LASIK vs Smile

LASIK vs SMILE: What Are The Differences?

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If you have ever looked at having laser eye surgery done, you’ll no doubt have been introduced to a new world of terms and abbreviations, but what exactly do they mean?

When it comes to refractive surgery, there are several choices and we’re going to take a look at the difference between LASIK and SMILE so you can make an informed choice on which is the best option for you.

What Is LASIK?

Laser-assisted in situ keratomileusis, or LASIK for short is the most common type of refractive surgery.

LASIK is carried out using 2 lasers. The first, a femtosecond laser, used to gently open up a small flap in the cornea while the second, and excimer laser, is used to reshape the cornea itself.

Although this sounds complicated, laser eye surgeons are extremely experienced in this procedure, and is the most common procedure they will do each year with thousands of people choosing LASIK to correct their vision.

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What Is SMILE Laser Eye Surgery?

Small incision lenticule extraction, or SMILE for short, is a fairly new option for vision correction and involves reshaping the cornea through a small keyhole incision.

SMILE surgery is a quick and pain-free process with quick recovery times meaning you can get back to doing normal activities within a few days.

You’ll be given numbing eye drops before the procedure is started, this will help reduce any discomfort and reduce the urge to blink. The surgeon will then make small incisions and remove a layer of tissue which allows the corneal tissue to be reshaped.

LASIK vs SMILE: What Are The Differences?

So now that we’ve figured out what the LASIK and SMILE options are, it’s now time to discuss what the differences are and give you enough information to be able to choose which one is right for you. Of course, you should use this as a guide only and contact your laser eye surgeon for more detailed information.

The Surgical Approach

LASIK eye surgery involves creating a flap in the cornea using a femtosecond laser, then reshaping the underlying corneal tissue with an excimer laser. This refractive surgery is a more invasive procedure but is over quickly.

Although this process sounds uncomfortable and complex, the reality is very different. The excimer laser is a clever piece of technology that is programmed to do exactly what is needed to correct your refractive errors. The whole process takes only a minute per eye, and there is no need for stitches as the corneal tissue will flap back into place and heal without any interventions.

SMILE involves creating a small incision in the cornea and removing a tiny, lens-shaped piece of tissue from within the cornea to change its shape. It’s often referred to as keyhole laser eye surgery and is a minimally invasive procedure than LASIK.

Tissue Removal

During the LASIK procedure, the corneal flap is lifted to expose the underlying tissue, which is then reshaped with an excimer laser.

During SMILE surgery, the cornea is not lifted, but rather a small piece of tissue is removed from within the cornea to reshape it through a series of small incisions around the iris. This is useful as it prevents dry eye symptoms post-procedure which is often a hindrance with LASIK surgery.

Recovery Time

Studies suggest that LASIK patients typically experience a shorter recovery time than SMILE patients.

With LASIK, patients may experience a temporary disruption of the vision immediately after the procedure, but vision typically improves rapidly over the first few days, and often people can go back to work within 24-48 hours and return to other activities such as swimming and contact sports after 1-2 weeks.

With SMILE, vision may take longer to stabilize, and some patients may experience blurry vision or other visual disturbances for several weeks after the procedure. Clinical trials have shown that those who have undergone SMILE surgery are more likely to require visual enhancement surgery than those who had LASIK surgery.


In general terms, laser eye surgery is suitable for people over the age of 18, have a stable prescription for around 2 years and have no underlying conditions such as diabetic retinopathy which requires specific treatment.

LASIK eye surgery is suited for those looking to correct a refractive error such as myopia (short-sightedness), hyperopia (far-sightedness), and astigmatism.

SMILE is more limited to the type of patient it can assist. Typically, SMILE laser eye surgery is best for people who want to correct their short-sightedness, and in some instances, astigmatism can also be corrected using SMILE.

However, SMILE eye surgery cannot correct short-sightedness, and instead would need more advanced LASIK surgery to correct this refractive error.


SMILE laser eye surgery is not as common as LASIK which means it is not as widely available as of yet, and therefore is a more expensive option for vision correction.

Putting a definitive price on laser eye surgery is difficult, as the cost depends on the location and surgeon carrying out the procedure.

However, typically, LASIK surgery costs anywhere from £1000-£3000 per eye. Whereas SMILE will cost around £2500-£3300 per eye.

Make an Informed Choice

This article should be used as a guide only. We want to make sure you make the right decision for your needs.

It’s important to do your own research, look at the studies and speak to your laser eye surgery team for expert advice and guidance.


Is SMILE Better Than LASIK?

SMILE (small incision lenticule extraction) laser eye surgery is the new kid on the block for laser surgery, and therefore it’s difficult to find any data to suggest that SMILE is better than LASIK.

SMILE is limited in what it can treat, only offering corrections for advanced astigmatism and short-sightedness.

It’s always worth noting that although the procedure is completed only using a small incision, the recovery time has been shown to be longer, with people often having to take 2-3 days off work to recover in comparison to 24-48 hours with LASIK.

Is SMILE Eye Surgery Safer Than LASIK?

As SMILE eye surgery is only in its infancy, there is limited long-term data, so there is no evidence to suggest that SMILE is safer than LASIK. It appears that SMILE is a safe procedure and a full recovery is expected with a positive change in vision.

Here at Focus Clinic, we take pride in our 100% success rate for 20/20 vision. We know just how important it is to patients to have their vision corrected at the first time of asking.

Does SMILE Last As Long As LASIK?

Some studies show that a small number of patients who have SMILE can expect to require further vision correction at a later stage. It is expected that as the technology grows, this number will reduce.

LASIK on the other hand has very high success rates and is a permanent solution to vision correction. There are of course some complications at times, however, this can be treated quickly and permanently.

Is SMILE Cheaper Than LASIK?

At this time, SMILE is a more expensive option, due to the technology used. LASIK was once an expensive option that is now more affordable to many, and it could be expected that in the future, SMILE will become more advanced in its technology and more cost-effective.

Laser eye surgery here at Focus Clinic, is £4,400, in comparison to SMILE which could be anywhere up to £6600, LASIK is a permanent and cost-effective choice.

About the Author

Mr David Allamby is the founder and medical director of Focus Clinic - the leading provider of laser eye surgery in London. Focus’ commitment is to be the #1 clinic for vision outcome results with 100% of patients achieving 20/20 vision or even better. He is one of a limited number of UK surgeons who work in laser refractive surgery full-time.


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