How Is SMILE Different From LASIK? A Kugler Vision Surgeon Explains on KETV
Published by on May 11, 2026
SMILE and LASIK correct the same problem — nearsightedness — by reshaping the same structure, the cornea. However, more people have heard of the household name LASIK. Drew Dickson, MD, refractive surgeon at Kugler Vision in Omaha, Nebraska, visited with KETV Very Local Business Spotlight to explain the similarities and the differences between LASIK and SMILE, as well as the patient profiles SMILE best serves.
“[SMILE] is similar to LASIK in that it’s reshaping the cornea to fix people’s vision — but it just does it a little bit differently,” Dr. Dickson explains.
How Is SMILE Different From LASIK?
The mechanical distinction comes down to two things: the number of lasers used and whether a flap is created. LASIK requires both. Dr. Dickson notes:
“With LASIK, we have to use two different lasers. The first laser will create a little flap, and then we are able to input someone’s prescription. With SMILE, we are able to do this all just with one laser. And rather than make a flap, we can just make a tiny slit in the cornea that we can remove the prescription from.”
That tiny slit — roughly four millimeters wide — is the only opening made in the cornea. A small disc of tissue called a lenticule is created inside the cornea by the femtosecond laser, then removed through that incision. The outer surface of the cornea is never lifted. For a full clinical breakdown of how the procedure works step by step, visit our SMILE procedure page.
Does SMILE cause less dry eye than LASIK?
The flap LASIK creates disrupts more of the corneal surface nerves than SMILE’s small incision. Those nerves are involved in regulating tear production, which is the mechanism behind temporary post-LASIK dryness. Dr. Dickson explains that making the smaller incision rather than a flap “tends to cause less dryness temporarily,” though both procedures show similar dryness results in the long term.
For patients who already have borderline dry eye, or who spend significant time in front of screens or in air-conditioned environments, those lifestyle characteristics are factored in to the EyeAnalysis evaluation. It doesn’t make SMILE the automatic choice, but it makes it the more relevant conversation for that patient profile.
What are the post-operative restrictions after SMILE?
The absence of a flap changes what patients need to protect during recovery. LASIK patients follow specific precautions to keep the flap stable while it heals — restrictions around water exposure, eye rubbing, and contact sports. SMILE patients face fewer of those limitations. In Dr. Dickson’s words, the flapless approach “tends to have less restrictions post-op.”
How quickly does vision recover after SMILE?
Recovery after SMILE moves fast.
“Most patients are noticing their vision improving even later that day,” Dr. Dickson says. “Typically by the next day, people are seeing at a very functional level where they can resume work and normal activities. And within a few days, most people are seeing right around the 20/20 mark.”
That timeline is consistent with what Kugler Vision patients in Omaha report across the board.
Who is a good candidate for SMILE?
Dr. Dickson keeps the candidacy answer simple:
“SMILE in the United States is indicated for people typically in their 20s, 30s, 40s, and for people who are nearsighted. If you have trouble seeing far away without contacts or glasses, you’re could be a good candidate for SMILE.”
That’s the starting point, not the full picture. Corneal thickness, prescription range, and dry eye history all factor into whether SMILE is the better fit over LASIK or another procedure for a specific patient. Kugler Vision offers all seven modern vision correction procedures, which means the recommendation at consultation reflects the patient’s diagnostic data rather than a default preference for any single option. More than seven million SMILE procedures have been performed worldwide [source: ZEISS VisuMax clinical data], and Dr. Lance Kugler was the first surgeon in Nebraska or Iowa to perform the procedure — meaning Omaha patients have access to over a decade of institutional experience with SMILE before they walk in the door.
The difference between SMILE and LASIK isn’t about which procedure is superior. It’s about which one fits a specific set of eyes and a specific life.
To find out which procedure fits your eyes, schedule an EyeAnalysis at lasikomaha.com or call Kugler Vision in Omaha at 402-558-2211.
Full KETV Video Interview Transcript on SMILE with Drew Dickson, MD at Kugler Vision
The following is a transcript from a Very Local Business Spotlight interview filmed at Kugler Vision in Omaha, Nebraska.
Host: Get ready for another Very Local Business Spotlight. Today, we’re at Kugler Vision talking to Dr. Dickson about the SMILE procedure.
Dr. Dickson, what is the smile procedure and what does it have to do with the eyes?
Drew Dickson, MD: SMILE sounds like it should be a dental procedure or something but it’s actually one of the seven forms of vision correction we use here at Kugler Vision to fix people’s vision. It’s basically a newer form of LASIK. So it it’s similar to LASIK in that it’s reshaping the cornea to fix people’s vision but it just does it a little bit differently
Host: Well, how does it do it differently?
Dickson: With LASIK, we have to use two different lasers. And so the first laser will create a little flap, and then we are able to input someone’s prescription for LASIK. With SMILE, we are able to do this all just with one laser. And rather than make a flap, we can just make a tiny slit in the cornea that we can remove the prescription from, which tends to cause less dryness temporarily. It tends to have less restrictions post-op. So it’s a really great option for patients.
Host: And what’s the recovery time like?
Dickson: Typically pretty quick. So most patients are noticing their vision improving even later that day. Typically by the next day, people are seeing at a very functional level where they can resume work and normal activities. And within a few days, most people are seeing right around the 20/20 mark.
Host: And who’s a good candidate for this kind of procedure?
Dickson: SMILE in the United States is indicated for people typically in their 20s, 30s, 40s, and for people who are nearsighted. And so if you have trouble seeing far away without contacts or glasses, you’re probably a good candidate for smile.
Host: All right, Dr. Dickson, thank you so much.
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