---
title: Is PRESBYOND surgery suitable after SMILE?
description: "Presbyopic laser enhancement on a post‑SMILE cornea may be possible in selected patients, but is technically demanding. ## When it may be considered Stability and corneal reserve are key. - Stable post‑SMILE refraction with symptomatic presbyopia - Adequate residual corneal…"
url: "https://bluefinvision.com/knowledge-base/topics/suitability/is-presbyond-surgery-suitable-after-smile/"
updated: "2025-12-30"
category: Suitability
---

# Is PRESBYOND surgery suitable after SMILE?

Presbyopic laser enhancement on a post‑SMILE cornea may be possible in selected patients, but is technically demanding.

## When it may be considered

Stability and corneal reserve are key.

- Stable post‑SMILE refraction with symptomatic presbyopia
- Adequate residual corneal thickness and regular shape
- No evidence of ectasia or structural compromise
- Clear lenses and good retinal health
- Desire to delay lens‑based surgery despite presbyopic symptoms

## Why extra caution is needed

Re‑treating SMILE corneas is complex.

- Additional ablation further alters corneal biomechanics
- Increased risk of dry eye or night‑vision disturbances
- Limited published data compared with primary procedures
- Requires detailed discussion of alternatives, including lens replacement
- Should only be undertaken in centres with substantial SMILE and enhancement experience