SMILE Vs LASIK Vs PRK

If you’re considering vision correction surgery, understanding the differences between SMILE, LASIK, and PRK is critical to making an informed decision that fits your lifestyle and needs. 

Each procedure has its unique advantages, drawbacks, and suitability criteria. Here’s everything you need to know about these popular laser eye correction surgeries.

What Are SMILE, LASIK, and PRK?

SMILE (Small Incision Lenticule Extraction)

SMILE is a minimally invasive and relatively newer laser eye surgery that corrects nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. It uses a femtosecond laser to create a small disc-shaped tissue (lenticule) inside the cornea, which is removed through a tiny incision to reshape the cornea.

LASIK (Laser-Assisted in Situ Keratomileusis)

LASIK is the most commonly performed laser eye surgery, and it is known for its quick recovery and high success rates. It involves cutting a thin flap in the cornea, lifting it to reshape the cornea with an excimer laser, and repositioning the flap.

PRK (Photorefractive Keratectomy)

PRK is one of the earliest laser vision correction techniques. It doesn’t create a corneal flap but instead removes the outer layer (epithelium) of the cornea, followed by reshaping the cornea’s surface with an excimer laser.

Understanding their differences will help you determine which one aligns with your vision and lifestyle needs.

Key Differences Between SMILE, LASIK, and PRK 

Below, we’ll discuss these differences in more detail to help you evaluate their impact on your decision.

Differences Between SMILE, LASIK, and PRK 

1. Procedure Technique

• SMILE creates a small incision (2-4 mm) and removes a lenticule of tissue using a femtosecond laser. No flap is created.
• LASIK requires a flap to be cut in the cornea, reshaped by a laser, and then repositioned.
• PRK involves removing the epithelium (outer corneal layer), reshaping the cornea with a laser, and allowing the layer to regenerate naturally.

2. Recovery Time

• SMILE offers quick recovery since the procedure is minimally invasive. The majority of patients are able to resume normal activities within three to four days.
• LASIK also has a fast recovery—clear vision generally returns within a day or two, making it a popular choice for its convenience.
• PRK has the slowest recovery time, taking a week or more for the epithelium to heal and a few additional weeks for vision to stabilise.

3. Long-Term Safety and Complications

• SMILE has a low risk of complications and is less likely to cause dry eyes since it doesn’t involve a corneal flap.
• LASIK has a higher risk of complications like flap dislocation or chronic dry eyes due to greater disruption of the corneal nerves.
• PRK eliminates all flap-related risks but comes with temporary discomfort during recovery and higher post-surgical care requirements.

4. Pain and Discomfort

• SMILE: Minimal pain during and after the procedure. Most patients report mild discomfort for a few hours post-surgery.
• LASIK: Very little pain during surgery, but some patients feel minor irritation or dryness for 1-2 days.
• PRK: Mild pain and sensitivity are common during the first few days due to the removal of the epithelial layer.

5. Ideal Candidates

• Choose SMILE if you engage in contact sports or have thinner corneas, as there’s no flap to dislodge. 
• LASIK is the most versatile option for patients and is suitable for flap-based surgeries. 
• Select PRK if your corneas are extremely thin or you have certain preexisting conditions that rule out LASIK.

6. Visual Outcomes

While all three procedures provide similar visual outcomes in the long term, the speed at which clear vision is achieved differs:

• SMILE: Sharp vision typically in a few days. 
• LASIK: Immediate visual improvement within 24 hours. 
• PRK: Vision clears progressively over several weeks.

7. Cost

Costs can vary, but consider the following generalisations:

• LASIK and SMILE usually have similar price points, ranging around 1,00,000 for both eyes.
• PRK often costs slightly less than LASIK due to its older technology.

8. Suitability for Activities

• SMILE is particularly suited for active individuals or sports enthusiasts as it eliminates risks associated with corneal flaps.
• LASIK works well for most lifestyles, but its flap could be vulnerable in high-impact activities.
• PRK is recommended for less physically active patients or those who cannot undergo flap-based procedures.

9. Risk of Regression

With all three options, vision regression is rare but possible:

• SMILE and LASIK are less likely to regress if performed correctly and on suitable candidates. 
• PRK has slightly higher chances of regression but is still considered effective over time.

10. Technology and Experience

• LASIK and PRK have been around for decades and are known for predictable outcomes when performed by experienced surgeons. 
• SMILE is a newer technology (available since 2016), so ensure your surgeon has adequate experience with the procedure.

Which Procedure Is Right for You?

The best choice will largely depend on your individual eye structure, vision goals, lifestyle, and expectations:

• Choose SMILE if you have a physically active lifestyle or thin corneas, and you prefer a minimally invasive solution. 
• Go for LASIK if you want fast recovery, versatile vision correction, and meet the typical eligibility benchmarks. 
• Consider PRK if you have thin corneas, chronic dry eyes, or lead a less physically active lifestyle.

Ultimately, consulting with a trusted eye specialist is crucial to assess your eye health and make the most informed choice.

Final Thoughts

When deciding between SMILE vs. LASIK vs. PRK, consider what matters most to you—whether it’s recovery time, long-term safety, or compatibility with your daily activities. All three procedures offer excellent visual outcomes, but they differ in how they achieve those results.

Still unsure which option suits you best? Schedule a consultation with a vision specialist today to clarify all your questions. A clear vision for a brighter tomorrow is just one step away!