Which Laser Eye Surgery is Better: SMILE or LASIK?

When it comes to laser eye surgery, LASIK has been the “golden child” for laser eye correction—and for good reason. But there’s another procedure in the running that can offer equally astounding results—SMILE.

This new-age procedure comes with its own advantages that are worth exploring, depending on your vision concerns. This article will put SMILE and LASIK in a head-to-head “battle” showcasing their similarities, differences, and their suitability for your visual needs.

LASIK Eye Surgery

You’re probably well acquainted with LASIK by now thanks to T.V. ads, TikTok influencers, song lyrics, or even family members who had the procedure.

LASIK is an acronym that stands for Laser-Assisted In Situ Keratomileusis (yes, that’s a mouthful). The surgery incorporates lasers to reshape the cornea, which results in the correction of nearsightedness, farsightedness, astigmatism, and other conditions.

Ultimately, the goal is to restore and sharpen your visual acuity—the ability to see details and shapes of objects—without the need for glasses or contacts.

Ideal LASIK Candidate

Patients 18+ with stable vision for at least one year.
Patients with refractive errors within treatable parameters.
Patients who are free from chronic diseases or traumatic injuries.
Patients with adequate corneal thickness.

Pros of LASIK

It’s fast—LASIK surgery takes no more than 15 minutes per eye.
There’s minimal discomfort during and after LASIK procedures.
Results are quick—you can see vision improvement in just 24 hours.
Results are significant—you can attain better than 20/20 vision.

Cons of LASIK

There’s risk of dry eye syndrome.
There’s minor risk of over or under correction.
There’s a possibility of visual disturbances such as halos or a glare.
The procedure is not fully covered by insurance (if at all).

LASIK has a strong track record of success, and can treat several eye conditions. That makes it the standard procedure for patients.

Now let’s bring in the newer kid on the block—SMILE.

SMILE Eye Surgery

Short for Small Incision Lenticule Extraction, SMILE is a more recent advancement in the laser surgery world. Surgeons create a lenticule, which is a disc-shaped piece of tissue carved into the cornea. Afterwards, the surgeon removes the lenticule creating the new desired shape of your cornea. It’s similar to chiselling a sculpture.

The goal of SMILE is similar to LASIK—to reshape the cornea and improve vision so the patient doesn’t rely on glasses or contacts. However, SMILE eye surgery has some unique advantages that LASIK doesn’t offer and depending on who you are, it might be the better option.

Ideal Candidate for SMILE Eye Surgery

Adult patients with stable vision.
Patients with myopia.
Patients with or without astigmatism.
Patients who are not suitable for LASIK due to having dry eyes or playing contact sports.
Patients who are athletes, military, or law enforcement personnel (due to higher risks of eye injury).

Pros of SMILE

Less invasive than LASIK (since it creates a smaller incision).
Likely to produce fewer dry eye symptoms.
Benefits patients who have higher prescriptions.
Faster recovery of corneal sensation.

Cons of SMILE

Supporting term data isn’t as plentiful as it is a more recent technology growing in popularity.
Currently only approved for treating myopia and astigmatism.
Slightly longer visual recovery time compared to LASIK.
Not as widely available as LASIK.

Overall, if your risk of eye injury is higher or you have a thinner cornea, then SMILE might be the better bang for your buck.

Similarities Between SMILE Eye Surgery and LASIK

While LASIK and SMILE have differences, there are also similarities between the two methods of laser vision correction. Let’s take a look at what they have in common when it comes to addressing your visual deficits.

Purpose: Both SMILE and LASIK are designed to correct refractive errors, defects in how the light is focused on the retina. They both improve visual acuity and eliminate the need to wear glasses or contact lenses.

Efficacy: They both can achieve similar ranges of optimal correction, ranging from 20/30-20/20 vision, or even better in some patients.

Duration: Both procedures last roughly 15 minutes per eye.

Recovery: Although every patient is different, overall recovery for both procedures is short, with patients returning to their normal routine in 1-2 days.

Comfort: Both procedures present minimal discomfort during and after surgery.

Cost: The average fees for both SMILE and LASIK are roughly $2000-$3000 per eye (although this can vary if patients have private health insurance or medical expense accounts).

Eligibility: Patients for both procedures should have stable prescriptions and eyes that are free from diseases or defects caused by disease (i.e. diabetic retinopathy).

Differences Between SMILE and LASIK

The two procedures go head-to-head when it comes to how they work. They both use a laser to correct refractive errors, but they do so differently.

Aspect	LASIK	SMILE
Procedure	LASIK surgery involves creating a corneal flap with a femtosecond laser at near infrared wavelength. After, the surgeon lifts the flap, and then reshapes the cornea with an excimer laser.	Unlike LASIK, SMILE eye surgery does not create a flap, making it less invasive. Rather, this procedure requires surgeons to make tiny incisions—less than 4 millimeters long. The laser creates a lenticule (the removable piece of tissue) in the cornea to carve its new shape, which the surgeon removes after.
Incision Size	LASIK surgery produces a 300+ degree circular flap incision.	SMILE surgery produces a much narrower 60 degree incision.
Corneal Impact	LASIK is tunnel boring (but not painful!)—it cuts deeper into the cornea, which could lead to dry eye and flap complications (although it’s rare and manageable).	SMILE is like landscaping—surgeons make a lighter incision, reducing the risk of eye injury and preserving corneal nerves.
Surgeon Availability	LASIK is more widely performed, and therefore, more surgeons are trained to perform this surgery.	SMILE, on the other hand, is newer, requires more intensive training, and fewer surgeons specialize in it.

To sum it all up, LASIK is a bit more intensive than SMILE, meaning there’s a slightly higher risk of injury. However, LASIK surgery allows for more precision than SMILE thanks to its 3D imaging abilities. SMILE is a “gentler” procedure, and ideal for patients who have more sensitive visual systems or a higher risk of eye injury.

What Ultimately Decides Whether You Need LASIK or SMILE?

A consultation with a surgeon. We listed some of the requirements above for both surgeries, and assuming you neatly fall into one category, then that particular surgery may suit your needs. Of course, not everyone fits squarely into one box, and there are certain factors you can’t determine for yourself such as your corneal thickness.

That’s where a consultation comes in. Here at Lumea, we take precise measurements of your eyes to determine whether you’d be a better candidate for LASIK or SMILE surgery. With that said, we specialize in both procedures, so if you opt for a SMILE treatment, you’ll be in good hands.

Regardless of the end goal, rest assured that you can leave the clinic with the ultra HD vision you deserve, no glasses required!

Looking to change your vision and life with laser eye surgery? Get in touch with us to help you determine whether LASIK or SMILE is the best option for you!