LASIK vs. SMILE Eye Surgery – What’s the Difference?

Since its inception as a vision correction procedure more the 25 years ago, millions of LASIK surgeries have been performed with a success rate of 99 percent. As technology in laser eye surgery has advanced, new procedures, such as SMILE laser surgery, are starting to become more popular options. Depending on your situation, you may be a better fit for one procedure over another.

What are the benefits of LASIK?

LASIK eye surgery is the most commonly performed laser refractive surgery with individuals suffering from nearsightedness, farsightedness, and astigmatism. During this surgery, the corneal flap is replaced with a laser incision. Patients who undergo LASIK eye surgery have a quicker recovery and are typically able to resume normal activity within 24 hours. If your cornea is too thin, you may need to have more than one visit or consider a different procedure, such as SMILE. You can take our LASIK Self Test to see if you are a good candidate for this procedure.

What are the Benefits of SMILE?

Dr. Mattioli is the leading provider of SMILE in Houston, and as a partner of IQ Laser Vision, we are the leading provider of SMILE in the United States. Overall, SMILE tends to be a better procedure for individuals with nearsightedness and astigmatism. Its popularity is due to greater visual acuity, and it can be completed in one step. SMILE is less invasive than LASIK because there is no need for a corneal flap, so the incision will be smaller. For now, individuals with farsightedness are not good candidates for SMILE, but the good news is nearly 40 percent of the population in the United States suffers from nearsightedness. You can take our SMILE Self Test to see if you are a good candidate for this procedure.

With medical advancements occurring every day, it can be difficult to keep up with the latest procedures. In the case of vision correction, now entering its third generation of procedures, there are several options to consider. For many years now, LASIK surgery has been the go-to way to free yourself from glasses, but a new procedure has taken center stage: SMILE laser eye surgery. So, which procedure is best for you? In this month’s blog, we’ll be discussing the differences and benefits of both to see which would be a benefit to you. LASIK vs. SMILE. Who will win? Let’s find out.

What is SMILE Eye Surgery?

First, let’s break down what SMILE eye surgery is. SMILE, short for Small Incision Lenticule Extraction, uses advanced technology developed by Carl Zeiss Meditec, Inc. to reshape your cornea much like LASIK but does so with a much smaller incision. SMILE uses a femtosecond laser to sculpt a tiny, lens-shaped tissue in the eye and makes a microscopic incision on the cornea surface. The surgeon then removes the tissue, also known as a lenticule, through the incision and the cornea is altered, correcting nearsightedness as a result. With the lenticule removed, the patient will heal naturally and recover within one to two days. The procedure is quick, painless, and is trusted by ophthalmologists worldwide. In terms of technology, it’s the third generation of refractive surgery, proceeding LASIK eye surgery. This is because it’s essentially a one-step laser procedure and provides stunning results with less invasive surgery. So, now that we have an introductory understanding of what SMILE is, let’s see how it compares to LASIK and PRK.



Compared to LASIK, SMILE yields a greater visual acuity on average, but perhaps the biggest difference is that it is a one-step procedure. During the procedure, an excimer laser is not needed since the operation only requires a femtosecond laser for the entire procedure. SMILE is also much less invasive compared to LASIK or PRK. A corneal flap is not required, allowing the patient to achieve clearer vision with a smaller incision. Creating a flap can strain corneal nerves, temporarily causing a lower quality of vision in some cases.


SMILE outranks LASIK in every single way except that the procedure can only be used for nearsighted individuals. As of now, the procedure is not available for those with farsightedness or astigmatism. However, nearly 40 percent of the United States population has myopia or nearsightedness and that number is growing. Additionally, the visual recovery time of SMILE is slightly longer than LASIK’s. LASIK patients can begin to see a difference almost immediately after the procedure while SMILE requires about one to two days to take effect.


For many years, the LASIK procedure has been the most common way to correct your vision. It can successfully treat nearsightedness, farsightedness, and astigmatism. During the procedure, a tiny flap of corneal tissue is created with a laser, allowing the same laser to reshape your cornea. Once the corneal flap is replaced, the patient can almost immediately begin to see clearer. Visual recovery time is quick, too. Most patients can drive and return to their jobs the very next day. It’s no wonder this has become the most practiced vision correction procedure.


For those with thin corneal thickness, LASIK is not a good option since the procedure requires a flap to be made from the tissue. In fact, a certain degree of thickness is needed for the surgery to happen. People with irregularly shaped cornea may also be referred to a different procedure like SMILE. In addition, those suffering from dry eye symptoms are at risk of experiencing chronic dry eye after the procedure.

Which Laser Eye Surgery is Better?

That really depends on your situation, your desired goals, and what the results of a comprehensive eye exam from Dr. Mattioli and his team will provide. When you schedule a consultation with the dedicated team at Mattioli Vision Professionals in the Greater Houston area, Dr. Mattioli will go over all your laser surgery options with you in great detail and decide which procedure is a better fit for you. Whether it is SMILE, LASIK, or any other procedures, such as cataracts or implants, we will find the best solution for your vision correction.

Find the Best Option for You

So, who do you think won in LASIK vs SMILE? Are you considering PRK? These are questions best answered after receiving an in-depth consultation from an ophthalmologist, but there are a few factors to consider. If you are nearsighted, SMILE might be the best choice due to its minimally invasive technology. It’s also the most advanced procedure and may produce slightly better results. LASIK provides more flexibility since it treats nearsightedness, farsightedness, and astigmatism, but you may need another procedure if your corneal tissue is too thin. If this is the case, PRK may be your best option. Much like LASIK, it’s capable of treating all visual conditions but has a much longer recovery time. But again, only a comprehensive eye exam with an ophthalmologist can tell you which procedure would be most beneficial to you.

Where can I get more information on laser eye surgery in the Greater Houston area?

Board-certified by the American Board of Physician Specialties in Ophthalmology, Dr. Fred Mattioli has performed more than 60,000 eye procedures, including laser refractive treatments and cataract/implant procedures. Dr. Mattioli is the leading provider of SMILE in Houston, and as a partner of IQ Laser Vision, we are the leading provider of SMILE in the United States. If you have any questions on which laser eye surgery is right for you, schedule a consultation at Mattioli Vision Professionals today.