If you’re comparing LASIK in San Diego, you’ve probably run into two names that sound alike but aren’t the same thing: WaveLight Plus and SMILE. WaveLight Plus is the ray-tracing technology we use to plan and guide LASIK, and it treats nearsightedness, farsightedness, and astigmatism. SMILE is a separate, flapless procedure that treats a narrower range of prescriptions and doesn’t correct farsightedness. At Gordon Schanzlin New Vision Institute in La Jolla, we work with patients across San Diego to find the right fit. Here’s how the two compare, so you know what to ask about at your consultation.
What Is WaveLight Plus LASIK?
WaveLight Plus LASIK uses 3D ray-tracing to build a personalized model of your eye, called a Digital Eye Twin, before your procedure. Our surgeons use this model to plan your treatment. Two lasers then do the work: one creates a thin corneal flap, and another reshapes your cornea based on your Digital Eye Twin. LASIK has a long, FDA-documented track record treating nearsightedness, farsightedness, and complex astigmatism. WaveLight Plus adds a personalized ray-tracing plan to that established approach.
- Maps your eye in 3D, not just your prescription
- Treats nearsightedness, farsightedness, and astigmatism, including complex cases
- Builds your treatment plan around how your eye actually behaves, not an average
What Is SMILE Eye Surgery?
SMILE takes a different approach to vision correction. It skips the corneal flap entirely and uses a single laser for the whole procedure, removing a small piece of tissue from within your cornea through a tiny incision. Because there’s no flap, some patients see SMILE as a lower-risk option if they’re concerned about flap-related complications, including contact sport athletes and military service members.
Both WaveLight Plus LASIK and SMILE carry a temporary risk of dry eye, which your surgeon monitors and helps you manage during recovery.
SMILE also comes with real limitations. SMILE received FDA approval to treat nearsightedness in 2016, and astigmatism paired with nearsightedness in 2018, but it isn’t approved to correct farsightedness. Treatment planning is also more standardized than WaveLight Plus, and if your vision needs fine-tuning later, you’ll likely need a separate LASIK or PRK procedure to do it.
Why Does Gordon Schanzlin New Vision Institute Recommend WaveLight Plus LASIK?
“WaveLight Plus lets us plan each treatment around how light actually moves through a patient’s eye, which is why we rely on it for the range of prescriptions we see,” says Julio Echegoyen, MD, PhD.
We don’t currently offer SMILE at our La Jolla practice. WaveLight Plus treats a wider range of prescriptions, builds a personalized 3D map of your eye, and gives us more options if you need a touch-up procedure down the road. Results may vary from patient to patient, and the best way to find out which technology fits your eyes is a consultation with our team.
Who Is a Good Candidate for WaveLight Plus LASIK?
You may be a candidate for WaveLight Plus LASIK at our La Jolla practice if you:
- Are at least 18 years old with a stable prescription for one year or longer
- Have nearsightedness, farsightedness, or astigmatism
- Have adequate corneal thickness for the procedure
- Are in good overall eye health with no active eye disease
- Want to reduce or eliminate your dependence on glasses or contacts
Our team performs a comprehensive evaluation at your consultation, including corneal topography and wavefront analysis, to confirm your candidacy and recommend the right procedure for your eyes.
Frequently Asked Questions About WaveLight Plus LASIK and SMILE
Is SMILE better than LASIK?
Neither procedure is universally better. SMILE skips the corneal flap but treats a narrower range of prescriptions. WaveLight Plus LASIK treats a wider range of prescriptions and personalizes your treatment around how light travels through your entire eye. The right choice depends on your prescription, corneal health, and goals, which we review at your consultation.
Is WaveLight Plus LASIK safer than SMILE?
Both procedures are FDA-approved with strong safety records. The difference between them comes down to which prescriptions they treat and how personalized your treatment plan is, not a difference in fundamental safety. Your own eye health matters more for your safety than which technology you choose, and we review this at your consultation.
Does insurance cover WaveLight Plus LASIK or SMILE?
No. Both procedures are considered elective and typically aren’t covered by vision or medical insurance. We offer financing options to help make treatment more affordable, and our team will walk you through the details at your consultation.
If I’m not a candidate for SMILE, am I automatically a candidate for WaveLight Plus LASIK?
Not necessarily. Candidacy depends on your prescription, corneal thickness, and overall eye health. If you don’t qualify for SMILE, WaveLight Plus LASIK’s broader prescription range may still be an option, but our team confirms this with a full evaluation at your consultation.
Does SMILE take less time than WaveLight Plus LASIK?
No. Both are quick, outpatient procedures completed the same day, with similar time in the treatment chair. The real difference between them is how your eye is mapped and treated, not how long you’ll be there.
Schedule a Consultation
Ready to find out whether WaveLight Plus LASIK is right for you? Schedule a Consultation with our team in La Jolla, serving patients throughout San Diego.
Source Index
Brandenburg, T.M., Sitto, M.M., Hoopes, P.C., Moshirfar, M. Comparison of Zeiss MEL90 and Alcon WaveLight EX500 Excimer Lasers in FDA Premarket Approval Trials for the Treatment of Myopia, Hyperopia, and Mixed Astigmatism. Journal of Clinical Medicine, 2025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12347908/
Woodward, M.A., et al. One-Year Visual Outcomes for Small Incision Lenticule Extraction (SMILE) to Treat Myopia and Myopic Astigmatism. PMC, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9655124
U.S. Food and Drug Administration. VisuMax Femtosecond Laser, Premarket Approval P150040/S003: Small Incision Lenticule Extraction (SMILE) for the Treatment of Myopia and Myopic Astigmatism. FDA, 2018. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P150040