LASIK vs LASEK vs SMILE — Which Vision Correction Is Right for You?

At a Glance — LASIK, LASEK & SMILE

How They Work — What Is Different

In LASIK, a thin flap is cut from the top of the cornea and lifted like a lid, the tissue underneath is reshaped with the laser, and the flap is put back. There is almost no surface wound, so recovery is fast, but because the flap remains, a strong blow could shift it.

In LASEK, the thin surface layer (epithelium) of the cornea is removed, the laser corrects the cornea right away, and a protective contact lens is placed while the epithelium grows back. With no flap it holds up well against impact, but for the few days the epithelium regenerates there is pain and glare, and vision takes longer to settle.

In SMILE, the laser creates a thin lens-shaped piece of tissue inside the cornea, which is then removed through a small incision of about 2–4 mm. There is less damage to the surface and nerves, so recovery is fast and dryness tends to be milder, but your prescription range and corneal condition have to be suitable.

Which Surgery Suits Me? — Checklist

You may lean toward LASIK or SMILE if

• You have a short vacation and a quick return to daily life matters
• You have been told your cornea is thick enough
• You are worried about pain and want the shortest recovery

You may lean toward LASEK if

• You have been told your cornea is thin and a flap would be difficult
• Your sport or job could put a blow to the eye, such as martial arts or ball sports
• You can stay in Korea for a week or more

If you are considering SMILE in particular

• Your eyes are usually dry
• You want both impact resistance and fast recovery
• Your nearsightedness and astigmatism fall within the range SMILE can correct

If your cornea is thin or you are highly nearsighted — lens implant (ICL)

If tests show your cornea is too thin or your nearsightedness too severe to treat with a laser, a lens implant, which places a thin lens inside the eye without shaving the cornea, may be an alternative. Vision recovers fairly quickly, but extra tests are needed to check there is enough space inside the eye (such as anterior chamber depth), and follow-up such as eye-pressure checks after surgery matters more. The stay is often planned longer than for laser surgery.

Pre-Op Tests — What to Know

• Test time: usually 1.5–2 hours or more. If pupil-dilating drops are included, close-up vision will be blurry and your eyes sensitive to light for several hours. Bring sunglasses and do not drive.
• Stopping contact lenses: lenses change the shape of the cornea, so you must take them out for a set period before testing. In general this is about 1 week for soft lenses, about 2 weeks for toric (astigmatism) soft lenses and about 2–3 weeks for hard (RGP) lenses, and longer for ortho-k (dream) lenses. Each clinic has its own rules, so we confirm in advance.
• Main tests: vision and refraction, corneal thickness and topography, pupil size, tear volume, eye pressure, the condition of the retina and more
• Depending on the results, the surgery you wanted may be difficult, or you may be told surgery is not possible at all. In that case a different surgery may be recommended, or not having surgery may be the right choice.

Surgery Day Step by Step

1. 1
   Pre-op tests (1.5–2 hours or more)the final check on whether you can have surgery and which method. Tests and surgery are often done on the same day.
2. 2
   Doctor consultation and consent formyou hear about your test results, the surgery method and the expected course, and ask your questions. Your manager interprets.
3. 3
   Preparation (about 30 minutes)face washing, numbing eye drops and disinfection. Please avoid eye makeup, perfume and contact lenses that day.
4. 4
   Surgery (about 10–20 minutes for both eyes): the laser is active only briefly, and you are awake throughout. A device keeps you from blinking, so just look at the light.
5. 5
   Rest, instructions, then homeyou travel to your accommodation wearing protective glasses. The best thing to do that day is rest with your eyes closed.

After Surgery

• Day of surgery
  LASIK/SMILE: a few hours of stinging, tearing and a hazy feeling, then you feel much better after a night's sleep. LASEK: the soreness starts as the numbing wears off.
• Day 1
  Check-up the next day. With LASIK and SMILE, most people get their everyday vision back. With LASEK, pain and glare are strongest until day 2–4.
• Days 4–7
  With LASEK, once the epithelium has covered over, the protective lens comes out and your vision recovers to a level that allows daily life.
• Weeks 1–4
  Halos and dryness gradually fade. Your vision may go up and down a little from day to day.
• Months 1–3
  For most people vision stabilizes. With LASEK, it often keeps sharpening gradually until this point.

Trip Schedule — LASIK/SMILE vs LASEK

LASIK/SMILE (3 nights or more)

• Day 1
  Arrive → pre-op tests → surgery the same day if suitable → rest at your accommodation
• Day 2
  Check-up the next day. Light indoor sightseeing is fine; wear sunglasses
• Day 3
  One more check-up if possible, then eye-drop instructions
• Day 4
  Fly home

LASEK (6 nights or more)

• Day 1
  Arrive → pre-op tests → surgery
• Days 2–4
  Rest at your accommodation. Pain and glare make sightseeing difficult.
• Days 5–6
  Check that the epithelium has healed, then the protective lens is removed
• Day 7
  Check-up, then fly home

Eye Drops and Check-Ups After You Return Home

• Use antibiotic, anti-inflammatory and artificial-tear drops as prescribed. After LASEK, anti-inflammatory drops are sometimes used for several months to prevent haze, so be sure to take home a schedule for tapering the frequency.
• Wear sunglasses in strong sunlight. After LASEK in particular, UV protection is important for several months.
• Do not rub your eyes, and we recommend wearing protective glasses when sleeping for the first 1–2 weeks.
• It is a good idea to have a check-up at a local eye clinic at around 1 week, 1 month and 3 months after you return. Taking an English medical record and a list of prescriptions makes this easier.
• Send photos and describe your symptoms to your KBEAU manager and we will have the clinic review them and advise you.

Side Effects — Normal vs Contact Us Right Away

Common symptoms that mostly fade

• Glare and halos: you may see them, especially at night, for weeks to months, and they gradually fade.
• Dryness: it can last for several months and is managed with artificial tears. It may last longer if your eyes were dry to begin with.
• Vision fluctuation: during recovery your vision may vary a little between morning and evening.
• Regression: over time, some nearsightedness can return. The higher your prescription, the more likely this is, so it needs to be discussed at your consultation.

Symptoms to report right away

• Pain or redness that keeps getting worse
• A sudden big drop in vision, or one eye suddenly turning very blurry
• Yellow or sticky discharge
• Strange vision after a hard blow to the eye

Questions to Ask at Your Consultation

1. With my corneal thickness and prescription, which surgeries are possible, and why do you recommend or not recommend each?
2. How much corneal thickness do you expect to be left?
3. How likely is regression at my prescription?
4. Will the doctor I consult with perform the surgery personally?
5. When can I fly, swim, use a sauna and exercise?
6. Can you write down the eye drops I should use after I return home and the tapering schedule?
7. If a problem comes up after I return home, how do I contact you and get checked?
8. Can I get my test results and surgery record in English?

How to Choose a Clinic

• Whether an ophthalmologist explains your test results personally and is honest enough to say "don't have surgery" when the results call for it
• Whether they compare LASIK, LASEK, SMILE and lens implants for your eyes instead of recommending only one
• Whether they take enough time and cover enough items in the pre-op tests
• Whether they schedule the next-day check-up and a check-up before you fly home into your itinerary
• Whether they offer foreign-language service, English records and remote follow-up after you return home

KBEAU connects you with partner eye clinics in Seoul that perform vision correction surgery. Tell us the type of lenses and prescription you use now and your travel dates and we will work out your lens break and length of stay in advance, and a dedicated manager stays with you for the tests, consultation, interpreting on surgery day and transport.