SMILE and Femto LASIK. While these are both advanced types of refractive laser eye surgery, the method in which the cornea is restructured is different. This often causes patients to question SMILE vs LASIK which procedure is right for them and which will give them the best results.
There isn’t a single procedure which is best for all. What works best depends on your refractive error, corneal thickness and shape, tear film health, lifestyle, age, and results from a detailed eye exam. Both SMILE and Femto LASIK do well at providing effective vision correction in patients that they are right for. Research which has compared the two reports that in terms of safety, efficacy, and predictability they are the same for the treatment of appropriate cases of myopia.
What Is SMILE Eye Surgery?
SMILE means Small Incision Lenticule Extraction. It is a no flap procedure which is a form of laser eye surgery in which a femtosecond laser produces a thin lens shaped piece of corneal tissue called a lenticule within the cornea.
The surgeon makes an incision which he uses to remove the lenticule. What we do is break the corneal structure which in turn causes the cornea to change its shape and in that we improve the light’s focus on the retina.
In the case of SMILE vs LASIK we note that the creation of the large corneal flap which is a feature of the LASIK procedure is not present in SMILE. Instead what happens is the lenticule is removed through a small opening. This may be of benefit to certain patients as per there prescription, eye health and lifestyle.
What Is Femto LASIK?
Femto LASIK, which also is a term for what is known as Femto LASIK, is a type of LASIK in which we use a femtosecond laser to make a thin corneal flap. The surgeon then lifts the flap and uses an excimer laser to reshape the base layer of the cornea
After repair the flap is put back in place and heals naturally without the use of stitches.
In the case of Femto LASIK we use lasers for both flap creation and corneal reshaping which in turn presents a very precise method of refractive correction. Many appropriate patients see quick improvement in their functional vision post procedure.
However in the fact that we create a flap which is the case here, patients do have to take extra care in the post op period. The FDA reports that if a patient rubs their eye right after LASIK it may displace the flap which in turn may require more treatment
SMILE vs LASIK: What Is the Main Difference?
In terms of differences between SMILE vs LASIK the main thing is how the surgeon accesses and reshapes the cornea.
| Factor | SMILE | Femto LASIK |
| Surgical approach | Small incision, no LASIK flap | Thin corneal flap is created |
| Main laser | Femtosecond laser | Femtosecond + excimer laser |
| Visual recovery | Usually progressive and relatively quick | Often very rapid |
| Flap-related issues | No LASIK flap | Flap precautions are required |
| Dry-eye impact | May be lower in some patients | Temporary dryness can occur |
| Suitability | Depends on prescription and corneal findings | Depends on prescription and corneal findings |
The issue is not that one procedure is in fact safer or more effective for all patients. At an Eye hospital we do an evaluation which must be done before which procedure is chosen.
SMILE vs LASIK for Dry Eyes
Dryness is a key issue in pre op evaluation for any refractive procedure.
In the case of SMILE which uses a smaller corneal incision and does not create a LASIK flap, it is to report that fewer anterior corneal nerves are affected during the surgery. Also we see in many studies that postop SMILE has reported to produce milder dry eye symptoms or a faster return of corneal sensitivity as compared to Femto LASIK, mainly in the early post op period.
Also do not overstate this difference. We found that dry eye from both procedures is for the most part temporary and that in some objective measures of dry eye the differences may be small.
LASIK is also known to cause dry eye issues. The FDA reports dry eye as a which may follow LASIK in some patients’ reports which also note that at times symptoms produce large scale impact on comfort and visual quality.
If you have symptoms like burning, irritation, fluctuating vision or dryness, speak to your Eye doctor first before going ahead with laser eye surgery.
Which Gives Better Vision: SMILE or Femto LASIK?
In certain patients both of these procedures produce great results.
What the evidence does show is that for the correction of myopia both SMILE vs LASIK are effective, safe and-predictable with no procedure coming out on top in terms of standard visual results.
Visual recovery does vary. In the case of Femto LASIK we see very quick visual improvement which we attribute to the corneal tissue being re-shaped at the time of the procedure by an excimer laser. For SMILE procedures also quick recovery is typical though vision may continue to improve over the following days or weeks.
