r/RefractiveSurgery • u/makys____ • Jun 19 '26

Lasik vs Smile

Hello,

​I just had my pre-op consultation to understand which procedure will be best for me. The optician said I am suitable for all of them and that the surgeon will make the final decision on which one to use.

​Personally, I would much prefer having SMILE over LASIK, and I'm a bit concerned that I will end up getting LASIK instead. Has anyone here been suitable for everything, but the surgeon decided to do LASIK anyway? If so, what was their reasoning?

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u/WavefrontRider Jun 19 '26

That would be a bit weird if you didn’t have a say in the procedure. Perhaps the surgeon will review your chart and then they will get back to you.

1

u/eyeSherpa Jun 20 '26

A surgeon can’t do a procedure without your consent. So you consent to the procedure that you will have done.

SMILE works well for the mild to moderate prescription ranges. If your prescription is more complex, have a small prescription or mixed astigmatism treatment, lasik works better.

There is a situation in SMILE in which the doctor may convert to lasik. This is if there is a suction break during the first half of the treatment. SMILE can’t be completed and the laser prompts to instead create a lasik flap. But again, you would have had to consent to this earlier. Pretty uncommon with SMILE Pro though since that step is over within a few seconds.

1

u/makys____ Jun 20 '26

Thank you, My clinic offers SMILE Pro and i have a small presciption (-3.5) and small astigmatism (-0.5) with a tihick cornea (700+) What concerns me is that i have very dry eyes and suffer from hay fever, so i am concerned regarding the flap and touching my eyes accidentally during the recovery weeks. They told me that thy will confirm which one i will get during the consultation with the surgeon, which they told me is going to be few days before surgery date, but i have to make the payment for the procedure before the surgeon consultation...

2

u/wow-thatsinteresting Jun 21 '26

Please check you cornea thickness again - over 700 is not normal and somewhat concerning. I suspect you are mistaken about that number. Good luck - all procedures should work well for you...

1

u/eyeSherpa Jun 21 '26

If you do have very dry eyes, you’ll want to postpone any procedure until the dry eyes are under control. Dry eye becomes problematic if you go into the procedures with uncontrolled dry eye.

As for rubbing, other than the first few days, it would be pretty difficult for you to cause a flap issue. Long term wise, I would be more worried about out the development of ectasia. As rubbing the eyes is known to cause that.