Should you Choose LASIK or SMILE Eye Surgery? Eye Surgeon Explains
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- Опубликовано: 17 ноя 2024
- Have you come across the vision correction surgery known as SMILE? If not, brace yourself for an introduction.
In this video, Dr. Cohen breaks down SMILE and contrasts it with LASIK. Delve into the procedural distinctions, understand their safety profiles, and gain insights into Dr. Cohen's recommendations.
It's a knowledge-packed session, so ensure you watch till the end for a comprehensive understanding.
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If you're considering a vision correction procedure, don't miss out on this opportunity to learn from one of the best in the business. Start your journey towards clearer, sharper vision today with EVO ICL and Cohen Eye Institute.
Visit our website at www.coheneyein... for more information or to schedule a consultation.
Learn more about ICL: www.coheneyein...
Always remember: your vision is our mission.
Disclaimer: This video is intended for educational purposes only. It does not provide medical advice. Always consult with a healthcare provider for personal medical advice.
#lasik #eyedoctor #eyecare
Very well explained! Too many doctors keep saying "SMILE is the 3rd generation of eye surgeries, LASIK is only 2nd generation" or "there's no flap in SMILE so it's better, your flap will be displaced if you get LASIK" or "we don't cut the corneal nerves in SMILE" etc etc. Just as always the truth is more nuanced and not that black and white. I myself chose to get femto-LASIK over SMILE after doing my research.
Great choice
Cutting cornea creates a permanently weakened cornea flap. I had Lasik 28 years ago and even to this day, I am afraid of rubbing my eyes and always avoid sleeping with my face down. If I ever slept with my eyes pressured, I would have blurry vision for an hour before I recover. If SMILE were an option for me, I would have chosen it definitely.
I do understand SMILE is riskier but surgery on cornea is risky to begin with. You ask for the best surgeon to do it by paying a lot of money. My right eye's flap were wrinkled after surgery and the surgeon just smoothed it with his finger. I guess that is how it is done.
@@speedingAtI94 I had femto-lasik more than 3 years ago and I can rub my eyes without any issues, sleep in any position etc. Modern femto-lasik creates a very stable and strong flap. They used microblades to create flaps 28 years ago which is a totally different technology compared to flaps created by femto laser. As for the SMILE procedure - it creates micro irregularities inside the void created by the extracted lenticule, which can produce aberrations that you cannot fix unlike with lasik where you just lift the flap and correct it. SMILE needs more time to mature as a method and address its imperfections. LASIK is a mature well developed technology these days. I'm sorry to hear that your surgeon did it with his finger - that's a flawed surgeon not a flawed method though.
@@SergeyTheBold a flap is a flap. Laser cut flap doesn't heal any better than mechanically cut one, especially when part of the cornea under the flap is burned off. I read about cases of cornea flap detachments 10, 15 years after the surgery. There is a surgeon posted video of Lasik enhancement by lifting up the existing flap. He said he would do it for Lasik up to 15 years old. If you watched how easy it is to lift an old flap, you won't have as much confidence of its integrity. The flap stays in shape partly due to negative pressure -- i.e. it stays in place partly due to the suction of the cornea material. If you rub your eyes, the shear force will move the flap out of position. This is probably why it is so easy for a surgeon to lift the old flap.
@@speedingAtI94 Laser cut flap actually does heal better because its edge is created with a slope and when the flap is put back in place the ring area of where the scar develops is larger than with a microblade cut flap, plus the slope itself creates more stability. Cases always exist but what matters is statistics. The US military now accepts femto-lasik for all its branches because the data shows that the risk of flap detachement is very very low. It does exist but if you get hit hard in the cornea after SMILE you'll get a severe cornea damage as well so there's always some risk after every laser eye surgery including even PRK that doesn't cut the cornea but makes it thinner and destroys the Bowman's membrane. Again, blade based lasik is less stable than laser based, that's why it was forbidden in the US military but now is accepted in its modern version. The ease of relifting the flap when doing an enhancement is irrelevant because it is done with a special tool and you have to dig in to detach the flap. What you see in those enhancement surgeries does not translate into signigicant frequency of flap detachments in real life. The actual frequency is infinitesimally small. Like I said, I rub my eyes every day and do it the same way I did it before the surgery. I also get regular retina exam when they connect a lense to your eye with a strong suction and then they move the lense to look at the retina. At no point there's any remote feeling that something is about to detach from the cornea during this procedure. Once again, the data does not lie. And there's a difference between the old lasik and it newer version.
