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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
Related LASIK Surgeons
M. Farooq Ashraf, MD, FACS
Atlanta Vision Institute
SS
Steven Stetson, MD
Diamond Vision / LASIK ATL
BR
Benjamin R. Strauss, MD
Georgia Eye Associates
Related LASIK Practices in Atlanta
Atlanta Vision Institute
Atlanta
Eye Physicians & Surgeons
Decatur
Diamond Vision / LASIK ATL
Atlanta
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