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As the first surgeon in Orange County and greater Los Angeles to perform WaveLight® Plus LASIK after FDA approval in 2025, Dr. Gregg Feinerman has evaluated thousands of laser vision correction candidates, including many who asked about SMILE Pro. The comparisons in this guide are based on that direct clinical experience.
If you have been researching laser vision correction, you have probably come across more options than you expected. SMILE Pro has received significant attention from laser manufacturers and refractive surgery centers, and patients frequently search for comparisons online.
However, many patients still struggle to find a clear, balanced explanation of how these procedures actually differ. This guide covers what each procedure involves, how they compare on technology, safety, recovery, cost, and visual quality, and how to determine which one is right for your eyes.
Green cells indicate a WaveLight® Plus LASIK advantage. ✓ = advantage noted.
| Feature | SMILE Pro | WaveLight® Plus LASIK |
|---|---|---|
| Technology | Femtosecond laser lenticule removal | Excimer laser with full-eye 3D mapping ✓ |
| Customization | Standardized treatment profile | Fully customized via SightMap™ data ✓ |
| Higher-Order Aberrations | Not treated | Treated ✓ |
| Night Vision Optimization | Limited | Advanced, pupil-independent ✓ |
| Enhancement Flexibility | Four off-label pathways, all with significant risks; CIRCLE software unavailable in USA | Simple excimer refinement; lifetime commitment at Feinerman Vision ✓ |
| Flap Required | No (small incision only) | Yes (blade-free femtosecond laser) |
| Recovery | Functional vision within a few days | Often clear vision within 24 hours ✓ |
| Clinical Outcomes | 82% achieved 20/12.5 in head-to-head study vs. WaveLight® Plus | 100% achieve 20/20; 98% achieved 20/12.5 in head-to-head study ✓ |
Clinical outcomes data: He C, Bala C. J Cataract Refract Surg. 2023;49(11):1140-1146; Kanellopoulos AJ, AAO Annual Meeting, October 18, 2025.
→ Deep Dive
SMILE Pro vs. WaveLight® Plus LASIK: Which Is Right for You?
WaveLight® Plus vs. SMILE Pro: Which is Better For Night Vision?
SMILE Pro stands for Small Incision Lenticule Extraction. It does not use an excimer laser to reshape the cornea. Instead, a femtosecond laser cuts a small disc of tissue (called a lenticule) directly inside the cornea. A surgeon then removes that lenticule through a tiny incision of approximately 2 to 4 millimeters, changing the corneal curvature and correcting the refractive error.
The appeal of SMILE Pro is that there is no corneal flap involved, which theoretically reduces the risk of flap-related complications. Advocates highlight the flapless design as a potential advantage. Our published position differs: for contact sports Dr. Feinerman typically recommends PRK, and for meaningful dry eye risk EVO ICL™, since SMILE still removes corneal tissue and is usually ruled out for the same anatomical reasons as LASIK.
An important distinction: SMILE Pro does not incorporate wavefront-guided or full optical system analysis. The treatment is based on a predefined lenticule shape, meaning the level of customization is significantly more limited than what WaveLight® Plus LASIK provides. |
WaveLight® Plus LASIK received FDA approval in 2025 and represents a genuine step forward from conventional and topography-guided platforms. It does not simply measure your cornea. The INNOVEYES SightMap™ creates a full 3D model of your eye (including corneal curvature, lens position, and internal optical aberrations) then feeds that data into the WaveLight EX500 excimer laser for a correction built around your actual visual system, not just your prescription.
Here is what sets it apart:
A landmark head-to-head study presented at the 129th Annual Meeting of the American Academy of Ophthalmology in October 2025 provided the strongest clinical evidence yet. In a direct comparison of 60 patients who received WaveLight® Plus in one eye and SMILE Pro in the other, the results were striking: • 98% of WaveLight® Plus eyes achieved 20/12.5 or better, compared to 82% with SMILE Pro • 100% of WaveLight® Plus eyes were within a quarter-diopter of the target prescription, compared to approximately three-quarters of SMILE Pro eyes • More than 80% of WaveLight® Plus eyes gained an additional line of vision, compared to fewer than one-third of SMILE Pro eyes • WaveLight® Plus also produced lower levels of higher-order aberrations and better astigmatism correction (Kanellopoulos AJ. Presented at: 129th Annual Meeting of the American Academy of Ophthalmology; October 18, 2025; Orlando, FL.) |
| Dr. Feinerman was the first surgeon in Orange County and greater Los Angeles to perform WaveLight® Plus LASIK after FDA approval, giving his team deep hands-on experience with this specific platform. |
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WaveLight® Plus vs. SMILE Pro: Which Is Better for Night Vision?
