What Is The Difference Between LASIK and SMILE For Correcting my Vision?

During LASIK consultations, the question of how to eliminate the need for eyeglasses and contact lenses often arises. While LASIK is the most common and widely used practice, several other methods have begun to rise in popularity. In your research, you may come across a surgery known as SMILE, the latest form of Laser Vision Correction and another popular form of vision-correcting surgery.

SMILE, which stands for Small Incision Lenticular Extraction, shares similar goals with LASIK – reducing or eliminating the dependence on glasses or contacts. Additionally, SMILE is an FDA-approved surgery performed on the cornea, the same tissue where LASIK surgery is also performed. It has been FDA-approved in the United States since 2016 but has been around globally for over a decade.

To better understand the differences between the two, let’s imagine the cornea, the curved clear tissue on the front of the eye, as a hardbound book. In LASIK, the initial step involves using a Femtosecond Laser to create a hinged tissue flap, acting as the book cover. The surgeon manually lifts the flap, and then an Excimer Laser is used to remove “pages” beneath the cover, addressing your eyeglass prescription. The flap is then repositioned, adheres on its own without stitches, and heals naturally.

On the other hand, the SMILE procedure solely uses the Femtosecond Laser. Instead of a corneal flap, the laser creates a lenticule within the book’s pages and makes a small incision on the cornea’s surface. This incision grants access to the lenticule, which can be thought of as a tiny lens. By using forceps, the surgeon removes the lenticule, causing the remaining pages of the book to collapse and create a new corneal shape. The theory is that removing enough tissue allows the cornea to assume the correct shape for treating your prescription.

What makes SMILE appealing to some patients is the absence of a corneal flap, eliminating the risk of flap complications. Flap complications can occur during the procedure, its healing process or later down the road if the patient experiences ocular trauma. This makes procedures like SMILE and PRK more suitable for individuals engaged in high-impact activities such as MMA fighting or boxing. Additionally, evidence suggests that not having a corneal flap may reduce the chances of experiencing dry eye after surgery.

However, SMILE surgery does have drawbacks. It has a more limited range of treatable prescriptions compared to LASIK. Furthermore, if your vision changes after SMILE surgery, SMILE refinements cannot be performed. Nevertheless, many surgeons opt for Photorefractive Keratectomy (PRK) as a means of refining vision following SMILE. PRK is another type of refractive surgery with a significantly different recovery process compared to LASIK and SMILE. If vision changes occur after LASIK surgery, it can be repeated to refine the new prescription as long as you remain a suitable candidate.

At the 20/20 Institute, we are driven by results. A remarkable 99.67% of our LASIK patients achieve 20/20 vision. In comparison, published results indicate that approximately 99% of SMILE patients achieve 20/40 vision or better, with only 84% achieving 20/20 vision. To further correct vision, SMILE patients may require PRK surgery or resort to wearing glasses and contacts again.

As of now, the efficacy of LASIK in terms of visual results surpasses that of SMILE but that isn’t to say it will not improve in the years to come. As SMILE improves, it may become more commonplace but, as of today, that is simply not the case. Therefore, while we keep an eye on advancements in SMILE, our specialization at the 20/20 Institute lies in LASIK to provide our patients with the best chance of achieving 20/20 vision or better.

Choosing the right surgery and provider for vision correction is crucial. We recommend selecting the care that makes you most comfortable. We at 20/20 Institute we are committed to providing you the best results for LASIK in Denver and our online patient reviews demonstrate the satisfaction that many have experienced with us.