Is LASIK or SMILE better? This is a difficult question because as Confucius said, “The beginning of wisdom is to call things by their proper name.” And SMILE isn’t a good name because it implies a dental procedure rather vision correction. But SMILE is the name that the company Zeiss chose to call a vision correction procedure involving making 2 layers of bubbles in the cornea then extracting the thin layer of tissue between them to reshape the cornea and change the focus of the eye. The thin layer is called a lenticule. So, a better name for the surgery is laser assisted lenticule extraction (LALEX). LASIK is a way to change the shape of the cornea and correct vision by gently lasering away corneal tissue rather than extracting it.
The whole subject of laser vision correction has become even more confusing as laser manufacturers and organisations have come up with their own names for similar treatments. So now in addition to SMILE, the names CLEAR, RELEX, FLEX, SILK, SmartSight and K-Lex are used to describe LALEX. It’s like each designer having a different name for a dress. And as companies do, each tries to show that their LALEX is better than the others and better than LASIK. All this does is confuse people. Confusion leads to indecision and indecision leads to staying in your glasses instead of enjoying the pleasure and freedom of not having to wear your glasses. It’s like having too many dresses in your cupboard, you can’t make up your mind what to wear so you don’t go out and you stay at home in your pyjamas instead!
But is LASIK or SMILE better?
LASIK has been around for over 20 years, has been improved and refined and it’s now an extremely safe and effective way to correct vision. Therefore, the bar has been set high for any new procedure, such as LALEX – SMILE, to match it. LALEX-SMILE has been available in the UK since 2011, is also being improved and refined, and is also extremely safe and affective. So, LASIK and LALEX-SMILE are both great ways to correct focus errors of your eyes.
Unfortunately, there aren’t studies fairly comparing LASIK, SMILE, CLEAR, SILK etc. To properly answer to the question, a group of surgeons experienced in each treatment type and with each laser would have to do thousands of LASIK and LALEX treatments of the same size on all the different focus errors (low myopia, high myopia, astigmatism, and hyperopia) in the same way. And the results would have to be assessed independently. The results would take years to come out, which would delay your vision correction. And when we eventually got the results, all the technologies would have improved requiring another study!
But here are some of the current similarities & differences between LASIK & SMILE_LALEX:
- Both are precise, have excellent safety records & results & vision recovery after both is quick.
LASIK can treat myopia, hyperopia & astigmatism well. SMILE also treats myopia well. SMILE’s astigmatism correction results were inferior to LASIK but are improving. SMILE is not certified for hyperopia correction at the moment & there is limited information about the effectiveness of SMILE for hyperopia. - Neither LASIK or SMILE are good options for people with thin corneas. LASEK (PRK) & ICL’s are better vision correction solutions.
- Vision recovery after LASIK is usually slightly quicker than for SMILE, but by 1 month the results are similar.
- SMILE & LASIK can both increase dry eye symptoms. SMILE causes slightly less initially but by 1 year after surgery there is no significant difference between the 2 treatments.
- If additional vision correction surgery is needed after SMILE or LASIK, the options are more limited with SMILE. SMILE is usually not repeatable, LASIK is usually not done after SMILE either & a LASEK retreatment is usually the treatment of choice. LASIK can almost always be repeated and LASEK is also an option after LASIK.
So is Is LASIK or SMILE better? You should just know that all the types of vision correction treatment are excellent and improving. And you should book a consultation with an experienced surgeon who has great vision correction results with one or some of the technologies rather than waste time splitting hairs by trying to find out if one treatment beats another’s 99% success rate by another 0.1%.
