Yes. The thin, lens-shaped portion of corneal tissue – called a lenticule is permanently removed. It is minimally invasive, as the incision size is very small. As for any corneal refractive procedure for myopia, including SMILE, LASIK, or PRK, effects generally do not “wear off”. While living tissue can change subtly over time, the main reason people notice visual changes over long periods of time – and this is often age-dependent – is due to changes inside the eye. Around age 40, the natural lens on the inside of the eye becomes stiffer, causing difficulty focusing on near items or tasks. This is called presbyopia. Also, the natural lens can eventually become cloudy which is called a cataract. These natural changes of the eye still occur as the eye matures, even after SMILE or other corneal procedures.