But one procedure (LASIK) involves creating a flap during the procedure. The other (SMILE) involves removing tissue via a small incision.
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Key Facts About Contoura® LASIK & SMILE
- Contoura® and SMILE correct myopia (nearsightedness).
- Contoura® LASIK received U.S. Food and Drug (FDA) approval in 2013. SMILE received FDA approval in 2016, making it a newer solution.
- SMILE is considered a less invasive procedure, as doctors don’t need to create a flap in the cornea to access deeper tissues, as they do with LASIK.
- SMILE is sometimes used in people who don’t qualify for LASIK due to high myopia and thin corneas.
Contoura® LASIK vs. SMILE: Understanding Both Procedures
Your cornea works like a lens in a camera. It focuses light on the retina — a collection of light-sensitive cells on the back of the eye. Contoura® and SMILE reshape the cornea, allowing for sharper vision for people with nearsightedness or astigmatism.
How Does Contoura® Vision Surgery Work?
Contoura® is a form of LASIK. Advanced technology gives doctors detailed data that guides each moment of tissue removal.
A typical Contoura® vision procedure involves the following steps:
- Detailed examination: Your doctor performs a dilated eye exam. Your corneal thickness, tear production, pupil size, and more are all measured. After this exam, your doctor can ensure you’re a good candidate for surgery.
- Corneal mapping: Your doctor uses a Topolyzer machine to map 22,000 points on your cornea. The data creates a topographic map your doctor can use during your LASIK surgery.
- Surgery: Drops numb your eyes, while a suction device flattens them. You’ll look directly at a light, while a doctor creates a flap in your cornea. That tissue is lifted, and lasers reshape deeper tissue. The flap is replaced.
- Recovery: You’ll go home the same day. Your doctor will provide medications and detailed instructions to follow as you heal.
How Does SMILE Work?
SMILE is a laser surgery, but the procedure is slightly different from LASIK. These steps are typically involved in a typical SMILE procedure:
- Detailed examination: Your doctor performs a dilated exam to ensure your eyes are healthy enough for surgery. Corneal thickness, tear quality, pupil size, and more are all measured.
- Surgery: Your doctor cuts a thin disc (a lenticule) within corneal layers. That lenticule is removed via a very small corneal incision. That incision heals without any stitches.
- Recovery: You’ll go home the same day with detailed instructions and medications to help you heal.
Comparing Vision Correction Procedures
If you have nearsightedness, SMILE and Contoura® could be good options for you. But understanding the similarities and differences between these procedures can help you make an informed decision.
|Nearsightedness and astigmatism
|Nearsightedness and astigmatism
|Nearly 65% get 20/16 vision or better; nearly 93% get 20/20 vision or better. A recent NVISION study found that 100% of patients had 20/20 or better vision after the procedure.
|About 99% percent of people who undergo SMILE have 20/40 vision at their six-month follow-up appointment, and 88% have 20/20 vision at that point
|18 and older with stable nearsightedness and astigmatism prescriptions; thinner corneas and sharp corneal angles accepted in most cases
|22 and older with stable nearsightedness, farsightedness, or astigmatism prescriptions; thin corneas could disqualify patients
|$2,250–$3,000 per eye
|$2,250–$3,000 per eye
|Detailed corneal measurements make the procedure fully customized
|Doctors cut a disc-shaped piece of cornea below the eye’s surface and then reshape lower tissues
|24 hours to resume normal activity
|48 hours to resume normal activity
|Potential side effects
|Glare, halos, ghosting images, and blurring as tissues heal
|Visual disturbances as tissues heal
What Are the Similarities Between Contoura® & SMILE?
Contoura® and SMILE share several characteristics and factors, including the following:
- Lasers: Both Contoura® and SMILE involve using a laser to reshape the cornea.
- Target conditions: Both procedures can address nearsightedness and astigmatism.
- Cost: Contoura® and SMILE come with a very similar price tag, and both tend to cost more than standard LASIK.
What Are the Differences Between Contoura® & SMILE?
People with nearsightedness and/or astigmatism can choose between Contoura® and SMILE. Your doctor can help you determine which is right for you. These factors may be part of your doctor’s recommendations.
