Short answer
No — SMILE Pro cannot treat keratoconus and is contraindicated. Although SMILE is flapless, it still removes a lenticule of corneal stromal tissue — the same structural weakening that makes LASIK unsafe in KC. Cross-linking to stabilise, then toric ICL when stable — not SMILE, LASIK, or PRK.
Is SMILE safer than LASIK for keratoconus?
No. SMILE's flapless approach reduces dry eye and flap complications in healthy corneas — but it does not remove the ectasia risk in keratoconus. Both procedures remove stromal tissue from a cornea that is already biomechanically weak.
Some marketing suggests SMILE preserves more corneal strength than LASIK. In keratoconus, the baseline cornea is already compromised — any significant tissue removal is unsafe regardless of technique.
A clinic offered me SMILE despite keratoconus — what should I do?
Seek a corneal specialist second opinion. Any corneal laser without documented CXL stability and serial topography is inappropriate for confirmed or suspect KC.
Read: What is corneal cross-linking? · Keratoconus treatment options.
What can treat keratoconus instead?
- 1CXL — halts progression in active KC.
- 2Scleral / RGP lenses — best functional vision in moderate KC.
- 3Toric ICL — when stable 12+ months post-CXL; no corneal tissue removed.
Compare: Astigmatism vs keratoconus · Return to the keratoconus guide.
Offered SMILE with KC?
Get an honest CXL and ICL pathway — not corneal laser.
Share your Pentacam results — reply within 2 hours.
Related: Can LASIK fix keratoconus? · Is PRK safe for keratoconus?