I decided to go with SMILE since I needed a fast recovery for lifting plenty of heavy garbage bags up a flight of stairs for my job. My vacation was only 3.5 weeks from work. I was two-weeks in post-procedure, already started lifting heavy, with no problems (so far). I am on going one month post-procedure now, and it was said that combat sports athletes prefer SMILE over lasik because there is "no flap" that can be ruptured getting hit, and after just a short 6 months, they could resume sparring again. I was a competitive amateur Boxer myself, and plan on coming back after a long, long layoff due to the pandemic (very last fight was February 2020). I hope I made the right decision choosing SMILE over Lasek/PRK. Hope everything goes well, and can't wait for month 6, and be back sparring.
My dr said that I’m a possible candidate for the smile procedure and lens replacement and possible a contact implant but my case is complex due my nystagmus
Very nicely explained.
👍
Many thanks for uploading this educational video about reflective surgery.
you welcome
Do you do exclusive LASIK surgery?
@@redaa6720 no! I do all cornea related surgeries.
reflective surgery? Go with the Bates Method. It costs about $35 and has no side effects. In fact, you should notice a better resting heart rate, better blood pressure #s, and better insulin sensitivity levels when employing the relaxation techniques of the Bates Method.
Me am going to have LASIK with corneal cross-linking to have amore long term permanent fix,am -3 myopia.
Can treat my eyes -8 and I'm 25 years I hate my glasses I can't see with out glasses I'm thinking about pass away
Yes
Thank you !!!!! first i think smile is better,now i know ,thank you!!!!
You welcome.
less risk of dry eyes or flap getting displaced with smile, I got it done
great explanation,
please compare SILK vs LASIK. thankyou
I have done my contoura femto lasik but after 2 days my left eye is 6/4 but my right eye is still blurring. What can be the reason? The far distance
You say with lasik contoura u have the absolute best sharp vision compared to smile.
But how about lasik contoura vs prk?
they're the same. Except with LASIK it is faster.
Silk or lasik which is the better option??
Hello doctor, I'm 20 and I have myopia of - 9 and astigmatism 3 what do you recommend? I had a consult with a doctor and he said lasik is not an option but femto smile is. What do you think?
If you continue doing those things which caused you myopia what are the chances of having that eye defect again after any of these surgeries. Or the surgery permanently fixes it and you can continue staring at screen for long hours ?😅
Hello Doctor my son's eye sight is right eye
-6.50 cyl -1.75 axis 05⁰
Left eye -4.50 cyl -1.75 axis 165⁰
Which procedure do you suggest. Need your kind advice.
If his Cornea is otherwise normal, You can consider LASIK or ICL.
Hello doctor my eye sight is 0.5 long range eye sight problem also im facing lightening problem while I drive night time and im using glasses right now and my job is i use laptop 10-12h everyday what surgery do you recommend
You have sensitive dry eye symptom please blink more
Hello Doctor, I am a junior eye doctor with myopia -5.75 BE. I am considering to undergo SMILE surgery. But I want to know whether if one of the post op complications such as glare or halo can disturb our vision when using slit lamp or operating microscope? Can ophthalmologists or eye surgeons undergo refractive surgery???
I chose SMILE over LASIK last year. Now my vision is better than 20/20. I was concerned with the flap bc I like to rub my eyes.
Glad to hear your happy with your vision
I did the same. Lasik the flap does't fully heal, and dry eye is major concern.
