Refractive surgery
SMILE in Paris and Cachan: Minimally Invasive Refractive Surgery | Dr Tourabaly
Correction of myopia and astigmatism with the Zeiss VisuMax 800 femtosecond laser. 2 mm micro-incision, no corneal flap. Recovery within 24-48 h. Personalised assessment at the Cachan practice.
Comparing SMILE with LASIK? LASIK vs SMILE comparison — differences in surgical technique, recovery, dry eye, sport and pricing.
Refractive surgery
SMILE (Small Incision Lenticule Extraction) is a third-generation refractive surgery technique. Instead of lifting a corneal flap as in LASIK, SMILE involves cutting a thin disc of corneal tissue (the lenticule) with a femtosecond laser, then removing it through a 2 to 3 mm micro-incision. This all-in-one, flapless approach preserves more of the cornea’s nerve supply and offers an option particularly well suited to patients with a dry eye profile or those involved in activities carrying a risk of ocular trauma.
Dr Tourabaly performs SMILE at the Clinique Laser Victor Hugo (Paris 16th arrondissement) using the Zeiss VisuMax 800 platform, the latest generation of femtosecond laser dedicated to precision refractive surgery.
UNDERSTANDING SMILE
What is SMILE? Principle and technology
SMILE is a corneal surgery carried out in a single step with the Zeiss VisuMax 800 femtosecond laser. Unlike LASIK, which requires two lasers (a femtosecond laser for the flap plus an excimer laser for the reshaping), SMILE uses a single laser for the entire procedure.
The principle in three stages
1. Creating the lenticule: The femtosecond laser draws, within the thickness of the cornea, a small disc of tissue (the lenticule) whose shape corresponds exactly to the visual correction required. On the VisuMax 800, this step takes less than 10 seconds (compared with about 25 seconds on the previous VisuMax 500 generation).
2. Creating the micro-incision: The laser then makes a small opening of 2 to 3 mm at the surface of the cornea, which serves as the access point to the lenticule.
3. Extracting the lenticule: The surgeon gently removes the lenticule through this micro-incision. The cornea then reshapes, altering its curvature and correcting the visual defect.
The whole procedure takes around 5 minutes per eye, including less than 10 seconds of active laser time (Yoo 2024: Sci Rep, comparative study VisuMax 800/500).
VisuMax 800: the second generation, faster and more precise. The laser used by Dr Tourabaly is the 2024 version of the Zeiss platform. Compared with the VisuMax 500 (1st generation), it creates the lenticule in ~10 seconds (vs ~25-28 sec) thanks to a pulse frequency raised to 2 MHz, and delivers better refractive precision: 95.1% of eyes within ±0.50 D versus 88.1% in the largest series worldwide (Reinstein 2022, 4,138 eyes at the London Vision Clinic).
Why “minimally invasive”?
What sets SMILE apart is the absence of a corneal flap. Whereas LASIK opens a lamella of roughly 20 mm in circumference to reach the stroma, SMILE creates only a 2 to 3 mm micro-incision, affecting less than 15% of the corneal perimeter. This tissue preservation translates into:
- Better preservation of the corneal nerve fibres (responsible for sensitivity and tear regulation)
- Long-term biomechanical stability of the cornea is preserved
- The absence of any flap-displacement risk in the event of post-operative ocular trauma (contact sport, accident)
Written and medically reviewed by Dr Moïse Tourabaly, ophthalmologist — former chief resident (Quinze-Vingts National Eye Hospital). Last updated: July 6, 2026