If you’ve been thinking of correcting your vision, chances are you’ve come across many different methods of laser vision correction. It can be overwhelming and confusing trying to learn about all their pros and cons, and that is why we have decided to narrow it down to just two well-known procedures in our series of comparison articles.
In this article, we will be comparing one of the most well-known Advanced Surface Ablation (ASA) procedures, Epi-LASIK, with one of our main procedures, ReLEx SMILE.
Intro
Epi-LASIK
Epi-LASIK is an Advanced Surface Ablation (ASA) procedure, meaning that there is no cutting to create a flap, allowing an excimer laser to access and reshape the cornea. Instead the outermost layer of cells is gently shaken off using an epithelium separator vibrating at ultrasonic speed.
ASA procedures started with PRK in the early 1990s. Epi-LASIK was introduced in the mid 2000s and is one of the forms of ASA that preceded what we have today – true no-touch TransPRK.
ReLEx SMILE
ReLEx SMILE (Refractive Lenticule Extraction, Small Incision Lenticule Extraction) was created with the aim of bringing over some of the benefits of LASIK, being minimally invasive. It makes use of the creation and removal of a tiny lens-shaped piece of corneal tissue within the eye, to reshape the cornea.
ReLEx SMILE was introduced to the world in 2011 by ZEISS, and in 2016, it was introduced into the US after passing the US Food and Drug Administration’s (FDA) notoriously strict regulations and safety standards.
Treatable Conditions
Epi-LASIK
- Hyperopia (difficulty seeing objects up close)
- Myopia (difficulty seeing objects at long distances)
- Presbyopia (difficulty focusing on objects up close, in older age a.k.a. lao hua yan)
- Astigmatism (distorted, blurry vision at any distance)
ReLEx SMILE
- Myopia (difficulty seeing objects at long distances)
- Astigmatism (distorted, blurry vision at any distance)
Procedure Steps
Epi-LASIK


Pros
Epi-LASIK
- Flapless
- Low impact on corneal stability
- No flap complications
- Low incidence of dry eyes
- Suitable for thinner corneas
ReLEx SMILE
- Flapless
- Low impact on corneal stability
- No flap complications
- Low incidence of dry eyes
- Low risk of affecting night vision
- Almost no pain
- Fast recovery
Cons
Epi-LASIK
- Risk of affecting night vision
- Discomfort during healing
- Slow visual recovery
- Risk of hazy vision
ReLEx SMILE
- 2% risk of lenticule complications (suction loss, unsuccessful extraction, lenticule tear), requiring the patient to switch to TransPRK
- More narrow range of suitability criteria (hyperopia; high myopia or thin corneas not eligible)
- ReLEx SMILE cannot be performed twice, meaning that any further enhancements will have to be done using a different laser vision correction method
Conclusion
We hope that this comparison gives you a good idea of the advantages and disadvantages of both procedures. If you want to learn more about other laser vision correction methods, please visit our comparison table, or check out the comprehensive article comparing two of our main procedures – TransPRK and ReLEx SMILE.
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