SMILE vs LASIK vs Surface Ablation

For centuries, the go-to resolution for refractory conditions has been glasses, followed later on by contact lenses. While these options were both revolutionary in their time – and continue to offer significant results for millions – there is a new kid in town.

The inception of Laser Eye Surgery four decades ago introduced a new era of elective procedures and promised to reduce our dependence on easily-lost glasses, and inconvenient contacts. But, the increasing availability of LES has presented us with another problem: Knowing which procedure is right for you.

Well, the good news is there is plenty of information out there (and right here) to put your mind at ease. Our expert surgeons have the knowledge to recommend the right procedure for each individual patient. It is important to remember that every patient is different, and no two eyes are the same. This means that all patients will require a full consultation before a decision can be made regarding eligibility for Laser Eye Surgery and which treatment option is best.

But first, let’s take a deep dive into the three most common Laser Eye Surgery treatments available.


Also referred to as ReLEx SMILE or Small Incision Lenticule Extraction, this is the newest method of Laser Eye Surgery. It is been available at clinics in the UK since 2011 and it is largely credited with revolutionising the industry, thanks to its minimally invasive, keyhole procedure.

Unlike other procedures, SMILE does not require the removal of the corneal epithelium (the lens layer of your eye). Instead, surgeons are able to create a tiny hole using the state-of-the-art VisuMax laser. They are then able to draw tissue through this hole to reshape the corneal bed.

The full procedure can, in many cases, be carried out in less than four minutes. SMILE laser treatment has helped to improve the vision of millions of patients and is now available at more than 700 locations across the globe.


  • Little/no sensation during surgery
  • Near-complete tissue recovery in less than 24 hours
  • Minimal eye dryness and irritation during the healing process


  • SMILE is not yet available to patients with long-sightedness
  • It is currently only offered by select Laser Eye Surgery clinics in the UK


Despite the benefits of the SMILE procedure, LASIK remains the most popular method of vision correction offered around the world. More than 15 million people are now enjoying improved vision, thanks to this procedure, which has been available since the late 1980s. It is arguable the most reliable, effective, and widely proven method of vision correction.

LASIK, also called Laser-Assisted In-Situ Keratomileusis, involves the creation of a small circular flap in the outer layer of the cornea to allow access to underlying tissue. A laser is then used to reshape the corneal bed and correct the prescription of the patient.

This procedure can be used to treat a wide range of refractory errors, including short-sightedness, long-sightedness, and astigmatism. Exposure to the laser usually only lasts around 30 seconds per eye, and the full procedure for both eyes can be completed in less than 15 minutes.


  • Fixes a wide range of refractive errors
  • Decades of success
  • Widely available


  • Symptoms of dry eye may last longer than after SMILE, usually about 6 months
  • Although extremely rare, the flap might be displaced if there is trauma to the eye, so LASIK may not be recommended for patients practising contact sports.

Surface Ablation

Surface ablation is the oldest method of Laser Eye Surgery. It was developed in the early 1980s and, over the last four decades, has improved the vision of millions of people around the globe. Today, however, surface ablation procedures account for only around 10% of Laser Eye Surgeries – and less than 1% of procedures at London Vision Clinic.

There are a number of different forms of this method – PRK and LASEK being the most popular; however, these are all essentially the same procedure. In a surface ablation procedure, an area of the epithelium (surface skin) is completely removed to allow the tissue underneath to be treated. The skin is then replaced and a soft contact lens is applied to promote healing.

The main difference between different methods of surface ablation is the way in which the epithelium is removed. Studies have shown, however, that there is virtually no difference in the results achieved by any of these techniques.

Nowadays, surface ablation procedures are usually reserved for patients who are not eligible for other treatment methods. This may be due to extreme short-sightedness, thin corneas, or corneal dystrophy. While discomfort during the procedure is minimal, patients may experience some eye tenderness or irritation during the recovery period; this may be up to a week following the procedure. Due to the longer healing time required for surface ablation, vision may also remain blurry for up to a few weeks.


  • Option for patients with irregular corneas or corneal dystrophies
  • Is widely successful and available in most clinics


  • 1-3 week recovery period
  • May experience discomfort during recovery

Laser Eye Surgery can be complicated, but that doesn’t mean it should be difficult. At London Vision Clinic, our highly-trained team of optometrists, along with your surgeon, will guide you through the process and accurately determine which treatment is right for you.

If you would like to know more about your options, get in touch with one of our friendly clinic coordinators or book a consultation today and take a step closer to clearer, glasses-free vision.

Laser Eye Treatment Fees start from £5,900 for both eyes. Very complex treatments may cost more.

Interest-FREE finance available over THREE years, from £82 per month for both eyes, makes the best more flexible. Find out more.