SMILE Pro achieves correction by removing a precisely shaped lenticule of corneal tissue. Once the lenticule is extracted, the corneal shape is changed, but the surgeon has limited ability to fine-tune the result in real time. The treatment profile is fixed before the procedure begins.
WaveLight® Plus LASIK treats the cornea with an excimer laser that delivers sub-micron accuracy. Excimer lasers have decades of refinement behind them and remain the gold standard for refractive precision. The full optical system data integrated into WaveLight® Plus allows the treatment to address irregularities that a standard prescription-based correction would miss entirely.
For patients who want the most customized optical outcome, the ability to address higher-order aberrations with a proven excimer platform is a meaningful distinction. WaveLight® Plus LASIK’s full optical customization is the deciding factor for patients concerned about night vision, halos, or glare. SMILE Pro does not offer this level of individualized treatment. |
Both procedures offer rapid recovery. Most patients notice dramatically clearer vision within the first day or two and return to work and daily activities quickly. However, how fast your vision stabilizes and the overall quality of your outcome can differ.
In real-world practice, LASIK patients often achieve slightly faster visual clarity in the first day, while SMILE recovery can be more variable over the first few days. By one week, outcomes are typically similar for straightforward prescriptions. For a complete day-by-day breakdown of how the two recoveries compare, see SMILE Pro Recovery vs. LASIK Recovery: A Day-by-Day Comparison.
Green cells indicate a WaveLight® Plus advantage.
| Recovery Category | SMILE Pro | WaveLight® Plus LASIK |
|---|---|---|
| Initial Vision | Functional vision within 3 days for most patients | Clearer, functional vision within the first 24 hours ✓ |
| Time to Stable Vision | 1 to 2 weeks for full stabilization | Continued sharpening over following weeks; many notice rapid gains ✓ |
| Flap / Incision | No flap; small 2–4 mm incision only | Corneal flap created; heals quickly under controlled conditions |
| Visual Quality | Corrects refractive error; limited higher-order aberration treatment | Customized treatment often surpasses prior glasses or contact lens quality ✓ |
| Return to Activities | Most resume normal activity within a few days | Most return to daily activities within 24 hours ✓ |
| Variability | Recovery timelines vary from patient to patient | Outcomes depend on proper candidate selection and treatment matching |
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SMILE Recovery vs. LASIK: A Day-by-Day Comparison
Both LASIK and SMILE Pro have strong safety profiles with millions of procedures performed worldwide. Neither procedure carries a significantly higher overall risk than the other when performed on appropriate candidates.
SMILE is sometimes positioned as safer because it does not create a corneal flap. In practice, modern blade-free LASIK using a femtosecond laser has made flap-related complications exceedingly rare. The clinical literature does not support a meaningful safety advantage for SMILE over advanced LASIK in the hands of an experienced surgeon.
The most important safety factor is not the procedure. It is the thoroughness of your pre-operative evaluation, the experience of your surgeon, and the quality of the technology used to plan your treatment.
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SMILE Pro Enhancement: Why Touch-Ups Are More Complicated than LASIK
A small percentage of patients need an enhancement procedure after their initial laser vision correction to fine-tune the result. With LASIK, enhancement is one of the most predictable procedures in modern ophthalmology: the original flap is gently lifted, the excimer laser refines the correction, and the flap is replaced.
With SMILE Pro, enhancement is structurally more complicated. There are four pathways, each with meaningful drawbacks, and the technique most international surgeons consider optimal (the Zeiss CIRCLE software) is not approved or commercially available in the United States. American SMILE Pro patients who need an enhancement face a more constrained menu of options than international patients have access to.
