Nvision Blog

What Is the SMILE Procedure?

Posted on November 18, 2019

Surgeon performing an eye surgery under the microscope - healthcare and medicine concepts

You probably associate the word smile with orthodontia, not ophthalmology. But if you're nearsighted, this term could take on a whole new meaning for you.

SMILE, otherwise known as small-incision lenticule extraction, is a surgical procedure that could help you to reduce or eliminate your need for glasses or contact lenses.

How Does SMILE Work?

SMILE is a refractive surgery that involves reshaping your eye. After surgery, light should pass directly through the center of your eyeball and focus on the perfect spot on your retina. LASIK and other laser-based surgeries have the same goal, but they achieve it in a different way.

In a LASIK surgery, your doctor cuts a small flap in the front of your eye, and that gets lifted up. A laser moves in and corrects the exposed tissue, and the flap settles back into place when the work is done.

SMILE surgeries involve no flaps. Doctors use lasers to reshape layers within the cornea while leaving the surface untouched. Excess tissue is suctioned away.

Experts say the innovation is similar to one seen in general surgery. You could have:

  • Open surgery, in which doctors make big cuts to see the field and make revisions
  • Laparoscopic surgery, in which the cuts are smaller, but the surgical outcome is similar

SMILE fans say recovery times are quicker. And you might be less susceptible to injuries later.

People who go through LASIK retain that cornea flap for the rest of life. A hit to your eye (from an errant soccer ball or a flapping branch, for example) could theoretically push it out of place. That could require surgery. The chances of such a complication from LASIK are incredibly slim, but with no flap, you have no similar risk.

Research suggests SMILE is effective. In one study of 328 people, 99 percent had 20/40 or better vision six months after surgery. At the six-month mark, 88 percent of people had 20/20 vision.

Many refractive surgeries are designed to amend all sorts of vision problems. SMILE is different.

Experts say the FDA has approved this surgery for nearsightedness, but at this point, you can't use it for anything else. You'll also need to meet surgical requirements.

To sign up for SMILE, experts say, you'll need to demonstrate that you are:

  • 22 or older.
  • Living with a stable eye prescription that hasn't changed within the last year.
  • Holding a prescription measuring between -1 and -8 diopters.
  • Healthy, with acceptable corneas and no history of eye disease or eye surgery.


 

Preparing for Surgery

SMILE is a precise procedure, and doctors like to ensure their patients are good candidates long before the work begins. Expect to go through a thorough eye exam, and be prepared to pay for the procedure.

Your doctor will:

  • Perform an exam to check your vision, measure the size of your pupils, assess the thickness of your corneas, and more.
  • Discuss your options so you can make an informed choice about SMILE or another refractive surgery.
  • Address your recovery so you'll be prepared to care for your eyes and heal.
  • Outline the cost as SMILE isn't often covered by insurance. Expect to pay $2,000 or more per eye.

Recovering From SMILE

Your surgery will be over in minutes, and you won't feel a thing. Your eyes will be numb, and if you feel nervous, your doctor can use medications to soothe your nerves. But you'll need to take several steps at home to protect your vision.

You'll use eye drops to combat infection, reduce swelling, and ease pain. As reporters point out, you'll need to use them every few hours, even at night. So you might lose a bit of sleep while your tissues knit together.

You'll also wear goggles while you sleep and in the shower, to protect your eyes from water and pokes.

After surgery, you'll have plenty of eye appointments. Your doctor will check your healing and your vision. If you don't achieve a 20/20 score (or something you deem acceptable in consult with your doctor), you might need another correction.

Some doctors use LASIK to fine-tune vision after SMILE, but others choose another solution. Your doctor can explain your options to you if the need arises.

References

Small Incision Lenticule Extraction SMILE—The Future of Refractive Surgery is Here. (January 2018). Missouri Medicine.

SMILE Procedure Expands Laser Vision Correction Options. (May 2017). American Refractive Surgery Council.

