LASIK, PRK and SMILE – What’s the Difference?

LASIK, PRK and SMILE – What’s the Difference?

In the Detroit area patients often have questions about LASIK, PRK or SMILE

For patients seeking to reduce their dependence on glasses and contact lenses, there are many options available which can be overwhelming. The commonest procedure is LASIK (laser-assisted in-situ keratomileusis). LASIK surgery has been performed extensively since it’s approval by the FDA in 1998, with over 19 million procedures performed. The results of many scientific studies done show that the vast majority of patients are very satisfied with their results and are happy they had the procedure.

PRK stands for photorefractive keratomileusis. The difference between PRK and LASIK is that in LASIK a partial thickness flap is made on the cornea. The flap is reflected out of the way and a laser is used to reshape the cornea. With PRK a flap is not created. The corneal epithelium is removed and the laser is then used to reshape the cornea. A bandage contact lens is placed to allow the cornea to heal. This procedure is often considered when the corneas are too thin for LASIK.

SMILE refers to small-incision lenticule extraction. In this procedure a small incision is made in the cornea with a laser and a small lenticule of the cornea is created with the laser and extracted through the incision.

There has been much in the news recently about complications related to these procedures. As with any procedure, the most important initial steps are to have a thorough examination by the eye surgeon who will be performing the procedure to ensure you are a good candidate. At Akler Eye Center, our screening examination takes approximately 2 hours. We will obtain a thorough medical history and perform various tests and examinations of the eyes. The testing includes measuring the contour of the front of the eye, the thickness of the cornea and the tear production of the eye. Multiple refractions (measurements of the prescription) will be done as well. Dr. Akler will review all the tests and examine your eyes to make sure they are healthy. Following this, we will have a detailed discussion about which procedure is best for you and what to expect during the procedure and recovery.

Like any procedure, LASIK has risks and possible complications. The commonest initial side effects are burning and tearing in the eyes which is usually much improved several hours following the procedure. You will be instructed to go home and have a nap following the procedure. Fluctuating and blurry vision is very common initially and for the majority of patients lasts 4-6 weeks but is most pronounced in the first 2 weeks following the procedure. Glare, halos and starbursts in low light conditions are common initially but usually resolve completely. They are much less common with the newest generation of laser that we currently use and are rarely permanent. Dryness, grittiness and feeling like something is in the eye is very common initially and is treated by placing artificial tears in the eyes. These symptoms are usually much better after 4-6 weeks but can last longer in some patients. For more information on LASIK, visit our LASIK FAQ’s.

It is normal to have some fear when contemplating a procedure such as LASIK. I have been perfoming LASIK since 1999 and have done many thousands of procedures. In my experience, my patients overall are extremely satisfied with their vision and are happy with their decision. I invite you to check out our online reviews to see what our patients have said about us and their LASIK procedure. It is a privilege to have had so many people entrust me with their most precious sense – their sight.

Akler Eye Center is one of the top laser eye & LASIK surgery centers in Detroit, Michigan.

Call 313.563.3937 to Experience Excellence in Eye Care


Michelle Akler, MD
Akler Eye Center
Sterling Heights & Dearborn

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