For anyone considering saying goodbye to glasses and contact lenses, the world of laser eye surgery can seem a bit overwhelming. Two of the most popular and advanced procedures you’ll likely hear about are LASIK and SMILE. While both aim to correct your vision, they achieve this through different techniques, each with its own set of advantages. Let’s delve into the key differences between LASIK and SMILE to help you understand which might be the best fit for you.

LASIK: The Established Gold Standard

LASIK (Laser-Assisted In Situ Keratomileusis) has been the most widely performed laser eye surgery for decades, with a proven track record of safety and effectiveness.

How it works:

1. Flap Creation: The first step in LASIK involves creating a thin, hinged flap on the surface of the cornea. This is typically done using a femtosecond laser, ensuring incredible precision.
2. Laser Reshaping: The flap is then gently lifted, revealing the underlying corneal tissue. An excimer laser is then used to reshape this tissue, correcting your refractive error (myopia, hyperopia, and astigmatism).
3. Flap Repositioning: Once the reshaping is complete, the corneal flap is carefully repositioned. It naturally adheres without the need for stitches, acting as a natural bandage.

Key Features of LASIK:

• Broad Treatment Range: LASIK can correct a wide range of refractive errors, including high levels of myopia, hyperopia, and astigmatism.
• Fast Visual Recovery: Many patients experience significant vision improvement within 24-48 hours, with stable vision often achieved within a few days to weeks.
• Minimal Discomfort: The procedure itself is generally painless due to anaesthetic eye drops, and most discomfort during recovery is mild.
• Well-Established: With millions of procedures performed worldwide, LASIK has a long history and extensive research backing its safety and efficacy.

Considerations for LASIK:

• Flap-related risks: While rare, potential complications related to the corneal flap (e.g., dislodgement, epithelial ingrowth) can occur.
• Dry Eye: Some patients may experience temporary or, in rare cases, persistent dry eye symptoms after LASIK due to the impact on corneal nerves.

SMILE: The Minimally Invasive Alternative

SMILE (Small Incision Lenticule Extraction) is a newer, less invasive procedure that has gained popularity for its “keyhole” approach.

How it works:

1. Lenticule Creation: Using a single femtosecond laser, a small, lens-shaped piece of corneal tissue (called a lenticule) is created just beneath the surface of the cornea.
2. Lenticule Extraction: A tiny incision (typically 2-4mm) is then made on the corneal surface, and the surgeon carefully extracts the lenticule through this small opening.
3. Corneal Reshaping: By removing the lenticule, the shape of the cornea is altered, correcting your vision.

Key Features of SMILE:

• Flapless Procedure: The absence of a corneal flap eliminates the risks associated with flap complications, making it a potentially safer option for those involved in contact sports or professions where flap dislodgement could be a concern.
• Minimally Invasive: The smaller incision leads to less disruption of corneal nerves, which can result in a lower incidence of post-operative dry eye compared to LASIK.
• Good for Higher Myopia and Astigmatism: SMILE is particularly effective for correcting moderate to high levels of nearsightedness (myopia) and astigmatism.
• Improved Corneal Biomechanics: Due to the smaller incision and preservation of the anterior corneal layers, SMILE may offer better long-term corneal stability.

Considerations for SMILE:

• Niche for Treatment: Currently, SMILE is primarily used for correcting myopia and astigmatism, and is generally not suitable for hyperopia (farsightedness) or presbyopia (age-related reading vision decline).
• Slightly Slower Initial Visual Recovery: While overall recovery is fast, initial visual clarity might take a day or two longer to stabilise compared to LASIK.
• Newer Technology: Though well-established, it has a shorter history of use than LASIK.

Which One is Right for You?

The “best” procedure isn’t a one-size-fits-all answer. The choice between LASIK and SMILE depends on several factors, including:

• Your Refractive Error: The type and degree of your myopia, hyperopia, or astigmatism.
• Corneal Thickness and Health: Your ophthalmologist will assess your corneal health and thickness to determine suitability.
• Lifestyle: If you’re highly active or involved in contact sports, the flapless nature of SMILE might be advantageous.
• Risk of Dry Eye: If you have pre-existing dry eyes or are prone to them, SMILE may be a more favourable option.
• Surgeon’s Recommendation: Ultimately, a thorough eye examination and consultation with an experienced eye surgeon are crucial. They will assess your individual eye health, discuss your visual goals, and recommend the procedure best suited for your unique needs.

Both LASIK and SMILE offer fantastic opportunities for vision correction and freedom from glasses and contacts. Understanding their differences is the first step towards making an informed decision for your eyes.