SMILE vs LASIK What’s the difference?

What are SMILE and LASIK?

If you are thinking about laser eye surgery, you may have heard of SMILE and LASIK. Both are procedures that can correct some common vision problems, including short-sightedness and astigmatism.

While both treatments use laser technology, they work in different ways. The main difference is how the surgeon changes the shape of the cornea.

Neither procedure is right for everyone. Your eye health, prescription, corneal shape, lifestyle, and vision needs will all be considered before treatment.

Understanding the differences between SMILE and LASIK can help you have a more informed discussion with your eye surgeon.

How does LASIK work?

The corneal flap

LASIK uses a laser to reshape the cornea, which is the clear front surface of the eye.

During LASIK, a thin flap is created in the cornea. The surgeon then uses a laser to reshape the tissue underneath the flap.¹https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774

The flap is then placed back into position, where it begins to heal.

The aim is to change how light enters the eye so it can focus more clearly on the retina.

LASIK recovery

Many people notice an improvement in their vision soon after LASIK.

Your eyes may feel dry, watery, gritty, or sensitive to light during the early stages of recovery.

Your surgeon will provide aftercare instructions and tell you when it is safe to return to activities such as driving, exercise, swimming, and work.²https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774

How does SMILE work?

A small incision

SMILE stands for Small Incision Lenticule Extraction.

Unlike LASIK, SMILE does not create a large corneal flap.

Instead, a laser creates a small piece of tissue called a lenticule inside the cornea. The surgeon removes this lenticule through a small opening in the cornea.

This changes the shape of the cornea and can correct certain types of refractive error.

SMILE recovery

Recovery after SMILE varies from person to person.

Some people notice improved vision soon after treatment, while vision may continue to settle over the following days and weeks.³https://my.clevelandclinic.org/health/treatments/25076-smile-eye-surgery

As with LASIK, your surgeon will provide specific instructions for looking after your eyes during recovery.

What is the main difference between SMILE and LASIK?

Different surgical techniques

The biggest difference is how the corneal tissue is accessed.

LASIK creates a thin flap before the cornea is reshaped.

SMILE uses a small incision to remove a lenticule from within the cornea.⁴https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774

Both procedures aim to correct the way light focuses in the eye, but they use different techniques to achieve this.

Different laser technology

LASIK and SMILE also use different laser systems.

Your surgeon will explain which technology is available and which procedure may be appropriate based on your individual eye measurements.

The newest technology is not automatically the best choice for every patient.

Which has the faster recovery?

Recovery after LASIK

LASIK is known for a relatively quick visual recovery.

Many people notice clearer vision shortly after treatment. However, the eyes continue to heal after vision improves.

Temporary symptoms such as dry eyes, glare, halos, or light sensitivity can occur during recovery.⁵https://my.clevelandclinic.org/health/treatments/25076-smile-eye-surgery

Recovery after SMILE

SMILE can also have a relatively quick recovery, although the experience is different for each person.

Vision may be blurry at first and can take time to settle.⁶https://my.clevelandclinic.org/health/treatments/25076-smile-eye-surgery

Your surgeon will monitor your recovery and advise you when you can return to your normal activities.

Which procedure is more comfortable?

During surgery

Both SMILE and LASIK are performed using numbing eye drops.

You will be awake during the procedure, but the eye is numbed to reduce discomfort.

You may notice lights or pressure during treatment.

Your surgical team will explain what to expect before the procedure.

After surgery

Some people experience dryness, watering, light sensitivity, or a gritty feeling after laser eye surgery.⁷https://my.clevelandclinic.org/health/treatments/25076-smile-eye-surgery

The type and level of discomfort can vary between individuals.

Your surgeon will give you instructions and prescribe any medication or eye drops that you need during recovery.

Are both procedures suitable for everyone?

Your prescription matters

SMILE and LASIK can treat certain refractive errors, but they are not suitable for every prescription.

Your surgeon will assess your eyes and discuss which procedures may be available to you.

Your prescription also needs to be considered alongside your corneal measurements and overall eye health.

Your cornea matters

The shape and thickness of your cornea are important when deciding whether laser eye surgery is appropriate.

A detailed assessment allows your surgeon to measure your cornea and look for any factors that may affect treatment.

This is why an online suitability test cannot replace a full eye examination.

What about dry eyes?

Temporary dryness

Dry eyes can occur after both SMILE and LASIK.

You may notice burning, grittiness, watering, or a feeling that there is something in your eye.⁸https://my.clevelandclinic.org/health/treatments/25076-smile-eye-surgery

These symptoms often improve as the eyes recover, but recovery varies between people.

Your surgeon can recommend ways to manage dry eye symptoms during recovery.

Your existing eye health

If you already experience dry eyes, this will be considered during your assessment.

Your surgeon may recommend treating dry eye before deciding whether laser eye surgery is suitable.

It is important to tell your surgeon about any eye symptoms or conditions you have.

Which procedure is better?

There is no single answer

It can be tempting to ask whether SMILE or LASIK is better.

However, there is no procedure that is best for every patient.

The right option depends on your eyes and individual circumstances.

Your surgeon will consider your prescription, corneal measurements, eye health, lifestyle, and treatment goals when discussing your options.

An informed decision

You should understand the potential benefits, risks, limitations, and recovery for any procedure before deciding to have treatment.

Your surgeon can explain why a particular procedure may be recommended for you and answer any questions you have.

What are the risks?

Understanding the possible risks

SMILE and LASIK are surgical procedures and, like all surgery, they carry potential risks.

Possible side effects can include dry eyes, glare, halos, changes in vision, infection, inflammation, and problems with healing.⁹https://my.clevelandclinic.org/health/treatments/25076-smile-eye-surgery

Some people may need additional treatment.

Your surgeon will discuss the risks that apply to your individual circumstances before treatment.

Results can vary

Laser eye surgery does not guarantee perfect vision or that you will never need glasses again.

Your result depends on your individual eyes and how they respond to treatment.

Having realistic expectations is an important part of deciding whether laser eye surgery is right for you.

Learn more about SMILE and LASIK in Sydney

SMILE and LASIK both use laser technology to correct certain vision problems, but they do so in different ways. SMILE uses a small incision to remove a lenticule from the cornea, while LASIK creates a thin corneal flap before reshaping the underlying tissue.

The most suitable procedure will depend on your individual eyes rather than simply which procedure is newer or has a faster recovery.

At Envision Eye Centre in Sydney, our team can assess your eyes and discuss whether SMILE, LASIK, or another form of vision correction may be suitable for you. We can explain the differences between each option and help you understand what to expect before making a decision.

Take the next step

Thinking about laser eye surgery? The first step is finding out whether you may be suitable for treatment.

Take our suitability self test to learn more about whether laser vision correction may be an option for you.