SMILE vs Lasik Eye Surgery

What is SMILE?

The SMILE treatment is a form of refractive surgery that has recently been approved by the FDA and is still very new to Australia. Standing for SMall Incision Lenticule Extraction the SMILE treatments unique selling proposition is that it’s the first flapless procedure of its kind. Claiming that it provides a side incision that is 80% smaller than the flap created during LASIK surgery.

This laser refractive surgery is meant to be minimally invasive and involves removing a small layer of the corneal tissue (lenticule). This is different to iLASIK and PRK treatments offered by Perfect Vision which use a thermal laser to evaporate tissue, rather than extracting layers.

Currently, Perfect Vision do not perform the SMILE procedure. There are a number of reasons why we have chosen not to adopt the procedure, even though it has been approved in Australia. The primary grounds for this is that there simply hasn’t been enough testing of the SMILE procedure to convince us that it’s completely safe. SMILE eye surgery is relatively new, and therefore not enough data on its advantages or disadvantages have come to light yet. Perfect Vision does not currently feel that  implementing a procedure which  may have a higher risk of compromising   results for our patients is worthwhile, simply because it’s new and others are starting to adopt the procedure.

Difference between SMILE and iLASIK

Prescription range -2 to -10 +4 to -10
 Corneal extraction Yes No
Eyesight recovery 2-3 days Same day as procedure
Type of laser used Femtosecond laser Excimer and Femtosecond laser
Post-operative discomfort Rarely Rarely
Complications Rarely (relatively new) Rarely
Noise/odour during procedure No Yes
Flap No Yes


Another significant difference is the eye conditions that each of these procedures is capable of treating. The prescription range for SMILE is only -2 to -10. This means it is only capable of treating myopia and astigmatism (short-sightedness). SMILE also fails to treat any mild myopia conditions. Whereas, Perfect Vision’s iLASIK procedure can treat astigmatism, severe and mild myopia, as well as hyperopia (long-sightedness).


Another important point of difference between the two is the ability for retreatment. iLASIK offers retreatment for any residual prescriptions or regression in the future. If the SMILE treatment is unsuccessful then there is no SMILE retreatment option available, the layers of the cornea have already been removed. The next step after an unsuccessful SMILE treatment is usually a Photorefractive Keratectomy (PRK); which is an entirely different procedure with a much longer recovery time. Accompanying this possibility with the current learning curve practitioners are experiencing, the possibility of an unsuccessful treatment could be considered higher.

The cost of iLASIK is also cheaper than SMILE. Ultimately when it comes to SMILE vs iLASIK the iLASIK eye procedure has proven itself reliable, safe and more versatile.


Is SMILE right for me?

Deciding whether SMILE is the right option is completely up to you. Although as qualified professionals specialising in delivering refractive surgery treatment, including SMILE, it’s in our honest opinion that the small benefits don’t outweigh the risk of the relatively new treatment. As treatment continues and more data is collected, it’s entirely possible that this service will become available at Perfect Vision. It’s likely this won’t be for a number of years.

One of the main benefits that may attract you to the SMILE treatment seems to be for dry eye sufferers. The SMILE procedure claims to reduce the amount of postoperative dryness that occurs after refractive eye treatment. This doesn’t mean there isn’t any dryness, just that there is theoretically less dryness than iLASIK surgery. As the volume of SMILE increases, there is a realisation that there is actually very little benefit in this respect when it comes to SMILE over iLasik.

For now, the Perfect Vision team would rather continue to provide you with state-of-the-art iLASIK, the most reliable form of refractive eye surgery that is NASA approved. We have strong confidence in our technology that has provided us with a track record that is second to none.