What Is Small Incision Lenticule Extraction? (June 2019). American Academy of Ophthalmology.

Who Is a Good Candidate for SMILE? (June 2019). American Academy of Ophthalmology.

I Had Laser Eye Surgery, and Here's How It Went. (April 2019). Independent.

Skills and Know-How Necessary for Successful SMILE Outcomes. (March 2016). EyeWorld.

Why Is LASIK More Affordable Than Contact Lens Wear?

Posted on November 18, 2019

You've told yourself you couldn't have LASIK, even though you desperately want to stop wearing contact lenses all the time. You think you'll save money by sticking with the tried and true.

Do the math, and you might discover that you're paying more for contacts than you would for a LASIK surgery.

 

How Much Does LASIK Cost?

During a LASIK procedure, your doctor numbs your eyes, creates a corneal flap, and amends the tissue within your eye with a laser. The flap is replaced, and you're sent home with drops to help you heal. The procedure is sophisticated, and it can come with a high price tag.

Analysts say LASIK can cost between $1,000 to more than $3,000 per eye. That price includes your:

  • Eye exam. Your doctor needs to assess your vision loss and eye health before the work begins.
  • LASIK procedure. The doctor's time, the equipment, anesthesia, and all other details are included in this price.
  • Post-operative care. Drops you need to heal your eyes and your return visits with the doctor are included here.
  • Follow-up care. If you don't achieve the vision correction you want, a second surgery can be included in the fee.

Bargain-basement prices often come with loopholes. Your follow-up care might cost extra, for example, or you won't get a second surgery for free. You'll need to understand the price carefully before you sign on.

How Much Do Contacts Cost?

You don't need surgery to wear contacts, but you do need a special type of eye exam. And you'll need to pay for both your contacts and their upkeep. This is an expense you'll always see in your budget.

In 2012, researchers dug into eye health prices all across the country. These are some of the fees you can expect to pay as a person who wears contact lenses:

  • Contact exam: Fees range between $85 and $215.
  • Contact lenses: These fees vary widely, depending on the kind of contact you need. Expect to pay about $90 for a three-month supply.
  • Glasses exam: You'll also need glasses to wear when you're resting your eyes from your contacts. This demands a different exam. Expect to pay between $20 and $140.
  • Glasses: You'll pay between $50 and $300 or more, depending on your prescription.

You'll also need cases and solution to store your contacts when they're not in your eyes. Fees can vary, but it’s not unusual to pay $200 per year to maintain your contacts.

What About Insurance?

We use insurance policies to offset the cost of medical care and keep our expenses low. While some plans help to pay for vision care, it's rare to have full coverage. And even if you do, some of your fees won't be included in your benefits package.

LASIK is not covered by insurance plans. Officials consider this an elective procedure that you could skip by wearing glasses or contacts. It's rarely, if ever, covered.

Vision insurance programs offer benefits, but they can be lean. In one typical program, you'll get coverage for:

  • Eye exams.
  • Contact lens fittings.
  • One set of contact lenses annually.

You'll have to pay out of pocket for your glasses. And this plan won't cover the cost of your solutions and maintenance materials.

Vision insurance can be helpful, but it's rare. Analysts say just 35 percent of employers offer this kind of coverage to their employees. And Medicare doesn't cover routine eye exams at all, reporters point out.

If you don't have vision insurance, you're not alone. But it means you'll pay your bill on your own, regardless of whether you choose LASIK or contact lenses.

What's the Final Tally?

 

To determine if LASIK is truly more affordable than contact lenses, we'll have to do some comprehensive math.

We know LASIK will cost, on average, $4,000 for both eyes. That's a lifetime cost, as you won't need to repeat the experience every year.

Per year, contacts will cost:

  • $100 for an exam.
  • $300 for the lenses.
  • $200 in solution.
  • $115 for glasses (since glasses cost about $350, and they last for about three years).

