12 Mar Which laser eye surgery: SMILE, LASIK or PRK?
Are you looking into getting laser eye surgery? You would have by now come across lots of names and acronyms like SMILE, PRK and LASIK…. But what does it all mean? And what kind of laser eye surgery is right for you? Here, we talk through the basics of each type of laser eye surgery to help explain what kind of surgery suits what kind of eye condition and explain the differences of each.
Let’s start by listing the most common eye surgery procedures:
Flap procedures:
Surface procedures:
Flap procedures: SMILE, LASIK and All-laser LASIK
Smile and LASIK eye surgery involves cutting of a corneal flap which is why they are called ‘flap procedures’.
SMILE
SMILE… sounds friendly doesn’t it? Its long form name is ‘Small Incision Lenticular Extraction’.
Who should get it?
This type of surgery works best for people with more advanced myopia (short-sightedness) rather than for minor vision corrections
How does it work?
A femtosecond laser cuts a small lens-shaped disc of tissue within the cornea, which your ophthalmologist carefully pulls out from the cornea through a small incision, and so changes the shape of the cornea. Because there is no flap, and no removal of the surface of the cornea, it is considered less invasive than LASIK or PRK.
SMILE is just as safe and accurate than LASIK but is the procedure is almost a decade now and most refractive surgeons have moved on to newest procedures such as All-Laser LASIK and SmartSurface Trans PRK.
Learn more on procedures we offer
All-Laser LASIK
LASIK is short for ‘Laser In Situ Keratomileusis’ and is the most common type of laser eye surgery.
Who should get it?
This type of laser eye surgery is perfect for people who are nearsighted, farsighted, or have astigmatism.
How does it work?
All- laser LASIK is a 2-step procedure which uses two different lasers. Firstly, the ophthalmologist will use the femtosecond laser to create a flap in the top layer of the cornea. The Excimer laser is then used to precisely reshape the patient’s corneal tissue (the tissue underneath your cornea) so it can focus light properly. Your ophthalmologist may also use a type of computer imaging called wavefront technology to create a detailed image of your cornea that they can use as a guide.
Learn more on All-laser Lasik surgery
Traditional LASIK
Traditional LASIK is named in comparison with the newer form of All-Laser LASIK
Who should get it?
Like with All-Laser LASIK, this type of laser eye surgery is perfect for people who are nearsighted, farsighted, or have astigmatism.
How does it work?
Similar to the All-Laser LASIK, Traditional LASIK is also a two-step procedure, but instead of using a femtosecond laser to create the flap in the top layer of the cornea, a high-precision, oscillating blade called a microkeratome is used to create the flap instead. This method is the older of the two LASIK methods, having been used for over 20 years.
Learn more on traditional Lasik surgery
Surface procedures: PRK, Trans PRK and SmartSurface Trans PRK
Unlike LASIK surgeries which are considered ‘flap procedures’, ‘surface procedures’ such as PRK and SmartSurface don’t involve the cutting of the cornea and are blade-free.
PRK
PRK, otherwise known as ‘Photorefractive Keratectomy’.
If you suffer from mild to moderate near-sightedness, farsightedness, or astigmatism this type of surgery would be perfect for you.
How does it work?
PRK is a form of laser refractive surgery in which the shape of the cornea is altered using an Excimer laser. The laser correction is done on the surface of the cornea rather than under a flap as performed in LASIK. PRK is often used instead of LASIK if someone’s cornea is too thin, if there are problems or scarring on the surface of the cornea, or for those doing serious contact sports.
The result is just as good as LASIK but the post-op recovery is slower and more time off work is needed.
Learn more on procedures we offer
Trans PRK
Trans PRK laser eye surgery is perfect to correct refractive errors such as nearsightedness, farsightedness, or astigmatism.
How does it work?
Just like PRK surgery, Trans PRK is a non-invasive single-step refractive surgery procedure that doesn’t involve creating a corneal flap. In just a single step, the outer layer of the cornea called the epithelium is gently and evenly removed through vaporization (a process known as surface ablation) and the corrective treatment is performed. During the Trans PRK procedure, the refractive surgeon uses only an Excimer laser without the additional femtosecond laser used to create a flap as in the case of LASIK procedures.
Learn more on procedures we offer
SmartSurface Trans PRK
SmartSurface PRK laser eye surgery is ideal to correct refractive errors such as nearsightedness, farsightedness, or astigmatism. A SmartSurface procedure is usually recommended for people with irregular or very thin cornea, who might not eligible for LASIK eye surgery. This procedure is also an excellent choice for athletes or people with active lifestyles as it enables them to enjoy significantly improved vision right after the laser treatment.
How does it work?
SmartSurface Trans PRK is a gentle surgical procedure which uses the Excimer laser and the SmartPulse technology for optimal pulse distribution. SmartPulse has been clinically proven to improve the patient’s vision immediately after the laser treatment and thus quickly and effectively eliminate the need for eye glasses or contact lenses. The result of using this technology in conjunction with Trans PRK is a smoother surface of the cornea following laser reshaping, thus providing the patient with excellent vision right after treatment.
Like other laser eye surgery procedures, SmartSurface Trans PRK works by permanently changing the cornea’s shape so that light rays are clearly focused on the retina. One of the main differences difference between SmartSurface TransPRK and other procedures such as LASIK and PRK is that SmartSurface TransPRK allows for the shortest operating time of all laser eye surgery procedures, improves the patient’s visual acuity immediately after treatment and ensures much faster healing of the top layer of the cornea.
Learn more on SmartSurfACE™ surgery
Now that you know the basics of each type of surgery, the next step is to meet with your laser eye surgery specialist to talk through what option would be best for you! Contact us to make an appointment today.
Sources:
- Better Health.gov (Victoria) – Eyes – laser eye surgery
- AOO.org – Creating LASIK Flaps: Femtosecond Laser vs. Mechanical Microkeratome
- Ophthalmology Times.com – Pulse technology boosts all-laser PRK for one-step, no-touch ablation
This article is not a substitute for a consultation with your surgeon. Before choosing to proceed with laser eye surgery your surgeon will have a detailed discussion with you about the right procedure and about the potential complications.
A unique mix of expertise, experience and international reputation, Dr Ron Binetter is the figure behind the Binetter Eye Centre. With more than two decades of hands-on experience in eye surgery, Dr Binetter is a specialist in cataract, lens implantation and laser eye surgery. Learn more about Dr Ron Binetter’s background and qualifications.