@@TravelTechie415are you happy
@@Peehoo123 yes mostly, no dry eyes, no pain, see fine outside & indoors low light, but large artificially lit bright interiors - signs look a bit blurry - I wish this was better
Thank you. Very good explanation short n clear 🙏🏻
Hello doctor i am 18 years old and i have myopia and astigmatism which surgery is more good for me?
It depends on the degree of your myopia. In general, anyone less than five Diopters, I recommend Lasik as long as the corneal thickness is normal, and so are all other measurements of the eye.
With Contoura LASIK the quality of the vision is much better than with smile.
@@doctorilancohenhi doctor, what would you recommend for a patient with -8 myopia
Sir my prescription is
Sph:2.25 cyl:0.75 axis:180 for both eyes which procedure would be best for me according to you
In your range, only LASIk is a possibility
Hi Doctor, so if I have dry eyes and irregular cornea (with astigmatism), what’s better between PRK, Lasik and Smile?
None. Glasses perhapss depending on the degree of dryness.
For me, I was told by a Lasik clinic that I have a lot of matter in the cornea that can be removed to fix a very heavy diopter. I did not go for the SMILE procedure, which in Toronto is the Herzig Eye institute. I want to go with one of the procedures but there's no second chances on your eyes, even if they do it one at a time. Any advice/thoughts Dr. Cohen?
Depending on your prescription, you may be a better candidate for a procedure called implantable collamer lens. but if the prescription is not too high, you could still consider Lasik
Hey doctor,mine is anisometropia,myopia,,alsoo my right sight is 3/60 which is pathological and left sight is 6/12 which is myopia ... Please give me a suggestion for any surgery
Consider LASIK.
@doctorilancohen i appreciate ur reply tysm doctor 🫂😭
thanks for making usefull video, sir when do you think next genaration eye surgery will come that better than smile and lasik. im 32 years old.
The current generation provides a very satisfactory solution. I don’t foresee any major breakthroughs that will introduce any type of revolutionary change in the next 10 to 20 years.
I have around -,12 myopia, which one do tou recommend doc? Thanks in advance
Is that -12.00? If so, neither is for you. Two options that are possibilities are EVO ICL and Refractive Lens Exchange based on your age and some other factors.
@doctorilancohen yes, wow, thats a sad news, since its way more expensive and i heard it have a longer time to completely heal right? Anyway, thanks for the information docs, really appreciate.
Hai sir..How about TransPRk sir?
Excuse me doctor but I wanted to have some answers about my concerns I did the Smile surgery from 3 days and my glasses prescription were Right eye -4 cyl : -0.50 Axis:178
Left eye -2.50 cyl: -1.00 axis:175 now I see well but not 6/6 vision and I feel that my left eye is kinda more blurry and I think I did took the wrong decision going for smile instead of Femto lasik because I heard LASIK is better for astigmatism tho my astigmatism is kinda mild moreover the surgeon insist I do smile so what’s ur advice ? is there anything I should be worried of?
You should be positive... smile can take even 3 to 6 mnth for clear vision
Hello doc, i do combat sports like muay thai and boxing, should i do lasik or smile? In the website they say its better to do smile, is that true?
smile is better for contact sports, because of less risk of flap getting displaced
If i go through LASIK and 30 years from now my sight worsens, can i repeat the operation?
Yes.
What about SmartSight is it better
That is a type of SMILE.
How do you compare both with tPRK with or without wavefront?
Actually, the Topo guided treatments are far better than Wavefront guided, especially if you have a large angle Kappa or high astigmatism (> -2.00D)
TGPRK is a laser treatment for corneas that have some degree of irregular astigmatism. Most corneas have some and that's why it could improve vision even in some normal corneas. Wavefront is old history.
@@doctorilancohen However, some doctor also argue that removing corneal aberrations could increase overall eye HOA. Eg. Removing corneal coma could unleash lenticular coma. So, it's not always good to remove corneal aberrations. What's your opinion ?