That brings your yearly contacts price to $715. After about five years, you'll pay more for contacts than you would for LASIK.

References

How Much Does LASIK Cost? VSP.

How Much Do Glasses Cost? How Much Do Contacts Cost? (October 2012). Clear Health Costs.

Vision Insurance FAQ: Frame, Lens, and Contact Lens Benefits. (April 2016). VSP.

What Percentage of Companies Offer Vision Insurance? (January 2017). Zenefits.

Vision Care Lags, With Blind Spots in Insurance Coverage. (May 2018). National Public Radio.

Is LASIK Expensive?

Posted on November 18, 2019

You want to see clearly without the constant use of glasses and contacts. But as you sit at the kitchen table and crunch the numbers, you wonder if you can afford LASIK surgery.

It's true that LASIK surgery can — and often does — come with a significant price tag. But when you total up costs associated with glasses and contacts, you might find that you'll save money in the long run.

High angle view of unrecognizable mature man placing USA Dollar bills into wallet.

How Much Does LASIK Cost?

LASIK is a surgical procedure. Doctors use specialized (and expensive) equipment to measure your eye and make precise cuts to reshape the surface. You need anesthesia before the cutting starts, and you need drops to help your eyes heal. All of that comes for a price.

Expect to pay about $2,200 per eye for LASIK. And that's for baseline surgery. If you're hoping to use an advanced form of the procedure — where doctors use only lasers instead of cutting your eye — experts say you should expect to pay more.

You might also see a higher cost based on:

  • Your doctor's expertise. Doctors with exceptional reputations are in high demand. They often charge more.
  • Your location. LASIK prices vary from one state to another. If you live in a spot with little LASIK surgeon competition, your rate might be higher.
  • Your aftercare. If you need a touchup surgery, and it's not covered by the original fee you paid, you'll see another bill.

Some clinics offer discounts that can bring down your total price. If you opt to pay in cash, for example, or you sign up during a slow time of year, you might see a reduction.

Woman with glasses suffering from eyestrain after long hours working on computer

How Much Do Glasses and Contacts Cost?

It's rare to walk out of an optician's office with a bill for $2,200. But your glasses and contacts can cost you more than you might think.

It's not unusual, experts say, for glasses frames to cost $500 or more. Your lens cost is tacked on, and the price can rise due to:

  • Your prescription. If you're very nearsighted, your doctor might opt to compress your lenses. That makes them lighter and easier to wear.
  • Lens coatings. Your clinic might spray materials on the outside of your lens to protect you from the sun or keep hard objects from causing scratches.
  • Bifocals. If you need additional customization to help you read, that could cost more.

An eyeglass prescription lasts for two years. Every time your eyes change, you'll need a new set of glasses. If your bill comes to $800 or more each time, that can really add up.

Contact lenses are more expensive. A box of soft contact lenses, for example, can cost about $26, experts say. You'll need a box for each eye, and they'll last you for six months. In addition to your contacts, you'll need:

  • A case. You'll use this to store your lenses when you're not wearing them. It should be replaced every time you get new lenses. And if you crack it or damage it, you'll need a new one too.
  • Cleanser. Every time you take out your contacts, you'll need to use a solution to strip proteins and bacteria from the surface. You can't run out of this product.
  • Storage solution. When you pop your lenses in a case, they'll need to swim in a liquid. This is another product you'll need in constant supply.
  • Rewetting drops. If your eyes feel dry and gritty during the day, this product can make blinking more comfortable.

All of these bottles and cases can add up to big bills every month. If you scrimp and save by buying a little less or using water instead, you could develop an eye infection. That means another trip to the doctor for help.

You Could Save Money

LASIK comes with a one-time, large medical bill. But when the surgery is complete, you might never need to buy another pair of heavy-duty, prescription glasses. That could save you thousands over the ensuing years. For many, it's a smart financial move.

