It’s most likely that you’ve heard of LASIK laser eye surgery, and possible that you’ve come across SMILE eye surgery as well. Both of these are well-regarded forms of laser vision correction designed to correct refractive errors such as myopia (short-sightedness) and astigmatism. So, what’s the difference between SMILE and LASIK refractive surgery? What factors should you consider when choosing between the LASIK or SMILE procedure? Keep reading to find out more about LASIK and SMILE laser eye surgery.
LASIK vs SMILE Eye Surgery: the Procedure
Both LASIK and SMILE are similar in that they are techniques of refractive surgery involving the use of laser tools. Another type of laser vision correction is PRK (photorefractive keratectomy). This is in contrast to other forms of refractive surgery that don’t involve the use of a laser, such as refractive lens exchange or intraocular contact lenses.
LASIK stands for laser-assisted in situ keratomileusis. It was first approved for use in correcting refractive errors of the eye in the 1990s. SMILE surgery is a much newer technique compared to LASIK, and only a few refractive surgeons currently offer SMILE surgery in Melbourne. SMILE stands for small incision lenticule extraction.
Both the SMILE and LASIK techniques are able to correct the refractive error by modifying the shape of the cornea. The cornea is the transparent tissue at the front of the eye and is responsible for focusing light as it enters the eye.
By adjusting the curvature of the corneal tissue, the eye surgeon can ensure light is focused clearly onto the light-sensing retina, providing you with sharp vision. However, the way that LASIK and SMILE achieve this differs significantly.
The LASIK Procedure
The unique aspect of laser-assisted in situ keratomileusis is that LASIK requires the formation of a corneal flap. Your surgeon may perform the flap creation step using a handheld instrument known as a microkeratome or by using a laser tool known as the Visumax femtosecond laser.
The corneal flap is then gently opened to one side, which exposes the deeper corneal tissue layers known as the stroma. An excimer laser can then be applied to reshape the cornea. This excimer laser is guided by a computer algorithm based on the biometric data taken from your pre-operative consultation.
Once enough corneal tissue has been removed, the corneal flap is closed back over and allowed to self-seal during the natural healing process.
LASIK is suitable for a wide range of refractive errors, including myopia, hyperopia (long-sightedness), and astigmatism.
SMILE Procedure
Small incision lenticule extraction also employs the use of the Visumax femtosecond laser. However, unlike LASIK, SMILE eye surgery doesn’t require corneal flap creation.
Instead, the femtosecond laser is used to separate a disc-like piece of corneal tissue from the stromal layers of the cornea without disrupting the outer layers. Similar to LASIK, the shape and thickness of this disc is controlled by a computer algorithm based on your biometric measurements. This disc, also known as a lenticule, can then be extracted from the corneal through a keyhole incision. The final result is the correction of your refractive error by modifying the corneal curvature from the inside.
At this point in time, the SMILE procedure is suitable only for myopic and myopic astigmatism refractive errors; SMILE is not suitable for treating long-sightedness. There are also fewer options in Melbourne when it comes to finding an eye doctor to perform SMILE surgery, as it is still relatively new.
How Do SMILE and LASIK Compare? Visual Outcomes
Both SMILE and LASIK are considered to be safe and effective forms of laser vision correction with great visual outcomes.
One study found that SMILE and LASIK did not differ significantly in their target visual acuity and refractive errors and their final vision correction outcomes after five years.
Other small studies have noted that wavefront-guided LASIK gives slightly better vision compared to SMILE surgery, and the vision correction is slightly more predictable for cases with myopia over -10 dioptres. Yet another study reported more SMILE patients achieved better visual acuity compared to LASIK patients.
In terms of visual recovery, patients undergoing LASIK tend to achieve better vision slightly faster than those having SMILE.
Ultimately, LASIK and SMILE are considered to be comparable techniques, and most patients will be guided by the experience of their chosen eye surgeon and their own personal preferences.
LASIK vs SMILE Laser Eye Surgery: Risks and Potential Complications
All forms of surgery come with risks, with LASIK and SMILE laser eye surgery being no different. But how do SMILE and LASIK compare in terms of safety?
Due to the corneal flap created in LASIK, the LASIK procedure tends to carry a higher risk of scarring compared to SMILE. LASIK is also subject to flap complications, such as corneal flap dislocation, which are not found in SMILE. As the SMILE procedure disrupts fewer corneal nerves, there is also less risk of post-operative dry eyes compared to LASIK, though dry eye is still possible after SMILE.
Apart from these factors, LASIK and SMILE are comparable in terms of safety and carry minimal risk of severe complications that result in loss of vision.
Other potential complications of both SMILE and LASIK include:
- Infection
- Over- or under-correcting the refractive error
- Haloes around lights
- Increased light sensitivity
LASIK and SMILE Recovery
Visual recovery after LASIK is often faster compared to SMILE, with most patients achieving good enough visual acuity to drive within 24 hours of their LASIK procedure. However, overall, SMILE is associated with a faster recovery in terms of returning to your usual activities, including contact sports or occupations with a risk of eye trauma.
How to Choose the Best Procedure for You
Determining whether you’re a good candidate for laser eye surgery starts with a thorough eye examination with your eye doctor. He or she will ensure you have healthy eyes and whether your cornea might be more suitable for one procedure over the other. For the most accurate advice, speak with your eye surgeon by calling on (03) 9000 0389.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Is SMILE Safer Than LASIK?
https://www.medicinenet.com/is_smile_safer_than_lasik/article.htm
The Current State of SMILE vs LASIK.
https://www.reviewofophthalmology.com/article/the-current-state-of-smile-vs-lasik
LASIK eye surgery is a popular form of refractive surgery, a category of eye procedures designed to surgically correct the Read more
In the past, people with any significant degree of astigmatism were excluded from laser eye surgery, leaving only glasses or Read more
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