Deciding between PRK and SMILE surgery: What is the difference?

Two common laser eye surgery alternatives that typically come up when people think about correcting refractive defects like myopia, hyperopia, or astigmatism are PRK (Photorefractive Keratectomy) and SMILE (Small Incision Lenticule Extraction). While both treatments can help patients see better without glasses or contacts, they are not interchangeable regarding method, recuperation time, or patient compatibility. You might make a more educated judgment about which operation would be proper for you if you knew about these distinctions.

How Does PRK Surgery Work?

One of the first forms of laser vision correction, Photorefractive Keratectomy (PRK), reshapes the cornea to fix refractive defects. The process is as follows:

1. Epithelium Removal: To access the corneal tissue, the surgeon must first remove the epithelium, the thin outer covering of the cornea.  

2. Laser Reshaping: The corneal stroma is reshaped using a laser to fix the refractive error.

3. Recovery Period: Patients may feel pain or have trouble seeing clearly while the epithelium spontaneously regenerates.

Is SMILE Surgery Right for Me?  

Introducing SMILE, a relatively new development in laser eye surgery that stands for Small Incision Lenticule Extraction. As a method for correcting eyesight, it offers less invasiveness and a faster recovery, bringing a sense of optimism to potential candidates. Let's delve into the difference.

1. A lenticule is a tiny disc-shaped tissue created within the cornea using a femtosecond laser.

2. Tiny Incision Extraction: The lenticule is removed by a tiny incision around 2-4 mm in size rather than the complete epithelium removal.

3. Corneal Reshaping: Lenticule removal alters the corneal shape, resolving the refractive error.

 Critical Distinctions Between PRK and SMILE

After learning about the primary distinctions between PRK and SMILE, you can better assess your needs and preferences.

1. The Invasiveness of the Procedure

• PRK: The cornea's outer layer (epithelium) is surgically removed, exposing a more significant portion of the cornea and necessitating a period for the epithelium to regenerate.

• SMILE: The surgery is less invasive because it requires only a tiny incision and does not require the entire excision of the epithelium.

2. Time Required for Recovery 

• PRK: The recovery process might be more drawn out and may cause some discomfort. During the 3-5 day regeneration process, patients may encounter pain, blurred vision, and light sensitivity while the epithelium repairs itself. It may take several weeks or months for a full recovery of vision. However, the long-term visual outcomes are usually excellent.

• SMILE: Because it is not particularly intrusive, patients typically report less discomfort and a faster recovery. Within a few days, most patients report a marked improvement in their eyesight, allowing them to return to their daily routines promptly. The visual outcomes are also very good, with most patients achieving their desired vision within a few weeks.

3. Patients' Suitability

Patients whose corneas are too thin or who cannot safely undergo LASIK owing to the possibility of flap problems might consider PRK as an alternative procedure. Additionally, those who suffer from dry eyes or certain corneal surface imperfections often choose this alternative. On the other hand, patients with mild to moderate astigmatism and nearsightedness (myopia) are ideal candidates for SMILE. People with severe hyperopia (farsightedness) or mixed astigmatism, nevertheless, might not be good candidates. It's essential to consult with an eye surgeon to determine the best procedure for your specific eye conditions.

4. Visual Outcomes

• PRK allows patients with thin corneas or problems with the corneal surface to achieve good visual results on par with LASIK and SMILE. Owing to the delayed healing process, it may take a little longer to get clear vision.

• SMILE surgery offers predictable results with great accuracy and reduced pressure on corneal nerves, which might mean less post-operative dry eye. This predictability can bring a sense of reassurance and confidence to potential candidates.

5. Risks

• PRK: Possible side effects include a cloudy cornea, longer recovery time, and pain after the procedure. But unlike LASIK, there is no chance of issues linked to the flap.

• SMILE: Compared to LASIK, there is less trauma to the cornea and less likelihood of dry eye. Interface haze or residual lenticule fragments are unusual problems but can exist.

6. How Much Should It Cost?

• PRK: Because less sophisticated technology and equipment are needed, it often costs less than SMILE and LASIK.

• SMILE: As a more recent operation that uses modern laser technology, it may be slightly more costly than PRK.

How Can You Decide on the Best Procedure?

Several factors should be considered when choosing between PRK and SMILE. PRK might be preferable for people with skinny corneas.

• Preferred Recovery Time: SMILE might be the way to go if you hope for a less invasive, more rapid recovery. People whose jobs or way of life put them at risk for flap issues (as with LASIK) may benefit significantly from PRK. This includes sports and members of the armed forces.

• Individual Eye Issues: Discuss your options for correcting your refractive defect and maintaining good eye health with an eye surgeon.

  
  

It is now possible to live without corrective lenses thanks to the success of PRK and SMILE operations, which both target the eyes' refractive defects.

A skilled ophthalmologist at Eagle Eye Care can evaluate your unique requirements, eye health, and lifestyle factors before recommending PRK or SMILE. Knowing these distinctions, you may choose the method that meets your needs and produces the most outstanding results.