PRK Vs LASIK Vs SMILE Vs SMILE Pro

Are you squinting at this text through glasses or fussing with contact lenses? 

If you’re on the hunt for a permanent solution to correct your vision, you’ve likely heard about PRK, LASIK, SMILE, and the newer SMILE Pro. These are four highly talked-about vision correction procedures, each touting its own benefits and advancements in the realm of ophthalmology. 

But what exactly sets them apart? How can you determine which option suits you best?

This blog post aims to shine a light on each procedure, helping glasses wearers, contact lens users, and general vision correction seekers make an informed decision about their eye health and lifestyle.

 

PRK LASIK SMILE SMILE Pro
Type Ablation (surface), Flapless Flap-based Flapless Flapless
Suitable for Most prescriptions, thin corneas Thick corneas, most prescriptions Myopia, Astigmatism (limited range) Myopia, Astigmatism (limited range)
Procedure Steps Epithelial removal, laser ablation, healing Flap creation, laser ablation, flap repositioning Lenticule creation, small incision, lenticule removal Lenticule creation, small incision, lenticule removal
Recovery Time Longest (weeks to months) Faster (days to a week) Faster (days) Fastest (1 day)
Discomfort More discomfort post-surgery Moderate discomfort Moderate to medium discomfort Minimal to no discomfort
Flap Creation No Yes No No
Flap-Related Complications None Potential None None
Long-Term Results Strong track record Excellent success rates Promising initial studies Promising initial studies

 

PRK: Photorefractive Keratectomy

PRK pioneered laser eye surgery for vision correction and serves as the precursor to the widely recognized LASIK procedure. It is still widely used today to correct issues like nearsightedness, farsightedness, and astigmatism.

Here’s a detailed overview of the PRK procedure:

  • Anaesthesia: Your ophthalmologist will administer local anaesthesia using eye drops to ensure your comfort.
  • Epithelial Removal: Using either a laser or a blade, the surgeon carefully eliminates the epithelium, the outermost layer of your cornea.
  • Laser Ablation: An excimer laser precisely reshapes the underlying corneal stroma to correct any refractive errors present.
  • Healing: Following the procedure, a protective contact lens is placed on your eye to support the healing process of the epithelial layer. 

Pros of PRK:

  • It’s suitable for people with thin corneas who may not be candidates for LASIK.
  • There’s no risk of flap complications during surgery—since no flap is created.
  • Long-term results have a strong track record of success.

Cons of PRK:

  • Longer recovery time than LASIK, SMILE, or SMILE Pro as the epithelium regenerates, often taking a few weeks to a month to achieve the final corrected vision.
  • More discomfort post-surgery due to the removed corneal surface layer.

 

LASIK: Laser-Assisted In Situ Keratomileusis

LASIK is probably the most renowned vision correction surgery. It combines two types of lasers for a two-step process.

Here’s how LASIK differs from PRK:

  • Flap Creation: Using a femtosecond laser or a microkeratome, a thin flap is generated in the corneal tissue.
  • Laser Ablation: Similar to PRK, the excimer laser reshapes the underlying corneal stroma after the flap is created.
  • Flap Repositioning: The surgeon delicately repositions the corneal flap, allowing it to naturally adhere to the underlying stroma without the need for stitches.

Pros of LASIK:

  • Quick recovery time—many patients report improved vision within a few days to a week after surgery.
  • Moderate discomfort during and after the procedure.
  • Many patients achieve a 20/20 vision with high success rates.

Cons of LASIK:

  • Not suitable for people with thin corneas or certain corneal irregularities.
  • There is a slight chance of complications with the flap.
  • Discomfort is typically moderate. 

 

SMILE: Small Incision Lenticule Extraction

SMILE was introduced in 2016 and represents a less invasive approach. It aims to alter the game for myopic patients.

Here’s an overview of SMILE:

  • Femtosecond Laser: A single femtosecond laser forms a lenticule, a tiny, contact-lens-shaped layer, within the stroma.
  • Small Incision: The laser also makes a small, keyhole-sized incision in the cornea.
  • Lenticule Extraction: The surgeon utilizes specialized tools to extract the lenticule through a small incision, reshaping the cornea without requiring surface ablation or the formation of a corneal flap.
  • Self-Sealing Incision: The small incision typically heals independently.

Pros of SMILE:

  • It’s minimally invasive with a smaller corneal incision, resulting in less corneal weakening and less dry eye postoperatively.
  • Quick recovery, quicker than LASIK, with most patients able to return to normal activities within a couple of days.
  • It may be suitable for patients who were previously ineligible for LASIK.
  • No flap is created, negating related complications.
  • Discomfort is often medium to moderate.
  • Sturdy post-surgery corneal structure, ideal for people with active lifestyles.

Cons of SMILE:

  • Currently, it can only correct nearsightedness (myopia) and astigmatism, not farsightedness. 
  • It’s a newer procedure, so long-term results are not as extensively studied as PRK and LASIK, but initial studies suggest promising results.

 

SMILE Pro: Small Incision Lenticule Extraction

SMILE Pro is the newest of the four surgeries and advances the SMILE technique, touting even greater precision and potential benefits.

Though the SMILE Pro’s procedure bears many similarities to the standard SMILE, it incorporates refinements in technology with the introduction of the fully robotic AI-based Visumax 800 laser and technique which may provide an even smoother recovery and more accurate outcomes. It generally emphasizes improved laser equipment and refined surgical methods with faster laser treatment in just 9 seconds per eye.

Pros of SMILE Pro:

  • Enhanced precision and potentially better vision outcomes.
  • Retains the benefits of standard SMILE, including quick recovery (1-day visual recovery) and reduced dry eye symptoms.
  • Potential to address a broader range of vision corrections as technology moves forward.
  • Discomfort is often minimal to none.

Cons of SMILE Pro:

  • Newer on the scene, meaning less historical data compared to other procedures.
  • May not be as widely available as other methods.
  • Currently, it can only correct nearsightedness and astigmatism, not farsightedness. 

 

Making Your Decision

When deciding between PRK, LASIK, SMILE, and SMILE Pro, various considerations are involved, such as:

  • Corneal thickness and shape
  • Type and severity of refractive error
  • Physical demands of preferred activities
  • Desired recovery timeframe
  • Lifestyle and profession
  • Risk factors for dry eye development

Each procedure has its sets of pros and cons along with varying recovery periods and potential risks. 

 

Consult with a Specialist

This guide serves as a starting point for grasping these procedures, yet seeking advice from an eye care specialist is crucial. They will perform a thorough examination, assessing your corneal thickness, vision stability, and overall eye health. By discussing your goals and addressing any worries, they will help determine the most suitable procedure for you. Make sure to disclose any existing eye conditions, previous surgeries, and medications you’re taking.

Additionally, ensuring that the surgeon you choose is experienced in the specific procedure you’re considering is critical for achieving the best results.

 

Looking Ahead

Wave goodbye to the haze of uncertainty and step into a clearer future by educating yourself on these vision-correcting options. Whether you go for the time-tested reliability of PRK, the renownedness of LASIK, the cutting-edge precision of SMILE, or the next evolution in less invasiveness SMILE Pro, you’re investing in one of life’s most priceless assets – your sight. Added value to your life begins with the informed choice that caters best to your eyes’ unique needs.

In the quest for visual freedom, knowledge is your ally. Understand your options, consult with specialists, and choose your path to visual clarity with confidence. 

Your world awaits to be seen in all its splendour, and the decision you make today is the first step towards a brighter, sharper reality.

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