LASIK vs. SMILE/CLEAR: Which Laser Vision Correction Procedure Is Best?

For those seeking freedom from glasses and contact lenses, laser vision correction offers multiple options. Two of the most advanced procedures available today are LASIK and SMILE/CLEAR. While SMILE and CLEAR are essentially the same technique under different names, they differ from LASIK in key ways that may influence your choice. This article will provide a comprehensive lasik vs SMILE comparison, highlighting the key differences between these two surgeries to help you make an informed decision.

In this article, we’ll compare LASIK to SMILE/CLEAR, their benefits, and who they’re best suited for. Both LASIK and SMILE have been performed for over a decade, demonstrating a strong track record of safety and effectiveness.

Understanding the Procedures

Both LASIK and SMILE surgeries are designed to correct short sightedness (myopia) and improve vision, with visual outcomes that are generally comparable once healing is complete. When SMILE is compared to LASIK, key differences include a less invasive approach and potentially faster recovery time for SMILE, while LASIK offers broader suitability for different refractive errors.

LASIK (Laser-Assisted In Situ Keratomileusis)

LASIK is the most well-known laser eye surgery, using a femtosecond laser to create a thin flap on the cornea. The underlying tissue is then reshaped with an excimer laser to correct refractive errors before the flap is repositioned.

Pros:

• Quick recovery time (usually within 24 hours)

• Effective for a wide range of refractive errors (myopia, hyperopia, and astigmatism)

• Painless procedure

• Modern “topography guided” or “ray-tracing” techniques can offer exceptionally good outcomes

Cons:

• May cause temporary dry eyes

• Flap-related complications are very rare but possible

Best suited for:

• Those looking for a fast recovery

• Individuals without significant dry eye issues

Introduction to Laser Eye Surgery

Laser eye surgery, also known as laser vision correction, has revolutionized the way people address common vision issues like short sight, long sight, and astigmatism. By harnessing advanced technologies such as the femtosecond laser, these procedures offer a safe and effective alternative to glasses and contact lenses. Two of the most popular forms of refractive surgery are LASIK surgery and SMILE laser eye surgery, each designed to correct refractive errors and help patients achieve clearer vision.

Both LASIK and SMILE aim to improve visual acuity by reshaping the corneal tissue, but they do so in different ways. LASIK involves creating a thin corneal flap, which is then lifted so an excimer laser can reshape the underlying tissue. In contrast, SMILE—short for Small Incision Lenticule Extraction—uses a minimally invasive procedure to remove a tiny, lens-shaped piece of tissue through a small incision, without the need for a flap. This key difference means SMILE may offer potentially better biomechanical stability and a lower risk of flap complications compared to LASIK.

While both LASIK and SMILE are highly effective for vision correction, they each have unique advantages. LASIK is suitable for a broader range of refractive errors, including moderate refractive errors and myopic astigmatism, making it a versatile option for many patients. SMILE, on the other hand, is particularly appealing for those seeking a minimally invasive procedure with a small incision and potentially fewer complications related to the corneal flap.

Understanding the distinctions between these two procedures is essential for anyone considering laser eye surgery. By learning about the benefits and limitations of both LASIK and SMILE, you can make an informed decision that best matches your vision needs, lifestyle, and long-term eye health.

SMILE/CLEAR (Small Incision Lenticule Extraction)

SMILE and CLEAR are essentially the same procedure, involving the removal of a small, lens-shaped piece of corneal tissue (lenticule) through a keyhole incision. The SMILE procedure is a minimally invasive laser vision correction technique that reshapes the cornea and corrects vision without the need for a flap. SMILE surgery involves a smaller incision than LASIK, making it a less invasive procedure and resulting in less disruption to the corneal nerves.

Only qualified eye surgeons can perform SMILE. The healing process after SMILE is unique because the absence of a flap means the outer cornea remains largely intact, and the cornea acts as a natural bandage, supporting recovery. During the healing process, antibiotic eye drops are used to prevent infection. Corneal strength and corneal thickness are important factors in determining candidacy for SMILE, and healthy eyes are required for optimal outcomes. Blurry vision may occur temporarily during the initial visual recovery period.

Pros:

• Minimally invasive (no flap creation; smaller incision)

• Less risk of dry eye symptoms compared to LASIK due to less disruption of corneal nerves

• More biomechanical stability of the cornea

Cons:

• Limited ability to correct hyperopia (farsightedness) or astigmatism

• Visual recovery may be slower than LASIK, but most patients experience improvement over time

Best suited for:

• Patients with moderate to high myopia (-2.00 to -9.00 D)

• Individuals prone to dry eyes

• Athletes or those in contact sports (lower risk of flap displacement)

Which One Is Best for You? 

• Choose LASIK if you need quick recovery and have no major dry eye concerns.

• Choose SMILE/CLEAR if you want a flapless, minimally invasive procedure with reduced dry eye risk—unlike LASIK, SMILE does not require a corneal flap.

Both SMILE and LASIK are laser vision correction procedures designed to treat refractive error, including myopia, hyperopia, and astigmatism. Wavefront guided LASIK is an advanced option for those seeking highly customized correction based on detailed measurements of the eye. Recent studies published have compared the outcomes of these procedures, highlighting their safety and effectiveness.

The best way to determine the right option for you is through a consultation with an experienced eye doctor or ophthalmologist. Book an assessment today to explore the best vision correction solution tailored to your needs!