILE® from ZEISS and Femto-LASIK flap cuts.


1st surgeon to perform SMILE on the West Coast
When it comes to vision correction, it’s likely that you’ve heard of LASIK. Vision correction procedures have improved and changed immensely over the years, and new options for vision correction are regularly being developed and tested around the world. Now, almost anyone can find a procedure that will allow them to reduce their dependence on glasses or contacts, even if they are not a candidate for LASIK eye surgery.
The acronym “SMILE” stands for Small Incision Lenticule Extraction. SMILE was first developed in Germany over 10 years ago and FDA approved in the United States in 2016. In March 2017, Dr. Hamilton was the first surgeon to perform SMILE on the West Coast, bringing the ground breaking procedure to the greater Los Angeles area. To date, SMILE has been performed over 5 million times all over the world.
SMILE was approved in the United States in October of 2018 for treating myopia (nearsightedness) with astigmatism. Astigmatism is a common eye condition that can both cause near and distant objects to appear blurred, occurring as a result of a misshapen cornea. While a ‘normal’ cornea is spherical (has the same curvature all over), a cornea with astigmatism is steeper in some areas and flatter in other areas, resembling a football in shape rather than a basketball (spherical). This football shape distorts vision and creates refractive errors. People with astigmatism have blurred vision if it is left uncorrected. This is due to light refracting at many points, instead of one. The SMILE procedure has been used around the world for many years to treat myopic (nearsighted) patients with astigmatism. Fortunately, the FDA has recently reviewed an extensive study conducted in the United States and approved the SMILE procedure for use in nearsighted patients with astigmatism! The safety, efficacy, and excellent visual outcomes proven in the trials made FDA approval a clear decision for the FDA when evaluating the research. In addition to the ability to treat astigmatism with SMILE, the new approval also makes parameters within the femtosecond laser available that allow for a smaller incision and faster visual recovery than was attainable with the initial version of SMILE laser surgery!
LASIK is well-known in the vision correction community, and it’s an amazing procedure for many patients. A common side effect of LASIK, however, is the post-operative dry eye that can occur. In general, this lasts for about 6 to 12 months. Symptoms of dryness can be quite bothersome, particularly in patients who spend lots of time looking at screens for a profession or during their leisure time. Because of the larger incision required for LASIK, many of the nerves that sense dryness are affected by the procedure and need to regenerate. During SMILE, a significantly smaller incision is used and only a small fraction of the nerves are affected. The result: patients who get SMILE experience fewer dry eye symptoms for a shorter time as compared to LASIK. Los Angeles SMILE patients can expect a shorter recovery time from the procedure, and are less likely to develop dry eye symptoms. What does this mean for SMILE patients in Los Angeles where the environment is so dry? Los Angeles SMILE patients can expect a shorter recovery time from the procedure, and less chances of developing dry eye symptoms.
Corneal thickness is one of the most important factors considered for LASIK candidacy. Patients with corneas that are thin may not be candidates for LASIK eye surgery. Before SMILE Eye Surgery, these patients would have to resort to PRK. PRK is another successful vision correction procedure requiring removal of the epithelium (“skin cells”) of the cornea. The cornea is then reshaped using an excimer laser.During PRK, a contact lens is placed inside of the eye and acts as a bandage while the surface of the cornea heals. As the cornea is recovering, eyes are more sensitive to light, vision tends to fluctuate, and sometimes experience temporary eye irritation. These side effects are temporary and stabilize after a month of recovery. SMILE is less invasive than LASIK, making it better for treating patients who are severely nearsighted. The SMILE procedure allows our Los Angeles patients to have another alternative to LASIK, in addition to PRK, for patients with thin corneas.
While SMILE is able to provide safe, gentle vision correction for many, not everyone is going to be a good candidate for SMILE. Like LASIK, you must qualify as a candidate for the procedure. Currently, SMILE has been FDA approved for myopia with astigmatism. SMILE is capable of correcting nearsightedness up to -10.00 diopters, and -3.00 diopters of astigmatism. If your nearsightedness and/or astigmatism is outside these ranges, or if you are farsighted, Dr. Hamilton may recommend an alternative procedure for you. Following a comprehensive diagnostic examination, Dr. Hamilton will determine which of the amazing refractive surgery procedures at the Hamilton Eye Institute is best for your particular situation, lifestyle, and visual needs.
SMILE Eye Surgery | Los Angeles, CA