Home / Guides

Contoura vs SMILE: Which Is Better? (2026)

Is Contoura or SMILE better?

Contoura is often better for sharpness and irregular astigmatism; SMILE is often better for dry-eye-prone or very active people who want no flap. Both give excellent results in well-chosen eyes.

The two procedures answer different problems. Contoura Vision customises the laser treatment to the exact shape of your cornea, so it can smooth small irregularities as well as correct your glasses prescription. SMILE removes a precise lenticule through a tiny incision, leaving the corneal surface and most nerves intact. Which one fits you depends on your corneal map, prescription and lifestyle, assessed at a full pre-op eye exam.

How do Contoura and SMILE work?

Contoura is a form of LASIK with a topography-guided laser plan; SMILE is a flapless femtosecond procedure.

For Contoura Vision, a Topolyzer device maps the front of the cornea at about 22,000 elevation points. The surgeon creates a LASIK flap, then the Alcon WaveLight excimer laser applies a treatment that follows that map, with eye tracking and cyclorotation control during the laser.

For SMILE, a ZEISS VisuMax femtosecond laser cuts a lenticule inside the cornea, which the surgeon removes through a 2–4 mm incision. There is no flap and no excimer laser. SMILE Pro uses the newer VisuMax 800, which cuts the lenticule in under 10 seconds.

Contoura vs SMILE side by side

Dollar figures are approximate at ₩1,350–1,400 per dollar. We did not find enough published Seoul Contoura prices to give a reliable range, so ask each clinic for a written quote that names the laser.

What are the risks of each?

Contoura carries the usual LASIK risks, including flap problems; SMILE avoids flap risks but has its own, mainly around lenticule removal and slower fine-tuning of vision.

With any LASIK, including Contoura, a hard blow can shift the flap, and dry eye and night glare are common for the first months. Topography-guided plans can also change the treatment from your glasses prescription, so surgeons must check that the map is reliable; poor tear film or recent contact lens wear can distort it. With SMILE, problems are uncommon but include suction loss during the laser, incomplete lenticule removal and, early on, slightly slower sharpening of vision. Both can rarely cause corneal ectasia, which is why tomography screening matters. Stop contact lenses as your clinic directs before mapping. More on LASIK side effects and halos and glare after LASIK.

What does the research say?

Evidence is limited but leans towards topography-guided LASIK for crisp vision, with both procedures performing well.

In a 2017 randomised contralateral-eye study in the Journal of Refractive Surgery, 22 patients had topography-guided LASIK in one eye and SMILE in the other. At three months, 86.4% of LASIK eyes saw 20/20 uncorrected versus 68.2% of SMILE eyes, and 81.8% versus 50% had residual astigmatism of 0.25 D or less. The author attributed the gap mainly to eye tracking and centration control. The study was small and short, and SMILE techniques and software have improved since. A separate 2017 review of US FDA data found the Contoura platform produced a mean 12-month uncorrected vision of about 20/16.6, the best of three customised lasers compared.

Which is better for astigmatism and dry eye?

Contoura has the edge for astigmatism, especially irregular astigmatism; SMILE has the edge for dry eye.

Because Contoura reads the corneal shape, it can correct astigmatism caused by surface irregularity that a glasses prescription does not fully capture. Its US label covers cylinder up to about −3 D. SMILE has been FDA-approved for myopic astigmatism since 2018, but it relies on manual alignment for cylinder unless the clinic uses the VisuMax 800's centration and cyclotorsion aids. On dry eye, SMILE's small incision cuts fewer corneal nerves than a LASIK flap. See astigmatism correction in Korea and dry eye after LASIK.

Who should choose which?

Contoura may suit you if you:

• Have astigmatism, especially if your corneal map shows irregularity
• Are farsighted or have a mixed prescription
• Want LASIK-speed recovery and have healthy, thick enough corneas

SMILE may suit you if you:

• Are myopic, with or without regular astigmatism
• Have mild dry eye or work long hours on screens
• Play contact sports or want to avoid any flap

Whichever you choose, ask for a printed copy of your corneal map and treatment plan to take home. Neither is suitable for keratoconus or very thin corneas; those patients are often steered to ICL or cross-linking. If two clinics recommend different procedures, ask each to explain its reasoning from your corneal map. Your ophthalmologist should make the final call.

Sources

• Kanellopoulos (2017) – Topography-guided LASIK versus SMILE: randomized contralateral eye study
• Moshirfar et al. (2017) – FDA-reported outcomes of three customised LASIK platforms
• University of Utah Moran Eye Center – What is Contoura Vision?
• ZEISS – FDA approval for SMILE astigmatism indication
• ZEISS – VISUMAX 800 product page

FAQ

Frequently asked questions

Is Contoura better than SMILE?

One small 2017 trial found sharper three-month vision with topography-guided LASIK than SMILE, but both perform well. Contoura suits irregular astigmatism; SMILE suits dry eye and contact sports.

Does Contoura Vision use a flap?

Yes. Contoura is a type of LASIK, so a flap is created before the topography-guided laser treatment. SMILE does not use a flap.

Is Contoura available in Korea?

Some Seoul clinics with Alcon WaveLight lasers offer topography-guided LASIK. Ask which laser and software will be used and get the price in writing.

Which has less dry eye, Contoura or SMILE?

SMILE generally causes less dry eye because its 2–4 mm incision cuts fewer corneal nerves than a LASIK flap.

Can SMILE treat irregular astigmatism?

SMILE is designed for regular myopic astigmatism. Irregular corneas are more often treated with topography-guided laser or other options after a full exam.

Planning vision correction in Seoul?

Compare clinics by district, check 2026 price ranges, and read our step-by-step planning guide for international patients.