References

Pros and Cons of LASIK: Are the Risks Worth the Cost? (December 2017). Michigan Health.

Are You Confused About the Cost of LASIK Eye Surgery? (March 2016). American Refractive Surgery Council.

What's It Like to Have LASIK? Patient Shares Surgery, Recovery, Cost, and More. (August 2018). Today.

How Much Do Eyeglasses Cost? Cost Helper.

How Much Do Contacts Cost? (February 2017). Bankrate.

Do LASIK Surgeons Operate on Family Members? Do They Have LASIK?

Posted on October 30, 2019

How do you know if LASIK surgeons really believe in the procedure they perform every day? Finding out if they recommend the solution to their friends and family members is a good place to start.

Researchers say that it's common for LASIK surgeons to both recommend and perform the procedure on their family members. They know a lot about the benefits of this surgery, as they often have it themselves.

Why Wouldn’t Doctors Operate on Family?


Watch medical programs like Grey's Anatomy, and you'll walk away convinced that doctors often perform surgeries on the people they love. In reality, there are guidelines about the practice. Sometimes, those rules make doctors step away from the surgery room.

Experts point out that organizations like the American Medical Association encourage doctors to stay in the waiting room when their loved ones need help. A doctor treating a loved one can struggle to:

  • Remain impartial. Serious illnesses often call for analytic decisions. That's hard to do when you're working with someone you love.
  • Deal with a crisis. During an intense surgery, a loved one can experience a complication. Surgeons must work quickly under pressure. Relationships can make that hard.
  • Maintain confidence. Worries and doubts can keep surgeons from making the right calls in a crisis.

Despite these risks, it's somewhat common for doctors to work on those they love. In a 2017 study, 76 percent of doctors said they'd performed surgery on friends and family members.

How Is LASIK Surgery Different?


When we're talking about surgeries and family, we're sometimes talking about life-and-death procedures. If someone we love has a severe bone break, a cancerous tumor, or a blocked artery, the surgical solution is serious. The surgery comes with enhanced risks. LASIK is a surgery, but the risk profile is a little different.

Doctors use finely calibrated equipment to perform LASIK procedures. They take very detailed measurements before the first cut is made. And the whole surgery is over in minutes.

It's still a surgery, but the chance that something will go catastrophically wrong is minuscule.

Doctors might choose to perform LASIK on those they love because:

  • They trust their skills. A doctor who has performed LASIK surgeries thousands of times knows the equipment inside and outside. Sending a loved one to a different surgeon can seem silly.
  • It helps with marketing. Patients trust doctors who are willing to perform LASIK on those they love. It's a vote of confidence that could help nervous patients feel safe while in surgery.
  • They believe in the surgery. Researchers say more than 90 percent of LASIK surgeons recommend the procedure to friends and family members. They know it works, and they want those they love to take advantage.
  • They understand the patient's lifestyle. Close families know one another well. LASIK surgeons may know their husbands have dry eyes in the summer, or they know their wives enjoy knitting in the winter. They can take precautions to match surgical outcomes to fit the person's lifestyle.

Doctors might also encourage family members to have LASIK because they know it works. Researchers say more than 62 percent of experts who perform LASIK have been patients at one point.

They couldn't treat their own eyes, of course. But they trusted a colleague to help them. And now, they see the results every day. They're in an exceptional position to discuss risks and benefits with those they love.

Patients have choices. There are plenty of practitioners ready to help people who want to leave a life of glasses behind. But if you know and love someone who provides this surgery, it could be a good option for you to consider.

References

Why Doctors Shouldn't Treat Family Members. (January 2012). CNN.

When You Operate on Friends and Relatives: Results of a Survey Among Surgeons. (May 2017). Medical Principles and Practice.

Do Ophthalmologists Undergo LASIK? (May 2016). The Ophthalmologist.

Eye Doctors Are LASIK Patients Too. (February 2016). American Refractive Surgery Council.

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