SMILE Pro Laser

 

One of the key advantages of femtosecond laser technology is its ability to deliver high-energy laser pulses in extremely short bursts. This allows surgeons to make precise incisions in the targeted area while minimizing impact on the surrounding tissues. As a result, there is less collateral tissue damage, and the accuracy of the surgical procedure is significantly improved.

Building on this advanced technology, ZEISS developed the VisuMax system, which enables the creation and removal of a lenticule inside the cornea without cutting the corneal surface. This innovation marked the beginning of a new era in vision correction surgery with SMILE.

In this article, we will take a closer look at the concept of “gentle surgery,” a term often used to describe SMILE and SMILE Pro procedures, and explore how this approach is made possible from a technological standpoint.

▲ (Top) Laser spots delivered at uniform intervals
(Bottom) Overlapped, elliptical-shaped laser spots

1. A gentle correction technique enabled by lenticule extraction

Unlike traditional LASIK or LASEK procedures, SMILE vision correction does not require creating a corneal flap. Instead, it involves forming a precise, microscopic lenticule inside the cornea, which is then removed through a small incision. The term “gentle surgery” refers to how precisely and uniformly this lenticule is created and extracted.

ZEISS’s femtosecond laser system is built on more than 175 years of optical expertise. This advanced precision optics technology is the core driving force that makes SMILE possible.

While the laser used in vision correction surgery is often imagined as being delivered directly in a straight line to the cornea, in reality, it is reflected at multiple angles through a highly sophisticated mirror system to accurately deliver energy to the precise target area inside the cornea. The remarkable precision of this mirror system is a testament to ZEISS’s accumulated optical engineering excellence.

▲ Nomogram for surgical planning and simulation based on extensive surgical data

2. Uniform incisions enabled by the high-precision scanning of VisuMax

The ZEISS VisuMax system delivers consistent and uniform laser energy into the cornea using its high-precision scanning technology. During this process, the spacing and intensity of the laser pulses are meticulously controlled to minimize damage to surrounding tissue and enable smooth separation of the lenticule.

If the scanning were not highly precise, the laser pulses could overlap, leading to an energy accumulation effect. This may cause abnormal bubble formation in the treated area, resulting in an uneven lenticule surface that is difficult to separate cleanly. Such irregularities can negatively affect the accuracy of the correction and the overall quality of vision.

The VisuMax system continuously detects and compensates for micro-movements along the X, Y, and Z axes in real time, ensuring that laser energy is delivered precisely to the intended target within the cornea.

To illustrate the system’s extraordinary accuracy: it is said to be precise enough to hit a coin from a distance of 380,000 kilometers — the approximate distance from the Earth to the Moon.

▲ Laser mirror embodying ZEISS’s advanced optical technology

3. The relationship between gentle surgery and low energy

In explanations of SMILE surgery, the term “low energy” is often mentioned in connection with the concept of a gentle surgical approach. In general, using lower laser energy on the cornea helps reduce damage to surrounding tissues. However, simply reducing energy indiscriminately does not necessarily lead to better outcomes.

This is because each patient has a unique corneal structure — including differences in thickness, curvature, refractive power, and tissue density — meaning that the same energy setting cannot be universally applied. In other words, the optimal amount of laser energy must be carefully customized to each patient’s eye anatomy to achieve the best possible results.

If the laser energy is too low, the lenticule may not form properly, or the incisions may be incomplete and inaccurate. Conversely, if the energy is too high, there is a risk of unnecessary tissue damage.

Therefore, it is crucial to apply surgical settings based on extensive clinical data. To this end, the ZEISS VisuMax system utilizes a vast database of clinical cases and nomogram data to determine the most suitable laser intensity and energy levels for each individual patient. This ensures safe, stable, and effective vision correction outcomes.

4. Conclusion

Expressions such as “gentle surgery” and “low energy” are often used to describe the technological sophistication of SMILE vision correction. These terms are not just marketing phrases; they reflect the real surgical advantages made possible by the advanced technology of the ZEISS VisuMax system.

To date, SMILE has accumulated clinical data from over 10 million procedures worldwide, demonstrating its safety and effectiveness. This extensive clinical foundation allows for highly personalized treatment for each patient, and the procedure’s precision and safety are regarded as among the highest in modern vision correction surgery.

SMILE surgery can only be performed using the ZEISS VisuMax system. Its precise optical technology and highly controlled energy delivery form the core of what makes the surgery so gentle and effective.

If you are considering SMILE surgery, it is important to ensure that the clinic uses ZEISS equipment and has sufficient clinical experience. By choosing a clinic that meets these standards, you can expect precise, stable vision correction and highly satisfying results.