EPI-Lasik vs ReLEx® SMILE® vs LASIK, which degree correcting procedure should I choose?

Doctor's Answers 2

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Dr E-Shawn Goh

Ophthalmologist

We have many OTHER options of refractive surgery that do not involve a laser re-shaping your cornea.

These typically do not have the same side-effect profile of causing dry eyes, significant glares / haloes, loss of contrast sensitivity and period of visual recovery that post-LASIK patients typically report.

The first option here is that of Photorefractive Intrastromal Cross-Linking (PiXL). This is a non-surgical method of correction of minor degrees of myopia by riboflavin saturation and ultra-violet-A (UVA) accelerated cross-linking of the cornea. This non-surgical procedure corrects minor degrees of myopia, but does not correct astigmatism unfortunately.

The second option is that of an Implantable Collamer Contact Lens (ICL). This is a surgical procedure to implant a specifically tailor-manufactured lens that is placed in the posterior chamber (behind the iris, and in front of the normal crystalline lens). This is a completely reversible procedure (unlike LASIK) and offers excellent vision with minimal recovery time, and minimal / no dry eye complications. The most important benefit is that it may treat a wide-spectrum of hyperopia, myopia (in the thousands of degrees even!) as well as astigmatism, with excellent retention of contrast / color testing and minimal side-effects like glares / haloes.

In medicine, there’s generally a ten-year period with each procedure where patients are closely observed in various studies for side effects. That’s partly why Lasik took so long to be accepted amongst the greater population and doctors themselves – everyone was waiting and “observing” the initial batch of patients to see if there were any bad side effects 10 years later.

As always though, there are certain criteria and individual patient factors which may make you more suitable for one procedure over the other, so definitely get an opinion from your ophthalmologist before deciding “I definitely only want this procedure”.

In truth, Lasik is all about “case selection”, meaning the doctor’s expertise is in choosing the most appropriate treatment for each unique patient, which will produce the best results and minimise side effect. The procedure itself is relatively straightforward, as it’s mostly done by the machine.

Similar Questions

How can I prevent blood clots on the whites of my eyes after LASIK?

Hi Susanne In the first step of the LASIK procedure, a ‘flap’ is created using a femtosecond laser (or, in the past, a special blade called a microkeratome). During this step, the laser is ‘connected’/docked to the eye with a ring-like device that grips the white part of your eye. You can watch an animation here: There are many small blood vessels on this part of the eye, and sometimes the suction pressure providing the grip may cause some of the blood vessels to leak some blood, causing red patches after the LASIK.

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Human

What are possible solutions regarding treatment/enhancement of poor ReLEx® SMILE® surgery results?

Thank you for the extensive information. Let us address the issues one at a time. With regards to enhancement surgery following ReLEx® SMILE®, it is usually enhanced by way of PRK as the prescription to correct by then is usually low. PRK, in this case, is able to offer distinct advantages for lower prescription for example, the benefits of a flapless treatment are preserved. LASIK may also be a possible method, however, it involves the creation of a flap which does have its own disadvantages.

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