Refractive errors affect millions of people making the vision blurry, reading difficult, and give headaches. Vision correction surgeries have evolved in recent years, providing patients with different options to address refractive errors. Two of the popular vision correction surgeries are SMILE and Femto LASIK.
In this guide, we will compare SMILE and Femto LASIK highlighting their similarities and differences that help you make informed decisions about the best procedure for you.
Understanding SMILE
SMILE, Smile Incision Lenticule Extraction, is a revolutionary minimally invasive laser vision correction procedure.
It uses advanced femtosecond laser technology to reshape the cornea for clear vision and reduces the need for glasses or contact lenses. It is approved for treating myopia and astigmatism.
Procedure
The different steps in the SMILE procedure are
- Eye examination: Your Ophthalmologist will perform a complete eye examination before the surgery.
- Administration of anaesthesia: Local anaesthesia is usually administered in the form of eye drops, and the patient’s eye is fixed in place using a device to keep the eyelid open.
- Lenticule creation: Femtosecond laser creates a lenticule (a disc-shaped piece of tissue) within the cornea.
- Removal of lenticule: The surgeon creates a small incision in the cornea to remove the lenticle. The lenticule is removed through the incision thus reshaping the cornea and improving the ability to focus the light.
- The incision heals without stitches.
Eligibility
The individuals must meet the following criteria to qualify for the SMILE procedure.
- Over 22 years of age
- Have a stable eye prescription for the last six months
- Your myopia should be between -1 and -10 and astigmatism should be less than 3 diopters
- Have healthy eyes free from pre-existing eye conditions or diseases
Benefits
The different benefits to choosing the SMILE eye surgery are
- Minimally invasiveness: SMILE eye surgery requires a small incision in the cornea and it results in less discomfort.
- Fewer dry eye symptoms: SMILE eye surgery involves less disruption of the corneal nerves and tends to cause fewer instances of dry eye symptoms.
- Lower risk of complications: As SMILE surgery does not involve creating a flap in the cornea, it carries a lower risk of flap-related complications.
- Faster recovery time: Due to the smaller incision and less invasive nature of SMILE, it has typically a faster recovery rate.
Complications
SMILE surgery is generally safe but like any surgery it comes with few risks or chance of complications, including
- Having halos and glare with lights
- Carries the risk of over-correction or under-correction
- May require another surgery to smooth the cornea
- Loss of vision which is very rare
SMILE is a newer technology and is not widely available in all clinics.
Understanding Femto LASIK
Femtosecond-assisted laser in-situ keratomileusis (Femto-LASIK) is a type of laser eye surgery that is used to reshape the cornea and resolve the vision problems.
In this procedure, a femtosecond laser is used to emit ultra-short pulses to create a small flap in the cornea and then an excimer laser is used to reshape the cornea.
Procedure
The different steps involved in Femto LASIK are
- Administration of numbing drops: Numbing drops will be placed into your eyes to prevent discomfort
- Placement of eye speculum: The surgeon places an eye speculum to keep the eyelids open during the procedure. A suction is then centred over the pupil and suction is applied.
- Creation of flap: The surgeon then uses a femtosecond laser to create a flap in the surface of the cornea and release the suction.
- Reshaping the cornea: The flap is then peeled back and the surgeon uses a precise excimer laser to reshape the cornea as required to resolve your condition.
- Replacement of flap: The flap is replaced once the cornea is reshaped. The flap will heal without sutures.
Eligibility
The following criteria are to be met to be a candidate for Femto LASIK, including
- Age should be over 18 years
- Should have stable vision for at least a year
- Should not have any conditions or take any medications that may prevent proper healing
- Should not have had previous refractory surgeries
Benefits
The different benefits of Femto LASIK are
- High precision and safety: Femto LASIK offers an extremely high level of precision in flap creation and reduces the risks of human errors.
- Quick recovery time and minimal discomfort: Femto LASIk has a faster recovery time and minimizes discomfort during and after surgery.
