Laser vision correction – CLEAR/SMILE method

Laser vision correction procedures are highly popular as they allow patients to become independent of glasses and contact lenses. They provide an effective and long-lasting way of correcting refractive errors.

In order to tailor the procedure to each patient’s individual needs, a range of different methods has been developed. These techniques differ in how the cornea is prepared for the action of the laser. Each method has its own indications and limitations, which is why there is no single universal solution suitable for everyone.

What does the CLEAR/SMILE procedure involve and how is it performed?

CLEAR, also known as SMILE, is a technique that involves creating a small lenticule within the cornea and then removing it. In this way, the shape of the cornea is altered. This enables images to be properly focused on the retina, resulting in clear vision without the need for glasses or contact lenses.

The procedure is performed exclusively using a femtosecond laser and serves as an alternative to surface-based methods such as TransPRK. It is characterised by a shorter recovery time and less pronounced post-operative discomfort.

Who is it suitable for?

The CLEAR/SMILE method corrects myopia and/or astigmatism. As no corneal flap is created, it is particularly suitable for individuals with an active lifestyle, those involved in contact sports, or those working in uniformed services. It is also a good option for patients who wish to return quickly to their daily activities.

Possible sensations immediately after the procedure

Immediately after the procedure, the patient may experience discomfort such as a dry eye sensation or watering, as well as slight blurring of vision. These symptoms should subside within 24 hours.

Recovery

Following the CLEAR/SMILE procedure, the recovery period typically lasts 1–3 days. Regardless of the method, it is generally assumed that full corneal healing takes around one month, which is why it is important to avoid dusty and smoky environments during this time.

Physical exertion involving heavy lifting and sudden movements that may increase intraocular pressure should be limited for around one month. Light physical activity can be gradually resumed, usually after about a week, while returning to water sports is possible sooner than with other methods — even after a few days. The appropriate level of activity is best determined individually with your doctor during a follow-up appointment.

Follow-up appointment

After the CLEAR/SMILE procedure, the follow-up visit takes place the next day. Until then, patients should not drive.

Improvement and stabilisation of vision

Vision improves very quickly, with the first effects becoming noticeable within just a few hours after the procedure. Full stabilisation, in line with the outcome predicted during the pre-operative assessment, may take from a few weeks up to six months, depending on the type of refractive error and adherence to post-operative recommendations.

Contraindications

• Excessively thin cornea,
• Excessively severe refractive error,
• Hyperopia (far-sightedness), 
• Eye conditions such as glaucoma, cataract (until surgically treated), and untreated keratoconus,
• Ocular inflammation and generally poor health (e.g. diabetes with retinopathy),
• Advanced Dry Eye Syndrome (DES).

The CLEAR/SMILE method is becoming increasingly popular and is often the subject of online discussions. However, when it comes to laser vision correction, decisions should not be based on trends or made in advance. A detailed pre-operative assessment, including full diagnostics and medical history, is essential. Only on this basis can the surgeon determine whether the procedure is suitable and select the most appropriate method for the individual patient, as each case requires a personalised approach.

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