Book a Consultation
  • Location Icon – Optimal Vision Harley St, Marylebone, London
  • Location Icon – Optimal Vision 7 Gower Street, London WC1E 6HA
020 7183 3725
Optimal Vision Logo

Open six days a week - book a consultation with a specialist now - No Hidden Charges, No Pressure, Affordable

SMILE and CLEAR Surgery SMILE and CLEAR Surgery
SMILE and CLEAR Surgery 020 7183 3725 Book a Consultation

SMILE and CLEAR Surgery 

Different types of laser treatments are available to correct vision and prescription, but the three main options are LASIK, PRK/LASEK and SMILE.

Other treatments such as iDesign LASIK , Accu-wave LASIK, Ultra LASIK, Wavefront LASIK, Ultra LASIKplus, Zyoptix, and Custom LASIK are brand names that most clinics use to differentiate the procedures that are basically the same in principle. For example, they take treatment like LASIK and include technology like a wavefront measurement as an addition. 

These technologies can improve the result of the treatment and is incorporated with majority of modern technology and should be part of the standard cost. However, many clinics use the name to increase the cost of their services. At Optimal Vision we offer Wave Front technology to all or our clients with no extra cost.

Regardless of the type of treatment, laser eye surgery works with the same principle – using a laser to reshape the stroma or tissue in the surface of the eye called cornea, which serves as the eye's front window. This makes the cornea flatter or steeper or more regular, depending on the treated prescription. The result is light focusing properly on the retina to eliminate refractive errors such as long-sightedness, short-sightedness and astigmatism. 

However, certain steps in the procedures are different, particularly the method used to access the tissue in the cornea.  

The cornea's surface has a skin layer called the epithelium, and this layer is constantly regenerating. For effective laser surgery, the surgeon needs to lift or remove the epithelium to access the stromal tissues underneath. 

The main difference between SMILE, LASIK, and LASEK/PRK

The epithelium is the visible barrier in the eye, preventing debris and bacteria from entering the eye. It is thin but strong and can regenerate every 7 – 14 days. 

In PRK, a type of surface treatment similar to LASEK, the surgeon will completely remove the epithelium before reshaping the underlying layer. After reshaping the cornea tissues, the surgeon will apply a bandage contact lens to allow the epithelium to regrow again under the contact lens

In LASEK, which is a form of surface treatment, the surgeon will remove the epithelium. Still, instead of discarding it, they will temporarily push it to a side to reshape the underlying tissue. After reshaping the cornea tissues, the surgeon will move the epithelium back and then apply a contact lens to protect the eye while the new epithelium regenerates. 

Unlike the LASEK and PRK procedures, LASIK eye surgery isn't a surface treatment. It involves creating a thin flap consisting of a small part of the stroma and epithelium. The flap gives the surgeon access to the permanent inner layer to reshape the cornea. After reshaping the cornea, the surgeon will place back the flap. This procedure doesn't require a contact lens. 

The SMILE procedure involves making a keyhole to access the underlying tissues that require reshaping. The surgeon will create a small connected tunnel through the epithelium to the target tissue from the surface. It offers minimal disruption to the epithelium, and the eyes can heal almost immediately.  


Photo refractive keratectomy (PRK) was one of the first laser vision treatment used by surgeons to treat patients with vision problems since the 1980s. It is the first treatment to use the excimer laser, a precise alternative to traditional scalpel procedures such as the radial keratotomy (RK). 

LASEK later became available as an alternative surface treatment to reduce post-operative blurring, enhance visual recovery speed and reduce post-op pain. However, no scientific evidence shows the difference between LASEK and PRK. 

Generally, surgeons use LASEK and PRK when the LASIK procedure is not an option. Although LASEK and PRK give good results, Your surgeon may suggest LASIK for correcting different prescriptions like hyperopia, Mixed astigmatism, and presbyopia.

The pros of LASEK/PRK laser eye surgery 

PRK and LASEK has other therapeutic indication besides correcting prescription(refractive error), such as treating loose surface epithelium layer (RCE), removing haze or scars or for PTK treatment.

The cons of LASEK/PRK laser eye surgery 

  • Recovery time 

During PRK and LASEK, the surgeon will shift the entire epithelium to one side instead of creating a small flap to access the underlying tissue, as in LASIK. The result therefore has longer recovery period because it takes several days for the epithelium to regenerate. LASEK and PRK have the longest recovery time among the three main laser eye surgery procedures although is just matter of few days extra and majority of patients very functional within few days. 

  • Comfort and safety

Although LASEK and PRK are pain-free, patients usually experience eye irritation and discomfort in the first few days after the procedure. The discomfort is a normal part of the healing process, but you may get pain relief eye drop to manage the pain. 

LASIK eye surgery 

LASIK eye surgery has become more popular due to speed of recovery and its advantages for higher prescription over LASEK and PRK. Instead of removing the entire epithelial layer like in PRK/LASEK, the surgeon will create a thin flap to access the underlying tissues and then close the flap after reshaping the tissues. 

Since the surgeon will only lift part of the flap, only these areas need healing, significantly reducing the recovery period also help the laser application deeper in surface of the eye(cornea) and less reaction of immune system. Most patients that undergo LASIK can resume their activities within 24 hours after the procedure. 

The pros of the LASIK eye procedure 

  • Recovery time     The procedure requires only creating a flap on the cornea's outer layer. This lead to a less recovery time. You can return to your routine activities in 1 – 2 days. 
  • Reduce over reaction of immune system with less swelling

The cons of LASIK eye surgery 

  • Treatment options 

Since the LASIK procedure is the most popular laser eye treatment, many variations and offers are available, making it difficult to know the right place to access quality treatment. Consider clinics with advance technology, experience surgeons and transparent pricing and ask the surgeon your questions before undergoing the treatment. 

  • Minor side effects 

Most patients experience some side effects in the first 24 hours after the procedure. These side effects include night vision disturbances, dry eyes, halos, and temporary starbursts. However, you can manage your symptoms by using lubricating eye drops. Dry eyes usually subside within 3  months. 


Small incision lenticular extraction (SMILE) or Cornea Lenticular Extraction of Advance refractive Correction is another laser eye surgery technology which only uses femtosecond laser for its treatment. This procedure is minimally invasive. Instead of flap creation, it requires making a small keyhole incision in the cornea and removing a lenticule from surface of eye. 

SMILE/ CLEAR  procedure is possible due to the Femto laser used to perform the procedure. This laser is the one femtosecond laser capable of performing SMILE due to its high precision. 

The pros of SMILE 

  • Recovery and treatment time 

SMILE laser eye surgery has fast recovery similar to LASIK procedure ,Comfort and safety

  • Suitable for moderate to high prescriptions 

The cons of SMILE 

  • Limited prescriptions 

Although SMILE can treat very high prescriptions, it only corrects astigmatism and short-sightedness. SMILE procedure for longsightedness is yet to be released. 

  • Lack of Wave Front technology 

The Wave front technology that is used for modern LASIK is still not available for this type of laser 

To know the right laser treatment for correcting your refractive error, you need to visit an experienced surgeon in a good clinic. The surgeon will examine your eyes and conduct other assessments to determine the right choice. 

Visit Optimal Vision today for a consultation with our experienced eye surgeon. You can also contact us on 020 7183 3725 to schedule an appointment. 

Dr Amir Mani - Specialist refractive surgeon

One of the most experienced refractive surgeons in London

Dr Mani has performed more than 20,000 ophthalmic procedures, including LASIK, LASEK, PRK, Femto Cataract, RLE, Lens ICL and Phakic IOL Surgery

Call Back Call Now Book Now