Comparing Procedures
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LASIK vs SMILE: Which is better?
Quick Answer: SMILE uses a smaller incision with no flap. Better for dry eyes but currently only treats nearsightedness.
SMILE (Small Incision Lenticule Extraction) is a newer alternative to LASIK with some distinct advantages.
Key Differences
| Factor | LASIK | SMILE |
| Incision | 20mm flap | 2-4mm incision |
| Flap | Yes | No |
| Lasers used | 2 (femtosecond + excimer) | 1 (femtosecond only) |
| Treats | Myopia, hyperopia, astigmatism | Myopia, astigmatism only |
| Dry eye | More common | Less common |
| Recovery | 24-48 hours | 2-3 days |
How SMILE Works
1. Femtosecond laser creates a lens-shaped piece of tissue (lenticule) inside the cornea 2. Small incision (2-4mm) made at corneal surface 3. Surgeon removes lenticule through incision 4. Cornea reshapes as it heals
Advantages of SMILE
- Less dry eye: Fewer corneal nerves disrupted
- No flap complications: No flap to dislodge
- Corneal strength: Maintains more structural integrity
- Single laser: Simpler procedure
Limitations of SMILE
- Only treats myopia: Cannot correct farsightedness
- Limited astigmatism: Up to 3 diopters
- No enhancements: Cannot easily retreat
- Longer visual recovery: 2-3 days vs 24 hours
- Less customization: No wavefront-guided option
Who Should Consider SMILE
- Myopic patients (-1.00 to -10.00)
- Those with dry eye concerns
- Contact sports participants
- Military/pilots (some branches)
- Patients concerned about flap complications
Top LASIK Surgeons in Atlanta
MP
Milan Patel, MD
Milan Eye Center
Jeffrey A. Carlisle, MD
Thomas Eye Group
Gayle Leff Goldstein, MD
Georgia Eye Partners
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