Short answer
Yes — SMILE Pro can treat astigmatism, but only with myopia (minus Sph). It is approved for myopic astigmatism within platform limits — typically up to roughly 5 D cylinder combined with minus sphere. It does not treat hyperopic astigmatism (plus Sph with Cyl). For plus prescriptions, choose LASIK or toric ICL.
How much astigmatism can SMILE Pro correct?
SMILE Pro treats myopic astigmatism up to platform limits — similar cylinder range to LASIK (roughly 5 D Cyl) when combined with minus sphere and confirmed on topography.
SMILE uses a femtosecond laser to create and remove a lenticule inside the cornea — flapless, often preferred for contact sports and dry-eye-prone patients. Axis alignment is as critical as with LASIK for astigmatism correction.
SMILE vs LASIK for astigmatism
| Feature | SMILE Pro | LASIK |
|---|---|---|
| Myopic astigmatism | Yes | Yes |
| Hyperopic astigmatism | No | Yes |
| Flap | Flapless | Corneal flap created |
| Dry eye profile | Often less disruption | Standard — may suit lower dry eye risk with SMILE |
| High Cyl above ~3 D | LASIK often preferred by surgeons | Excellent track record |
Read: LASIK vs SMILE · Can LASIK fix astigmatism?
Can SMILE treat hyperopia with astigmatism?
No. SMILE Pro cannot treat positive (+) sphere — so hyperopic astigmatism (e.g. +2.50 / −1.50 × 90) requires LASIK or toric ICL, not SMILE.
Always confirm your Sph sign: minus = myopic astigmatism (SMILE may suit) · plus = hyperopic astigmatism (LASIK or ICL).
When is SMILE the right choice for astigmatism?
- ✓Minus Sph with Cyl within platform range.
- ✓Contact sports or military — no flap to dislodge.
- ✓Dry eye history — flapless profile may suit better.
- ⚠Very high Cyl or thin cornea — LASIK or toric ICL may be safer.
- ⚠Irregular topography — neither SMILE nor LASIK until keratoconus ruled out.
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Related: Can LASIK fix astigmatism? · Astigmatism treatment options · Astigmatism guide