Evidence Based

LASIK vs. SMILE Eye Surgery

What Is LASIK Laser Eye Surgery?

LASIK (laser-assisted in situ keratomileusis) is a type of vision correction surgery. The procedure is quick, safe, effective, and provides long-lasting results. LASIK surgery can correct a few types of refractive errors, including:

  • Nearsightedness (myopia)
  • Farsightedness (hyperopia)
  • Astigmatism (blurry vision caused by irregular cornea shape)
diagram showing six steps of lasik eye surgery

During a LASIK procedure, a refractive surgeon will either use a traditional or bladeless technique. Traditional LASIK involves using a surgical blade to cut a flap in your cornea (the clear covering of your eye). Bladeless LASIK uses a laser instead of a surgical blade. Both procedures are considered extremely safe and effective. 

What Is Small Incision Lenticule Extraction (SMILE)?

ReLEx SMILE, also known as small incision lenticule extraction, is a newer laser vision correction procedure that was approved in 2016. It is shown to be as safe and effective as LASIK eye surgery. SMILE procedures are currently available to correct myopia (nearsightedness) and myopic astigmatism.

Keep in mind that SMILE has not been around for very long. Doctors do not know as much about long-term safety and effects as they do for LASIK.

During SMILE laser eye surgery, your surgeon will use a femtosecond laser to create a thin, contact lens-shaped layer below the surface of the cornea. It only takes about 30 seconds to create the layer. Then, the layer is removed through a 2 to 3 mm opening in your cornea. The surrounding tissues will heal together within a few days, resulting in clearer vision.

LASIK vs. SMILE Eye Surgery

LASIK and SMILE are both extremely effective and safe refractive surgeries. They have many similarities but differ in terms of side effects and procedure steps. SMILE has many of the same advantages as LASIK and PRK (photorefractive keratectomy). PRK is another type of refractive eye surgery that reshapes your cornea, so your vision is less blurry. 

Depending on your needs and the type of refractive error you have, your eye surgeon can help determine whether LASIK, PRK, or SMILE is right for you.

Similarities Between LASIK & SMILE Eye Surgery

LASIK and SMILE share many of the same benefits, including:

  • Low risk. Both procedures are very safe and effective.
  • Minimal downtime. The downtime for both procedures is minimal. Patients can get back to their daily activities, including exercise, within a few days.
  • Quick and relatively painless. SMILE and LASIK patients can return home the same day as the procedures.
  • Similar recovery time. Patients will have 20/20 vision within one to two days.

Differences Between LASIK & SMILE Eye Surgery

LASIK and SMILE are similar vision correction procedures and provide the same results (20/20 vision). The main difference between LASIK and SMILE is that SMILE does not use an excimer laser to remove the corneal tissue. There are a few other differences between the two procedures, including:

LASIK
  • Uses an excimer and femtosecond laser
  • Risk of dry eye symptoms
  • Requires postoperative restrictions
  • More invasive procedure
  • Requires a corneal flap
  • LASIK can correct more refractive errors than SMILE
SMILE
  • Uses a femtosecond laser
  • Less risk of dry eye symptoms
  • Slightly faster recovery than LASIK
  • Slightly less invasive procedure
  • Does not require a corneal flap
  • SMILE cannot correct farsightedness (hyperopia)

Comparing Costs: LASIK & SMILE

Both LASIK and SMILE are relatively affordable. There is also not a significant difference between the cost of these two procedures. In the United States, the average cost of SMILE and LASIK eye surgery is between $1,800 and $3,600 per eye

Author: Alyssa Hill | UPDATED July 15, 2020
Medical reviewer: MELODY HUANG, O.D. 
Resources

Kathryn Hatch, MD. “Small Incision Lenticule Extraction (SMILE): It's What's New in Laser Vision Correction.” Harvard Health Blog, 4 May 2020, www.health.harvard.edu/blog/small-incision-lenticule-extraction-smile-its-whats-new-in-laser-vision-correction-2020051419765.

Klokova, Olga Aleksandrovna, et al. “Quality of Life after Refractive Surgery: ReLEx SMILE vs Femto-LASIK.” Clinical Ophthalmology (Auckland, N.Z.), Dove Medical Press, 26 Mar. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6440445/.

Titiyal, Jeewan S., and Manpreet Kaur. Small Incision Lenticule Extraction (SMILE): Surgical Technique and Challenges: Comprehensive Text and Video Guide. Jaypee, The Health Sciences Publisher, 2018.

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