LASIK Surgery and SMILE- A Comparison - Dr. Kevin Niksarli May 2014

LASIK Surgery and SMILE- A Comparison - Dr. Kevin Niksarli
LASIK is an acronym for Laser in-situ keratomileusis (LASIK) and is one of the more popular forms of laser
refractive procedure to treat myopia. The main reasons of its popularity includes-

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Early postoperative perfection and stabilization of visual sharpness
Minimal postoperative patient uneasiness
Option of improvement in the future

The common side effects includes dry eyes, compromised vision in poor lighting conditions, visual
anomalies such as glare and haloes can still occur in up to 1% to 2% of cases. More serious complications
like inflammation, infection flap dislocation can also occur rarely.

LASIK eye surgery consists of two procedures which are completed using two different forms of Lasers.
Femtosecond lasers are used to create the corneal flap while the corneal ablation is executed using a
separate excimer laser. There are distinct advantages of using femotosecond or ‘bladeless’ LASIK over
microkeratome LASIK flaps. These include reduces incidence of postoperative dry-eye symptoms,
reduced likelihood of flap dislocation, and reduced incidence of buttonholes or free caps.

In recent times refractive lenticule extraction (ReLEx) has done away with the need for two different
forms of Lasers and a single laser refractive procedure without the use of an excimer laser is all that is
required.

Another recent development is SMILE or the Small incision lenticule extraction. The process does not
require any retractable flap. Advantages of SMILE include less surgical time, less inconvenience to the
patient and more accurate ablation.

Current research materials are inadequate to validate the effectiveness ReLEx or SMILE. ReLEx or SMILE
has already obtained CE Mark approval in 2009 but has not been approved by US FDA till date. However,
the clinical results of ReLEx or SMILE have been very promising and the results as comparable with LASIK
procedures with scarce complications. The refractive outcome of SMILE is in no way inferior to LASIK
process