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Most SMILE patients achieve stable, lasting vision correction after their initial procedure, but a small amount of residual refractive error can occasionally remain once healing is complete, even when everything about the original procedure went exactly as planned from start to finish.
When that happens, an enhancement procedure is often available to fine-tune the original result rather than requiring patients to simply live with the small residual error indefinitely. Here's how SMILE enhancement generally works and who actually tends to need one.
A SMILE enhancement is a secondary procedure performed after the original surgery to address any remaining refractive error once the eye has fully healed and stabilized. Depending on the specific situation, an enhancement may use SMILE's own laser technology again or a different laser-based approach suited to the smaller amount of correction needed, a decision your surgeon makes based on your corneal measurements at the time rather than defaulting to whichever method was used originally.
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Enhancement isn't a sign that the original procedure failed. It's a refinement step available to patients whose vision needs a small additional adjustment after initial healing is complete, calculated from your current prescription rather than the one you had before your first surgery.
Surgeons typically wait until vision has fully stabilized before evaluating whether an enhancement is appropriate, since SMILE results continue settling for a period after the original procedure. Evaluating too early risks recommending an adjustment for a healing pattern that would have resolved naturally without any additional treatment.
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Modern Vision Centers
6880 EP True Pkwy Suite 110, West Des Moines, IA 50266
(515) 674-2020
Website: https://www.mvcvision.com/smile/
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SMILE Surgeon Des Moines
SMILE Surgeon Des Moines
A follow-up diagnostic evaluation, similar to the original candidacy process, confirms whether an enhancement would meaningfully improve vision before anything additional is ever planned, giving the surgical team an accurate, current picture rather than an outdated one.
Patients correcting a higher original prescription are somewhat more likely to have a small residual refractive error than those correcting milder nearsightedness, simply due to the larger overall adjustment involved in the initial procedure.
SMILE Recovery Des Moines
SMILE Recovery Des Moines
Individual healing response also plays a role, since no two eyes stabilize in exactly the same way or on exactly the same timeline, even between two eyes belonging to the same patient who had both treated on the same day.
An enhancement isn't automatically offered or recommended to every patient. It's evaluated case by case using updated diagnostic measurements gathered after the original surgery has fully healed, rather than offered as a routine second step for every single patient regardless of their actual outcome.
An enhancement is generally a shorter, more narrowly targeted procedure than the original SMILE surgery, since it addresses a smaller amount of residual error rather than a full original prescription that hasn't been treated at all.
The specific technique used depends on your corneal measurements at the time of the enhancement evaluation, which may differ slightly from your original treatment plan given how much healing has occurred since your first procedure.
Recovery from an enhancement tends to be brief as well, though this varies based on the amount of correction actually needed and how your eyes specifically responded to the original procedure the first time around.
Not every SMILE patient will need an enhancement, and for many, the original procedure produces a stable result that holds for years without any further treatment or follow-up correction of any kind. When an enhancement is needed, it's typically a single, limited adjustment rather than the start of an ongoing pattern of procedures.
Surgeons generally discuss this possibility during the original consultation, so patients understand it as a normal part of the overall process rather than an unexpected complication later on. Setting that expectation early tends to make the topic far less stressful if it does come up down the road.
Modern Vision Centers evaluates every SMILE patient's long-term results at scheduled follow-up visits, which allows Dr. Drew Dickson to identify enhancement candidates accurately and early when needed, rather than waiting for a patient to bring up a concern on their own.
Des Moines patients working with the practice have access to this same level of ongoing evaluation well beyond the initial procedure itself, using updated measurements rather than general assumptions about how healing typically goes for most people.
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If you've had SMILE and feel your vision hasn't fully settled where you originally expected, a follow-up evaluation is the right next step rather than assuming nothing more can be done or that your original result is simply final and unchangeable.
Modern Vision Centers' Des Moines team can assess whether an enhancement is appropriate for your specific situation.
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