SMILE vs LASIK Eye Surgery

Explore the differences between SMILE and LASIK eye surgeries to make an informed decision for better vision.

SMILE and LASIK are surgical procedures that correct vision issues like myopia and astigmatism. Both procedures reshape the cornea to improve vision Using laser technology. LASIK is well-known and accepted, while SMILE is a newer, minimally invasive option. Key differences include surgical techniques, recovery time, and patient suitability. This article explores these differences to help you make an informed decision about the best procedure for your vision needs.

SMILE Procedure:

Initial Assessment:

• A thorough eye examination is conducted to determine the suitability for SMILE surgery.
• Measurements of corneal thickness, refractive errors, and other relevant factors are taken.

Creating Lenticule:

• A femtosecond laser is used to create a small, disc-shaped lenticule within the cornea. This involves making precise incisions in the corneal tissue.

Extraction of Lenticule:

• A small incision is made on the corneal surface, and the surgeon removes the lenticule through this incision. This step reshapes the cornea, correcting refractive errors.

Healing Process:

• The small incision is self-sealing, requiring minimal stitches or none at all.
• The cornea begins to heal, and visual recovery typically occurs relatively quickly.

LASIK Procedure:

Initial Assessment:

• Similar to SMILE, a comprehensive eye examination is conducted to assess the patient’s suitability for LASIK.
• Corneal measurements, refractive errors, and other factors are evaluated.

Corneal Flap Creation:

• A microkeratome or femtosecond laser is used to create a thin flap on the cornea. This flap is lifted to expose the underlying corneal tissue.

Laser Reshaping:

• An excimer laser is then used to remove precise amounts of corneal tissue, reshaping it to correct the refractive errors.

Flap Repositioning:

• After the laser treatment, the corneal flap is carefully repositioned back into its original place.

Healing Process:

• The corneal flap typically heals without the need for stitches.
• Visual recovery is generally quick, although it may take a few days for optimal results.

Key Differences:

Incision Size: SMILE involves a smaller incision than LASIK since it doesn’t require the creation of a corneal flap.

Flap vs. No Flap: LASIK involves the creation and repositioning of a corneal flap, while SMILE doesn’t use a flap.

Recovery Time: Some studies suggest that SMILE may offer quicker recovery and less discomfort, but individual experiences vary.

Surgical Technique: SMILE is considered a flapless, minimally invasive technique, while LASIK involves the creation and manipulation of a corneal flap.

Benefits of SMILE vs LASIK eye surgery

SMILE benefits:

• Minimally invasive: No corneal flap creation, reducing the risk of flap-related complications and enhancing corneal stability.
• Faster healing: No flap to heal, leading to quicker recovery and return to normal activities.
• Reduced dry eye: Less disruption to corneal nerves, minimizing dry eye symptoms compared to LASIK. This is especially beneficial for patients with pre-existing dry eye conditions.
• Potentially better vision quality: Studies suggest SMILE may provide sharper vision, reduced higher-order aberrations, and potentially better night vision and contrast sensitivity.

LASIK benefits:

• Wider treatment range: Can treat a broader range of refractive errors, including hyperopia, astigmatism, and myopia, while SMILE currently focuses on myopia and astigmatism.
• Faster initial visual improvement: LASIK patients may experience earlier noticeable vision improvement compared to SMILE.
• More established procedure: LASIK has been around longer and has more extensive data on its long-term safety and effectiveness.
• Lower cost: LASIK may be slightly cheaper than SMILE.

Risks for SMILE vs LASIK eye surgery

Both SMILE and LASIK are effective procedures for correcting refractive errors, but they each come with a potential for certain risks. Here’s a comparison:

SMILE Risks:

• Dry eye: Although SMILE has a lower risk of dry eye compared to LASIK, it’s still possible due to the procedure’s impact on corneal nerves and tear production. Dry eye symptoms usually improve over time, but artificial tears may be needed temporarily.
• Undercorrection or overcorrection: Like any refractive surgery, there’s a chance of inaccurate vision correction if too much or too little corneal tissue is removed by the laser. Additional procedures may be required.
• Glare, halos, and starbursts: Temporary visual disturbances after SMILE and LASIK usually fade within a few months.
• Infection: Although rare, eye infections can occur after any surgery, including SMILE. Seek prompt medical attention if you experience symptoms like redness, pain, or vision changes.
• Corneal ectasia: This serious complication, characterized by corneal thinning and weakening, is more likely in patients with pre-existing conditions or thin corneas. Careful screening reduces the risk.

LASIK Risks:

• Flap complications: This primary risk of LASIK involves the corneal flap. It can dislodge from trauma, become infected, or develop wrinkles, affecting vision quality.
• Dry eye: Similar to SMILE, LASIK can cause dry eye due to nerve disruption. The risk is generally higher compared to SMILE.
• Undercorrection or overcorrection: As with SMILE, this risk exists with LASIK as well.
• Glare, halos, and starbursts: These temporary visual disturbances are common after LASIK and usually resolve within a few months.
• Infection: The risk of infection is present after LASIK but remains relatively low.
• Corneal ectasia: Similar to SMILE, LASIK can lead to corneal ectasia in susceptible individuals.