At Feinerman Vision, all primary LASIK procedures (both Wavefront-Optimized LASIK and WaveLight® Plus LASIK) include lifetime enhancement coverage. If your eyes change over time and you need a touch-up years or decades after your original procedure, the enhancement is provided at no additional cost as long as you have remained under our care.
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SMILE Pro Enhancement: Why Touch-Ups Are More Complicated Than LASIK
In Orange County, the cost of LASIK and SMILE Pro are generally comparable, typically ranging from $4,000 to $7,000 for both eyes depending on the technology used, the surgeon’s experience, and the complexity of your prescription.
It is worth noting that not all LASIK is priced equally. Budget centers advertising very low prices typically use older technology platforms, higher patient volumes, and limited surgeon involvement, factors that directly affect outcomes. WaveLight® Plus LASIK with an experienced surgeon represents the premium end of the pricing range, and for most patients the difference in long-term visual quality justifies that investment.
Both procedures are eligible for FSA and HSA reimbursement, which can reduce your effective out-of-pocket cost by 20 to 30 percent depending on your tax bracket.
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WaveLight® Plus LASIK Cost in Orange County
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SMILE Cost vs. LASIK: What Patients in Orange County Pay
Not every eye is a good fit for every laser platform. Corneal thickness, prescription, tear film quality, pupil size, and the unique topography of each eye all play a role in determining the best path forward. Understanding where each procedure performs best matters.
| SMILE Pro May Be Appropriate For | WaveLight® Plus LASIK May Be Ideal For |
• Myopia and astigmatism • Patients strongly preferring a flapless procedure | • Myopia and astigmatism • Those prioritizing maximum optical customization • Patients with higher-order aberrations • Those concerned about night vision, halos, or glare • Those wanting long-term enhancement flexibility • Pilots, athletes, and professionals with visual demands • Patients with moderate to high prescriptions |
For patients who play contact sports, Dr. Feinerman typically recommends PRK, and for patients with meaningful dry eye risk, EVO ICL™ avoids a corneal flap without removing additional corneal tissue.
If you have been told in the past that you are not a LASIK candidate, it is worth having a current evaluation. Diagnostic technology has advanced significantly, and many patients who were previously considered poor candidates are now suitable for WaveLight® Plus LASIK with modern mapping tools.
Who Is a Candidate for WaveLight® Plus LASIK?
No article, comparison chart, or online calculator can tell you which procedure is right for you. What a thorough consultation can tell you is whether you are a candidate for one, both, or neither, and which platform is most likely to give you the sharpest, most stable result based on your actual measurements.
At most high-volume vision correction centers, patients rotate between staff for consultations, testing, and follow-up. The surgeon may be performing dozens of procedures a day with limited time for individual assessment. This is not the model that produces the best outcomes for every patient.
How Dr. Feinerman Approaches Every Case ✓ All consultations are conducted personally by Dr. Gregg Feinerman ✓ Surgical planning is reviewed directly by your surgeon, not delegated ✓ There is no co-management model with outside optometrists ✓ Dr. Feinerman performs every procedure himself ✓ Postoperative care includes direct surgeon follow-up at every visit ✓ Special attention to patients with professional visual requirements, including pilots, athletes, and military personnel |
Refractive surgery is elective. The surgeon you choose, the technology they use, and the care model they practice matter as much as the name of the procedure itself.
SMILE Pro is an innovative procedure, and some patients with moderate myopia may be drawn to its flapless approach.
For most patients seeking the highest level of optical customization, the best possible night vision, and long-term enhancement flexibility, WaveLight® Plus LASIK represents the most advanced option currently available. It is the platform Dr. Feinerman uses at Feinerman Vision, and the reason patients travel from across Orange County and Southern California for their consultation.
The most important step is a comprehensive evaluation. Schedule a consultation with Dr. Feinerman to find out which platform makes sense based on your measurements, your prescription, and your visual goals.