Contoura® is a specialized form of LASIK that tends to cause fewer side effects than standard LASIK. But it still involves removing layers of corneal tissue with lasers.
Common side effects associated with Contoura® include the following:
- Dry eyes
- Halos around lights
SMILE doesn’t involve removing multiple corneal layers. Instead, doctors remove a piece of corneal tissue through a small incision. Some people experience fewer dry eye symptoms and visual distortions with this method.
In Contoura® LASIK, doctors use a small flap to access deeper tissues. This flap will heal within a few months after the procedure.
But during this time, you must protect this healing tissue, especially if you play contact sports. Sometimes, organizations won’t allow people to have flap-based surgeries due to the healing times.
SMILE involves a tiny incision and no flap. You must still protect your eyes as they heal, but the risk of flap problems is nonexistent.
In Contoura® LASIK, doctors create a topographic map of your eye before surgery. That information can guide the laser during your surgery, ensuring that your doctor doesn’t remove any more tissue than is absolutely required. Contoura® is a very detailed, personalized form of surgery that uses incredibly advanced machines.
SMILE doesn’t involve custom eye mapping and topographic maps. Experienced surgeons know how to take the proper measurements and take the right amount of tissue to improve your vision. But computers and detailed data don’t guide your surgeon’s hand during SMILE.
Contoura® and SMILE come with very specific qualifications you must meet before the surgery can be scheduled.
To qualify for Contoura®, you must meet the following qualifications:
- Age: You must be at least 18 years old.
- Vision: Your myopia prescription must measure -8.0 diopters or less. Your astigmatism prescription must measure -3.0 diopters or less.
- Eye health: Your eyes must be free of excessive dryness, infections, big pupils, or thin corneas.
To qualify for SMILE, you must meet the following qualifications:
- Age: You must be at least 22 years old.
- Vision: Your myopia prescription must measure -10 diopters or better. Note that this is a much larger range than is available for Contoura®. Your astigmatism must be -3.0 diopters or less.
- Eye health: Your eyes must be free of infections. Some doctors will perform surgery on those with dry eyes and thinner corneas. If you’re disqualified for LASIK for these reasons, SMILE might be a better option.
To qualify for either procedure, you must meet the following qualifications:
- Stable prescription: Your vision scores must remain unchanged for about a year to ensure you get the results you want.
- Good health: You must not have uncontrolled diabetes, an autoimmune disorder, or another issue that could make surgery difficult. You must stop taking some medications (like immune suppressants) too.
Which Procedure Is Right for You: Contoura® LASIK or SMILE?
Surgical qualifications often help people understand which procedure is right for them. For example, if you’re 19, you can only qualify for Contoura®. And if your prescription is -9.0 diopters, SMILE might be better.
A qualified surgeon can help you explore your options in detail. Together, you can discuss the risks and benefits of each surgery. A thorough exam is part of this conversation. If you’re trying to decide which option is right for you, scheduling an exam is critical.
- Myopia (Nearsightedness). American Optometric Association.
- Alcon Introduces Contoura® Vision as First Personalized LASIK Procedure at American Academy of Ophthalmology Annual Meeting. (November 2015). Alcon.
- Comparison of Clinical Outcomes of LASIK, Trans-PRK, and SMILE for Correction of Myopia. (February 2022). Journal of the Chinese Medical Association.
- The Current State of SMILE vs. LASIK. (April 2021). Review of Ophthalmology.
- Comparison of Visual, Refractive and Ocular Surface Outcomes Between Small Incision Lenticule Extraction and Laser-Assisted In Situ Keratomileusis for Myopia and Myopic Astigmatism. (September 2019). Ophthalmology and Therapy.
- Topography-Guided Laser Assisted In-Situ Keratomileusis vs Small-Incision Lenticule Extraction Refractive Surgery — A Summary of Clinical Outcomes. (2019). Alcon.
- Comparison of Corneal Higher-Order Aberrations Following Topography-Guided LASIK and SMILE for Myopic Correction: A Propensity Score Matching Analysis. (October 2022). Journal of Clinical Medicine.