SMILE vs LASIK Vs LASEK/PRK

What is SMILE Surgery?

Introduced in 2011, SMILE – which stands for small incision lenticule extraction – is one of the newest forms of laser eye surgery available. It’s minimally invasive, bladeless, and can be used to correct short-sightedness. 

SMILE: types of treatment and procedure

SMILE eye surgery is designed to treat short-sightedness by removing tissue on the cornea. 

It works as follows: 

1. First, your surgeon will administer anaesthetic eye drops to numb your eye. 
2. They’ll then use a Carl Zeiss VisuMax laser to place pulses on the cornea’s centre.
3. These pulses will create tiny bubbles that outline the tissue that needs to be removed.
4. The laser will then create a small tunnel that will allow the surgeon to remove the tissue, improving your vision in the process.

All in all, the procedure takes no longer than 20 minutes, and the laser is only used for a small fraction of that time. 

SMILE: recovery and aftercare

SMILE surgery is one of the least invasive eye surgeries available and doesn’t require much recovery time. You will be able to return to day-to-day activities within a few days. 

In terms of aftercare, you’ll usually be asked to wear bandage contact lenses overnight as a precaution. You will also be given safety goggles to drive home in.

Pros of SMILE

• SMILE is known for fast results
• It’s a completely ‘flapless’ procedure, which removes the risk of cornea damage
• SMILE surgery is painless, thanks to a low-pressure laser
• More people are accepted for SMILE surgery because it’s so minimally invasive, including those with astigmatism
• Patients can expect to recover very quickly
• There’s less chance of dry eyes
• The procedure is very quick

Cons of SMILE 

• SMILE can only treat short-sightedness
• It isn’t as widely available as other treatments
• It’s more expensive than other treatments

Smile Surgery Costs

The cost of SMILE surgery will depend on your surgeon and clinic, but you should expect to pay between £2,000-3,000 per eye.  

What is LASIK surgery?

LASIK stands for laser-assisted in-situ keratomileusis, and is a type of laser eye surgery that works by reshaping the cornea and changing the way light enters the eye. It’s suitable for those who are long or short-sighted or have astigmatism.

LASIK: types of treatment and procedure

There are three main steps to LASIK eye surgery: 

1. A small blade is used to cut a thin, circular ‘flap’ in the cornea. This ‘flap’ is then peeled back to expose the corneal stroma. 
2. Once exposed, a laser will be beamed onto the stroma to reshape it so that it can more accurately focus light on the retina.  
3. The corneal flap is then cleansed and put back in place, where it will heal naturally without stitches. 

The procedure usually takes around 15-30 minutes. 

LASIK: recovery and aftercare

Recovery from LASIK eye surgery is usually quick. You should be able to get back to your usual activities within a few days or so after the initial side effects (such as blurry vision and dry eyes) have passed.  

Your surgeon will give you specific advice and instructions on what you can and can’t do after your surgery, based on your specific needs. 

This might include: 

• Resting your eyes
• Avoiding contact with substances like shampoo, face cream and make-up 
• Blinking more often to relieve any discomfort
• Wearing eye shields at night, and sunglasses in the sun
• Stopping driving and taking part in sport for a week or so
• Limiting contact with computer screens for a day or two

You will also be prescribed eye drops and bandage contact lenses as part of your aftercare plan, as well as follow-up appointments. 

Remember: every patient is different, and you should always ask your surgeon what precautions you need to take after surgery, and for how long. 

Pros of LASIK

• LASIK eye surgery is very quick, taking no longer than 30 minutes
• It’s a pain-free procedure
• It’s very effective, with more than 90% of patients achieving 20/20 vision
• It’s one of the most widely available laser eye treatments
• Recovery time is quick

Cons of LASIK

• The ‘flap’ on the cornea could get damaged during or after surgery
• More precautions need to be taken after surgery
• LASIK is often unsuitable for those over the age of 40
• Side effects, including dry eyes, may persist for up to 12 months after surgery

LASIK Costs 

LASIK treatment usually costs between £1,500-2,700 per eye, depending on your prescription and choice of clinic. See our overview of LASIK costs in UK clinics here.

LASEK/PRK

LASEK surgery (laser assisted subepithelial keratectomy) and PRK (photorefractive keratectomy) are both ‘flapless’ surgeries that do not cut into the cornea, which makes them an ideal alternative for those with thin corneas or corneal scarring. 

LASEK/PRK: types of treatment and procedure

Both LASEK and PRK involve the same steps: 

1. First, eye drops are provided to numb the eye.
2. Then, the corneal epithelium (the thinnest layer of the cornea) is moved to provide deeper access to the cornea.
3. A laser is then used to fix any irregularities in the cornea. 
4. A soft contact lens is applied to support healing. 

The key difference between LASEK and PRK is that LASEK preserves and then replaces the epithelial layer, whilst PRK completely removes the epithelium and waits for a new layer to grow back after surgery. 

Both procedures take around 15-20 minutes and are pain-free. 

LASEK/PRK: recovery and aftercare

LASEK and PRK surgery usually require a slightly longer period of recovery than LASIK. 

You are likely to experience blurred vision and mild discomfort for a week or so, and will be asked to avoid certain activities like driving, rubbing your eyes and showering. 

Aftercare techniques will include wearing bandage contact lenses, taking eye drops and resting your eyes as much as possible. 

Your surgeon will provide more specific advice based on your specific prescription. 

Pros of LASEK/PRK

• Less invasive than LASIK
• Avoids some of the risks of LASIK
• Suitable for those who cannot have LASIK
• Quick procedure

Cons of LASEK/PRK  

• It is sometimes not as effective as LASIK
• Patients may experience some discomfort in the healing process
• Healing can take slightly longer than after LASIK surgery

Costs 

LASEK surgery usually costs around £1200-17000 per eye, while PRK costs around £800-1000 per eye. Prices will depend on your prescription and choice of clinic.