Your final results are a function of your prescription, corneal health, rate of healing and any preexisting eye conditions which you may have, not just the name of the procedure.
Is SMILE Better for an Active Lifestyle?
In some people who have occupations or are into activities which put their eyes at risk of an accidental injury SMILE may be put forth as an option.
In SMILE we do not have that issue at all which is related to flaps.That is not to say patients may go back to contact sports after SMILE. Your surgeon will at this time also give what you can and cannot do in terms of healing. Stick to the post op schedule as outlined by your Eye specialist which may be different from what you may think when your eyes are healing.
Who Is a Good Candidate for Laser Eye Surgery?
Being into SMILE or Femto LASIK doesn’t mean that you are a candidate for either.
Before we recommend refractive Eye treatments we will evaluate your spectacle prescription, corneal thickness, corneal topography, tear film condition, pupil size and overall eye health.
Some eye conditions, variable prescriptions, large degree of dry eye or other health issues may play a role in eligibility. The FDA also puts forward that proper patient assessment is key before LASIK.
This is the reason for a thorough preoperative evaluation. Going in for a procedure which is based only on ads, price or a friend’s experience may not account for the individual features of your eyes.
SMILE vs LASIK: Which One Should You Choose?
When it comes to choosing between SMILE vs LASIK think in terms of what is best for you as an individual rather than which is better.
SMILE which is a flap free procedure may be the choice for the patient that prefers that approach and also when the patient’s prescription and corneal parameters are a good fit. Also it may have an advantage of dealing with early dry eye issues in some patients.
Femto LASIK is still a well recognized option which has wide clinical use and fast visual recovery. It may be a very good choice when exam results show that LASIK is appropriate.
Which procedure is to do what is safest and most predictable for your individual eyes. Which procedure is to do what is safest and most predictable for your individual eyes.
At Vasan Eye care we see that a detailed refractive evaluation is which in turn may help determine between SMILE, Femto LASIK, or another vision correction option that is best for you. Also you have the chance to consult with an expert Eye specialist who will go over what you may expect from the procedure, the recovery process, what may not be a good fit for you and what risks are present which in turn will help you in your decision.
Conclusion
The choice between SMILE vs LASIK isn’t which is the latest or most popular. SMILE puts forth a small incision, no flap approach and may reduce early dry eye issues for some patients, while Femto LASIK presents very predictable results and usually very quick visual recovery.
Both are high levels of laser eye surgery also in which we see very good results when performed on the right candidates. An in depth assessment at a trusted Eye hospital is the best way to determine what treatment best fits your eyes, lifestyle and vision goals.
If you want to reduce your reliance on glasses or contact lenses, consult Vasan Eye care for personalised advice and guidance on suitable refractive Eye treatments.
Frequently Asked Questions
1. Is SMILE safer than Femto LASIK?
Both in large groups of patients these procedures prove to be safe. SMILE does away with the LASIK flap, also Femto LASIKhas its own benefits which include fast visual recovery. It is your individual corneal measurements and eye health that matter more than which procedure comes out on top in general comparisons.
2. Which is more painful, SMILE or LASIK?
Both in the usual course of events anesthetic eye drops are used for these procedures which means that surgery pain is not a great issue. Mild watering, irritation, foreign body sensation or light sensitivity may report temporarily after laser eye surgery.
3. Does SMILE cause less dry eye than LASIK?
Research reports that some patients have reduced early dry eye symptoms and quicker return of corneal sensitivity after SMILE. But dryness is a post procedure issue for both and your results may vary.
4. Can everyone choose SMILE instead of LASIK?
No. Eligibility for a procedure is determined by factors like refractive error, corneal thickness, corneal shape and total Eye care. A full eye exam by an Eye doctor is required before we determine which technique is best.
5. Is SMILE or Femto LASIK better for me?
There is not a definite winner in the battle between SMILE vs LASIK. What is best for you will depend on your prescription, cornea, tear film health, lifestyle, and what you as a patient want to achieve. An Eye specialist will look at these factors for you and put forth the best recommendation.