From thousands of victims restored to having their vision, and being freed from wearing eyeglasses and contact lenses, vision correction surgery has revealed its potential. The two most popular methods for the treatment of refractive errors remain LASIK-Laser-Assisted In Situ Keratomileusis and SMILE-Small Incision Lenticule Extraction, which happen to be amongst the two most adopted procedures for refractive errors correction. Although the procedures both change the shape of the cornea, which may correct one's vision, there are many differences in technique, recovery and what can be done for the patient and what cannot. It is grave importance that anyone contemplating laser correction of vision makes available to people the difference in these two procedures before making their own personal choice. I will then look at the differences, benefits, drawbacks, and what might be the best for you.
Overview of LASIK
One of the oldest and most performed laser eye surgeries for correction of visions is LASIK. This surgery has been around for decades, helping millions of people clear their visions over the years. In LASIK, an incision is provided at the surface of the cornea, which is the clear outer layer covering the eye, and then a laser applied reshapes the tissue found underneath it. LASIK generally reshapes the cornea in order to correct a wide range of refractive errors, which are exactly what myopia, hyperopia, and astigmatism refer to.
How LASIK Works
Firstly, a hinged flap is created in the cornea by either a femtosecond laser or by a microkeratome, that is, a mechanical blade, penetrating to the other tissue layer beneath the cornea.
Excimer laser is employed and precise quantity of tissues in the cornea is removed so that it can be reshaped in a form that would overcome the error of refraction in the eye. Then, the flap is readopted and it acts as a natural bandage with adhesive properties since no stitching is required after excimer laser reshaping.
This procedure takes about 10-15 minutes in both the eyes, and most patients notice a big difference in their vision the next day.
Smile Overview
SMILE is a relatively new type of laser eye correction. An overview is taken from the start of 2010, focusing on the minimally invasive procedure intended to correct vision without cutting an incision large enough to allow a flap like in LASIK. It is accomplished by taking out a lenticular-shaped small amount of corneal tissue through a tiny incision.
How SMILE Works
So, the SMILE procedure, like any surgical technique, is really made up of stages and is defined today in two.
Lenticule formation procedure: The femtosecond laser makes a small disc-shaped tissue in the cornea in the procedure of creating a lenticule. That is to say, lenticule is a small disc-shaped tissue. The laser does only very fine cuts within the cornea and does not make an open flap like other surgeries, though.
Lenticule extraction: A small incision to the cornea, between 2 and 4 millimeters in size, represents the small opening through which the lenticule is extracted. Lenticule extraction reprofiles the cornea, and thus, corrects the refractive error.
SMILE does not create a big flap, thus much less invasive than LASIK.
Differences between SMILE and LASIK
Although SMILE and LASIK share some basic principles from which they are derived, differences characterize the two procedures .
1. Surgical Technique
LASIK: It involves creating a corneal flap which needs to be flipped up, followed by correction through reshaping of the corneal tissue beneath it. Replacement of the flap acts as a protective covering over the eye follows the reshaping.
SMILE: There is no major flap that has to be performed. It only requires minimal incision and removal of a lenticule of tissue for recontouring of the cornea .
2. Invasiveness
LASIK: This procedure is more invasive. This is because cutting of the greater extent of the cornea has to be done in order to create a corneal flap.
SMILE: The smaller incision of SMILE makes it more minimally invasive with a lower chance of flap-related complications like flap displacement and infection.
3. Suitable Patients
LASIK: Suitable for most patients who have mild to moderate refractive errors. Those whose cornea is thin, who have dry eyes, or who have extremely high prescriptions would not be good candidates.
SMILE: This "fear of dryness" that may affect the lesser extent of corneal nerves that produce tears is also well suited in patients that have high prescriptions.
4. Healing Time
LASIK: Vision heals in most of the patients shortly after surgery, whereas most patients regained nearly perfect vision within 24-48 hours post-procedure, while some may temporarily suffer from dryness or photophobia.
SMILE: The healing time is slightly on the longer side and improvement in the vision takes some days to a week. Dry syndrome complication is highly unlikely to happen with SMILE as the procedure is not too invasive.
5. Nerve Impact on the Cornea
LASIK: The formation of the corneal flap compromises the nerves significant for tear production. Patieints are likely to suffer from either mild or chronic issues with dry eyes.
SMILE: Since there is no great flap, involved SMILE tends to disturb the corneal nerves to a lesser extent, and hence the chances of developing dry eyes after surgery are lower.
Advantages of LASIK
Heals quickly: Patients can regain their proper vision almost within a day or two after the surgery.
Widely practiced: LASIK is done by all surgeons and has reached perfection to a large extent.
It can treat a vast range of refractive defects, myopia, hyperopia, and astigmatism.
Benefits of SMILE
It's the least invasive procedure. This minimizes the incision that decreases complications since the chances are much lower in that and heals quickly.
It's less risk-prone to dry eyes: As fewer nerves of the cornea are touched, the risks of dry eyes encountered by SMILE patients are minimal.
It is flap-free of complications. Because no flap is involved, any complications associated with a flap, such as displacement and infection, will not happen to the patient .
Which Procedure is Right for You?
Which procedure-LASIK or SMILE-is best suited to you? If you do not know that too depends on a number of factors like prescription, corneal thickness, lifestyle and personal preferences. Some of the following considerations:
You have dry eyes: SMILE is more advisable as it will less likely cause further exacerbation.
You have a high prescription: SMILE proves best for those who have higher levels of myopia.
If you need to recover fast: In most of the patients, complete visual recovery happens within 24 hours by LASIK.
If you do not require a flap: SMILE will not require any flap on the cornea. This will reduce the chances due to flaps in LASIK.
Conclusion
SMILE and LASIK are both superb treatments for correcting the vision, but it approaches and recuperates otherwise. Results of the long-term success in LASIK procedures speak for themselves: the results are fast, and LASIK procedures have become common. However, SMILE brings to the at-risk patient, who is experiencing complications because of dry eyes or higher prescriptions, a less invasive alternative. It solely depends on a consultative discussion with an experienced ophthalmologist what procedure will best fit the need of the patient.