Both SMILE Pro and LASIK are considered safe and FDA-approved procedures when performed on appropriate candidates. SMILE Pro avoids creating a flap, which eliminates flap-related risks, while LASIK has decades of long-term safety data and highly predictable outcomes. The most important factor in safety is proper candidate selection and surgeon experience.
WaveLight® Plus LASIK typically offers faster visual recovery, with many patients seeing clearly within 24 hours. SMILE Pro patients often achieve functional vision within a few days, with continued improvement over one to two weeks.
SMILE Pro is sometimes marketed as gentler on corneal nerves because of its smaller incision, but it still removes corneal tissue and is not a dry eye solution. Modern LASIK techniques have significantly improved dry eye outcomes, and proper patient selection remains the most important factor in minimizing post-operative dryness.
For patients with significant contact sports or eye-trauma exposure, Dr. Feinerman typically recommends PRK. For patients with meaningful dry eye risk, he typically recommends evaluation for EVO ICL™, which removes no corneal tissue and leaves the corneal nerves largely undisturbed.
WaveLight® Plus LASIK has the advantage of treating higher-order aberrations using full-eye mapping technology, which can improve visual quality beyond standard prescription correction. In a real-world study, 50% of WaveLight® Plus patients achieved 20/12.5 vision, sharper than most had experienced with glasses or contacts. (He C, Bala C. J Cataract Refract Surg. 2023;49(11):1140-1146.) In a direct head-to-head comparison, 98% of WaveLight® Plus eyes achieved 20/12.5 or better, compared to 82% with SMILE Pro. (Kanellopoulos AJ. Presented at: 129th Annual Meeting of the American Academy of Ophthalmology; October 18, 2025; Orlando, FL.)
Patients with thin corneas, unstable prescriptions, certain corneal diseases, or significant dry eye may not be candidates for either procedure. A comprehensive evaluation is required to determine eligibility and identify the best option for your specific eyes.
"LASIK is the best choice I ever made!!"
"It's a big relief for me to have a doctor that actually cares for my wellbeing and for how I feel. Dr. Feinerman really was amazing at making me feel at home; I consider him a friend now. Anytime someone asks me for LASIK in LA, I'll 100% say Feinerman. "
"The whole procedure took less than five minutes. It was completely painless. Once it was done, I could see everything super HD clear, and I was really excited because I haven't been able to see like that in so long. I'm truly grateful for Dr. Feinerman. "
"Dr. Feinerman was super friendly and open to any questions or concerns I had. It felt like a normal eye appointment; you don't feel anything... I even went out to dinner that night. LASIK gave me so much freedom. It's the best thing I've ever done."
"Going to see Dr. Feinerman, he just made me feel really comfortable straight away. And the surgery was over so quick. After going through the procedure, which was basically pain free, I slept for six hours, woke up, and had perfect eyesight!"
"Dr. Feinerman is probably one of the more baller doctors I've ever met. He blasted Drake during the surgery, which was really soothing for me as a millennial. The surgery itself only took five minutes, which was crazy. The healing process was really quick!"
Deeper comparisons of SMILE Pro and LASIK across specific clinical dimensions:
Five clinical safety dimensions compared, including the Kanellopoulos 2025 head-to-head study and the often-overlooked enhancement pathway risks.
Why higher-order aberrations and contrast sensitivity matter for night driving, and how the two procedures compare.
A complete walkthrough of the WaveLight® Plus LASIK recovery timeline, from the first hour through full visual stabilization.
Day-by-day recovery comparison of both procedures, from the first 24 hours through return to full activity.
The four enhancement pathways for SMILE Pro patients and why none match the simplicity of a LASIK flap-lift.
Why WaveLight® Plus LASIK at Feinerman Vision ($5,100) is priced below the typical SMILE Pro range in Orange County ($6,000 to $8,000), and what that price difference actually buys.
This quiz is educational and does not diagnose any condition or guarantee candidacy for any procedure. Candidacy is determined only by a comprehensive evaluation, including corneal imaging and a full eye exam, performed by Gregg Feinerman, MD, FACS. Feinerman Vision · 320 Superior Ave, Suite 390, Newport Beach, CA 92663 · (949) 631-4780 · FeinermanVision.com