Is ReLEx SMILE better than LASEK?

I think the short answer for that is that there are many patients for whom LASEK and ReLEx SMILE are equally effective. But there are groups of patients for whom ReLEx SMILE is particularly useful.

Suitability of SMILE vs LASEK

These are patients who may not even be suitable for LASEK. For example, patients with high prescriptions, patients with a dry eye, patients who may be susceptible to ocular trauma, such as people playing contact sports or people in the military.

Now, the reasons SMILE may be better in those patients is that the dry eye induced by laser eye surgery relates to the vertical element of the laser, and with SMILE, of course, that’s a keyhole incision, just 2mm in size.

Some patients with thin corneas are not suitable for LASEK, but because ReLEx SMILE doesn’t affect the anterior portion of the cornea, which is the strongest bit of the cornea, then they may still be suitable for ReLEx SMILE. And what’s interesting, is that I used to perform lots of surface laser treatment in that group of patients who weren’t suitable for LASEK.

I’ve now switched to performing SMILE on those patients. And, the huge advantage of SMILE over a surface treatment is the eye is much more comfortable after SMILE surgery, and the recovery is quicker than with LASEK. Conversely, if patients have high astigmatism or are undergoing presbyopic laser eye surgery, then LASEK may be a more suitable procedure than SMILE.

So, I think that as with other forms of surgery, such as refractive lens surgery, we can only tell what solution would be best for you when we’ve had the opportunity to talk to you, examine your eyes, check your spectacle prescription, look at all the investigations and diagnostic tests we do.

And only then are we in a position to identify whether LASEK or SMILE would be the best procedure for you.

More about Robert Morris

Rob Morris is a Consultant Ophthalmic Surgeon at The Grange Eye Consultants. His special expertise is in cataract and refractive surgery, including Refractive Lens Exchange, and adult squint. He has over 30 years of experience in treating people with eye problems. Rob Morris founded Grange Eye Consultants to manage the increasing demand for more complex refractive surgery. He leads clinical trials investigating novel eye treatments. He is currently Medical Director at Optegra Eye Hospitals.