In my country NL I can not find any clinic that does tgPRK. They al do wavefront tPRK. I think al with abberation free profile. Wavefront is still very common here.
@@waltersteyger1215 You are confused bro... First understand Wavefront optimised (WFO) & Wavefront guided (WFG) treatments.
In Wavefront optimised (WFO), laser delivers some extra pulses around the periphery to maintain the Aspheric profile of cornea (which reduces halos/glare). This is also called Aspheric treatment, Q-LASIK.. etc..etc. It is used universally now & it's there in every modern laser. So, don't worry about this.
Secondly, Wavefront guided (WFG): It's a customised treatment, in which a waterfront sensor measures your overall eye aberrations and feeds into laser. It's always combined with WFO.
Thirdly, Topo-guided (TG): It's also a customised treatment in which a topolyser maps your cornea and feeds in laser. For Example, CONTOURA VISION is a TG treatment by Alcon. It's also always combined with WFO.
WFG & TG gives very good results for someone having higher amount of aberrations in eye. In general, almost 90-95% have little to no aberrations in their eye. So, a simple WFO treatment is enough for them.
Lastly,
TransPRK(tPRK) is a PRK in which laser itself removes the epithelium instead of a mechanical tool in standard PRK.
The aberration free PRK is a marketing name by Schwind Amaris. It's a simple WFO treatment.
Hoping your most doubts will be clear.
I had lasik 6 months ago but my vision get worse ( due to doctor’s error)
I’ve been told that i need an enhancement lasik surgery.
My question is that does enhancement surgery work and i get 20/20 vision or they are just giving me false hopes?!
It all depends very much on what was the exact problem.
u did smile or lasik and wht u mean with doctor error
How about u check with a different doctor as well and see if he gives u the same answer to ur problem to see if he’s honest
What is with ICL Lens in the eye sharpest vision ?
20/20 depending on the health of retina.
I recently go through SMILE surgery. My left eye vision is not clear as compare to right ..can i repeat the operation or not?
Because i thik in pre operative checkups they written .25 less than left eye and operate .25 less than the right eye thats why the vision in right eye is not sharp as compare to right.
SMILE cannot be repeated. They can enhance the vision by LASIK after SMILE if necessary.
@doctorilancohen are you sure? Because doctors practicing Smile say otherwise.
@@bennyhillariousSMILE can not be repeated. I just check with my doctor 😢 “because the piece of tissue that must be removed to correct vision is too thin to be safely removed again” - he said
What about ICL
ICL is usually for higher prescriptions. If you are a LASIK candidate you'll have better results with Contoura but if you're prescription is very high (> -7.00) you should consider ICL.
Thank you
Isn't PRK safest than both
I did SMILE = no dry eye and no risk dislodging flap, quick recovery, I see fine at night, no halos but a little haze on car lights - it's gotten much better. Looked into LASIK (better vision, but dry eye and flap dislodging flap is a risk - it's like a sticker that gets pulled back, doesn't fully heal after years), PRK (painful).
How about PRK vs smile? for normal cornea and don't mind recovery time
PRK is less invasive and safer in my opinion. But it also depends on the degree of correction.
@@doctorilancohen 500 myopia :) also have a keratoconus alarm (mild possibility, don’t have it), would prk be better as well than smile in that case?
@@doctorilancohen thank you doctor!
I can't get friends My life is boring
All of them are dangerous
Not really
Every surgery carries certain risks; that is correct. You should never do a procedure where the risks are not fully explained to you. At the end of the day, what you need to balance is the benefit of not having to wear contacts or glasses vs the small risks that are posed by the various types of vision correction surgery.
@@doctorilancohenDou you know Dr. Edward Boshnick? Morris Waxler? Dr. Cynthia Mackay? Paula Cofer? Sasha Rodoy? Dr. David Borsook? Do you know them? Dr. Cohen?
@@gabrielekarl9278what is it to u to ask him if he knows them? Curious….
It's safer than getting a tooth pulled