What are the pros and cons: LASIK vs PRK/LASEK vs SMILE?

Laser Eye Surgery team member

So you’ve learned a little bit about Laser Eye Surgery and the incredible benefits it has to offer.

You’ve got to get a clear picture of how it works: by removing tissue in the cornea and therefore permanently changing your eye’s focusing power.

And after visiting various clinics and doing your research, you’ve discovered that despite the huge list of brand names of treatments — including UltraLASIK, Accu-wave LASIK, Custom LASIK, and Zyoptix — there are actually only three main treatment types, LASIK, PRK/LASEK, and SMILE. These three treatments are used to treat a wide range of refractive errors.

But the hard work isn’t over yet; you’re now faced with the task of figuring out which one is best for you and your prescription.

Wouldn’t it be great if someone could spell out the differences — free from all the jargon and the sales pitch — so that you could make a quick, stress-free, and well-informed decision?

Well, fear not because that’s exactly what we plan to do in this article.

Below you will find an overview of the pros and cons of PRK/LASEK, LASIK, and ReLEx SMILE surgery. If you need a quick refresher on how each treatment works, check out the videos at the beginning of each section.

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Better option for some: For reasons listed below (cons), PRK is not as common as it used to be. Some patients, however, benefit if they have co-existing eye issues that may be treated the same time as correcting the vision. E.g scars and loose surface epithelium. (ABMD)


Recovery Time: In PRK/LASEK, rather than creating a small flap to access the tissue underneath like in LASIK and SMILE, the entire outer layer of the cornea is rolled to one side. As it takes several days for the outer layer to repopulate the surface of the eye, the recovery period is the longest of the three.

Safety and Comfort: Although the treatment is pain-free, some LASEK patients may experience minor discomfort or irritation in the seven days after surgery. This is an expected part of the healing process, and thus some clinics will provide pain relief eye drops.



Recovery Time: As the surgeon makes a small flap in the outer layer of the cornea, it’s only the edges of the flap that need to heal. Therefore LASIK patients spend less time in recovery, often returning to their normal routines within a day or two.

Safety and Comfort: Less disruption of the cornea allows LASIK to be performed in a shorter amount of time and with less post-operative discomfort.


Treatment Options: As the world’s most popular Laser Eye Surgery treatment, the marketplace for LASIK is swamped with offers, deals, variations, and added extras. This can make it difficult to know what you’re getting and to make the right decision. Choose a clinic with transparent and upfront fees, and be prepared with the questions you need to ask the surgeon.

Safety and Comfort: Patients may experience some irritation and discomfort for up to 24 hours after surgery. This is minor and is generally managed with lubricating eye drops.



Treatment and Recovery Time: As the latest of the three treatments, SMILE transforms Laser Eye Surgery into a minimally invasive procedure that can be performed in a matter of minutes. With the tissue being accessed and removed via tiny connecting tunnels in the outer cornea, no significant healing needs to take place. Add this to the short treatment time, and you have an incredibly swift recovery.

Safety and Comfort: SMILE also takes Laser Eye Surgery to another level of patient comfort. SMILE offers approximately half the amount and duration of dry eye over the recovery period. It also retains strength in the cornea as the flap is replaced by a cap.

Suitability: Due to their being less surgical manipulation of the eye, many patients who are told they are unsuitable for other treatments are surprised to discover they are candidates for SMILE.


Availability: At the moment ReLEx SMILE is only available for myopia and astigmatism. The treatment of hyperopia has been developed and is to be released in the near future.

The parting message is that the old-timer — PRK/LASEK — has largely been made redundant but may still be an option if you’re unsuitable for newer surgeries. LASIK retains the title of most popular and sought after treatment, yet this is changing in favour of the safer and more effective SMILE procedure.

If you would like to book a consultation at London Vision Clinic or find out more about our treatment options, leave us a comment or give us a call us on 020 7224 1005.

Dr Tim Archer
Dr Tim Archer

Dr Timothy Archer graduated from Oxford and Cambridge Universities with an undergraduate degree in Mathematics and a postgraduate degree in Computer Science. He joined the clinic in 2003, where he established his career specialising in laser refractive surgery research alongside Professor Reinstein. Today, he manages the in-house research team, of which achievements include 124 peer-reviewed papers, 32 book chapters, over 100 scientific articles and a published textbook. He also oversees and edits the content on London Vision Clinic’s website.

What are the pros and cons: LASIK vs PRK/LASEK vs SMILE? [VIDEO]

  1. Trevor van Minnen 31/05/2019 at 14:24

    Hi How much would SMILE cost. My prescription is SPH -2.75 CYL -1.00 AXIS 165.0 and SPH -3.00 CYL – 0.75 AXIS 20.0

    • Chloe Lay 03/06/2019 at 14:02

      Hi Trevor,

      We need to know more about your eyes before we can determine which fee bracket you fall within. Our fees are the same regardless of the procedure, but do depend on the complexity of your prescription. If you would like to know more you can call us on 020 7224 1005.

      Kind Regards,
      London Vision Clinic

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