- Customization: Surgeon may tailor Femto LASIK procedure to the specific corneal shape and refractive error of each patient leading to more accurate vision correction.
- Treat a wide range of treatable conditions: Femto LASIK is effective in treating a broad range of refractive errors, including myopia, hyperopia, and astigmatism.
Complications
Like any other surgery, Femot LASIK carried the risks of
- Permanent vision loss
- Reduced effectiveness over time
- Halos around the lights and rainbow glare
- Transient light sensitivity syndrome may result in extreme sensitivity to light
SMILE Vs Femto LASIK: Key Differences
Both SMILE and Femto LASIK use femtosecond laser technology to correct the refractive errors. Also, both procedures boast a remarkable success rate and minimal risk of complications.
SMILE does not have the need for flap creation whereas Femto LASIK requires a corneal flap to access the underlying tissue for reshaping. However, SMILE eye surgery is not widely available as Femto LASIK surgeries.
| SMILE | Femto LASIK | |
| Laser type | Femtosecond laser only | Femtosecond laser for flap creation + excimer laser for reshaping cornea |
| Incision | A smaller incision is made less than 6 mm | An incision may be slighter bigger about 20-30 mm due to flap creation |
| Flap procedure | Does not require flap creation | Requires flap creation |
| Procedure | Involves a small incision and a lenticule is extracted from the cornea | A corneal flap is created which is then lifted and then the cornea is reshaped using an excimer laser. |
| Dry eye symptoms | Negligible to no dry eyes | May worsen dry eye symptoms |
| Suitability | Recommended for correcting myopia and astigmatism | Recommended for correcting myopia, hyperopia, and astigmatism. |
| Safety | Does not have flap-related complications, including torn-off flaps, dry eyes, and flap displacement | May have flap-related complications |
| Corneal tissue preservation | Preserves more corneal tissue as it does not involve a flap creation | Larger portion of tissue is removed due to flap creation |
| Availability | Newer, less widely available | More widely available and well-established |
Table: SMILE eye surgery Vs. Femto LASIK: Similarities and difference.
Which Procedure Is Right For You?
Both SMILE and Femto LASIK are excellent options for patients who are looking to correct refractive errors and reduce their dependence on glasses or contact lenses. However, the right procedure for you may depend on
- Your eye health: Different factors, including corneal thickness, tear production and refractive errors of your eyes determine the suitable procedure. If you are concerned about post-surgery dry eye symptoms, SMILE may be best approach
- Lifestyle factors: If you are a contact sports enthusiasts, you may benefit from SMILE eye surgery. Femto LASIK offers verstality addressing a wider range of refractive errors and certain corneal conditions.
Both SMILE and Femto LASIK surgeries are advanced, safe and effective vision correction surgeries with high success rates. The choice between you depends on the individual’s needs, eye condition, and lifestyle factors.
It is important to consult with an experienced Ophthalmologist to assess your vision and recommend the best treatment option for you.If you are considering SMILE and Femto LASIK and want to know which procedure is suitable for you, feel free to book a consultation at Grewal Eye Institute to get all your questions answered.
Frequently Asked Questions
SMILE is considered less invasive as it requires a small incision to remove the lenticule while Femto LASIK requires the creation of a flap in the cornea which makes it little more invasive. SMILE preserves more corneal tissue and is gentler on the eye.
Both SMILE and Femto LASIK can treat common refractive errors, including myopia, hyperopia, and astigmatism. However, Femto LASIK may be used for a wider range of prescriptions.
Femto LASIK is slightly more affordable than SMILE, as Femto LASIK is a well-known procedure and is widely available. SMILE, being a newer technology may be slightly more expensive due to the expertise required. However, the cost may vary depending on the location of the clinic and individual needs.
Both SMILE and Femto LASIK are generally safe but SMILE is associated with fewer potential complications related to flap creation, including flap dislocation or wrinkles. Femto LASIK is generally considered safe but carries a small risk of flap-related issues.