Understanding LASIK vs. SMILE

At San Antonio Eye Specialists, we strive to keep our patients informed about the various vision correction options available. Among the advancements in refractive techniques, LASIK (Laser-Assisted In Situ Keratomileusis) and SMILE (Small Incision Lenticule Extraction) have emerged as two highly effective methods for correcting vision problems. Despite their common goal of improving vision, these two procedures differ in their approach, the conditions they treat, recovery periods, and overall effectiveness. Let's dive deeper into the unique aspects of each.

LASIK: A Proven Procedure

LASIK has been a mainstay in refractive surgery since the 1990s. The procedure involves creating a thin flap on the cornea's surface using a microkeratome or femtosecond laser. The surgeon then lifts this flap to reshape the underlying corneal tissue with an excimer laser, to correct refractive errors such as myopia, hyperopia, and astigmatism. The flap is then naturally repositioned without the need for stitches.

LASIK effectively treats myopia (nearsightedness), hyperopia (farsightedness), and astigmatism by adjusting the way light enters the eye, focusing it correctly onto the retina.

Recovery from LASIK is typically rapid, with many patients noticing an immediate improvement in their vision and usually returning to work or school the next day. Complete visual stabilization usually occurs within a few weeks.

SMILE: A New Advancement

SMILE is a more recent addition to the field of refractive surgery, becoming FDA-approved in 2016. Unlike LASIK, SMILE involves making a smaller incision in the cornea, through which a lenticular (a small piece of corneal tissue) is manually dissected and removed by the surgeon. This alteration changes the shape of the cornea, thus correcting the refractive error.

SMILE is primarily used to correct myopia and astigmatism. However, it does not currently treat hyperopia.

Most patients experience significant vision improvement within a few days, with full recovery typically within a few weeks. However, the visual outcomes of SMILE may take longer to stabilize compared to LASIK.

Effectiveness and Safety

Both LASIK and SMILE have proven to be safe and effective procedures for correcting refractive errors. Studies show high satisfaction rates and significant vision improvement following both procedures. However, there are subtle differences that may make one procedure preferable over the other, depending on individual needs.

LASIK, with its long history, has a substantial amount of clinical data supporting its safety and effectiveness across a broad range of prescriptions. It has been refined over the years and can treat a wider variety of refractive errors compared to SMILE.  

On the other hand, SMILE is a flapless procedure. In some cases, this may be beneficial in maintaining the structural integrity of the cornea and may result in fewer dry eye symptoms post-surgery compared to LASIK.

Most LASIK patients can see 20/20 or better the next day after LASIK.  In comparison, the visual recovery time for SMILE is slower than LASIK.  LASIK patients may have more dry eye symptoms immediately postoperatively as compared to SMILE. However, the symptoms are comparable in both procedures after a few months.   A study by Stanford University professors presented at the 2021 American Society of Cataract and Refractive Surgery annual meeting comparing wavefront-guided LASIK and SMILE  showed that both LASIK and SMILE have excellent outcomes and predictability.  LASIK had faster visual recovery than SMILE.  At 1 year postoperatively, LASIK had better-uncorrected distance visual outcomes of 20/20 or better than SMILE.  LASIK also had greater gains in distance-corrected visual acuity than SMILE.

Choose The Best In Refractive Surgery At San Antonio Eye Specialists

Both LASIK and SMILE represent major advancements in the field of vision correction surgery. While they employ different methods, both aim to provide patients with clearer vision and reduce dependence on glasses or contact lenses. Your suitability for either procedure will depend on several factors, including the specifics of your refractive error, your eye health, lifestyle, and personal preferences. A detailed discussion with an experienced eye care professional is essential to understand which procedure aligns best with your individual needs.

While San Antonio Eye Specialists does not perform the SMILE procedure, we recognize it as an advancement in the field of refractive surgeries. Considering LASIK In San Antonio? Look no further than our experienced, fellowship-trained refractive surgeons. Trust your eyes to San Antonio Eye Specialists. Contact us today to book your FREE consultation. For your eyes… don’t compromise!