in this video we're going to compare and review femto second Lasik relex
smile surgery and that of PRK these are the most common forms of refractive eye
surgery and if this is something you are considering getting then you're going to
want to know about the pros and cons of each of these procedures and some extra tips on
what to think about before getting any form of refractive eye surgery let's take a look
thank you hello and welcome this is Dr Joseph Allen here from the Dr Eye Health show the channel
that helps you learn everything about the eyes now today we're talking about three very important
procedures in the world of eye care we're talking about Lasik we're talking about smile and that of
PRK first of all let's just break down some of the major differences between these three procedures
as well as going over some of the pros and cons of each now let's work through them in chronological
order starting with PRK being that that is the oldest then we'll hit up Lasik and then we'll
go over smile surgery being that that one is the newest one PRK stands for photo refractive
keratectomy and this is a procedure where your surgeon doesn't really need to cut into the eye
at all instead they use a solvent to loosen the front surface of the eye called the epithelium
they remove that and then they use an eczema laser to basically carve and vaporize the corneal tissue
and remold it to compensate for any need for glasses then a bandage contact lens is placed
on the eye and over the course of the next week and several months the corneal tissue begins to
heal and stabilize now compare that of PRK to Lasik which stands for laser assisted in situ
Keratomileusis and most clinics that are doing this procedure these days they use what is called
femto second Lasik that is the complete bladeless Lasik where everything is done with lasers your
surgeon would first use a femto second laser to make a cut on the front surface of the eye
in almost a complete kind of a c shape leaving just a little bit attached so that they're able
to lift up about one-fifth of the cornea up like a hinge and then with the stromal bed underneath
then your surgeon uses a different laser again that eczema laser and then they basically carve
and reshape mold that stromal surface similar to PRK but with Lasik they can then put that flap
back down allowing it to self-heal and because of this flap and how it heals the surgery is very
quick basically painless and after the procedure almost most people end up seeing pretty close to
2020 just f after the procedure right away that's one of the reasons why Lasik has been so extremely
successful over the last 20 some years now let's talk about the relex smile procedure relex stands
for refractive lenticcool extraction and smile stands for small incision lenticule extraction
now funny enough I don't hear many surgeons refer to it as relaxed smile anymore I hear
most surgeons refer to it just as the smile eye surgery but because it is so new we hear a lot
of doctors kind of referring to it as almost the Lasik 2.0 in a way the smile eye surgery Works a
little bit more complicated and it has to do with the cornea being so thick and then they're able to
use a femtosecond laser to basically carve out a center chunk of the corneal tissue and I cut out
the center chunk and the shape of a lens to again compensate for your need for glasses and then that
Center lenticule that they carve out they then pull it out of the cornea through just a two to
three millimeter cut I was found it easier to visualize like somebody trying to carve out and
hollow out a loaf of bread and then somehow pulling out all the innards of the bread out
through a two three millimeter hole that's just a kind of an easy way to explain it kind of a good
mental image to have but the smile procedure is nice because then you get to avoid making such a
large cut like you do with Lasik and that helps reduce some of the potential side effects okay
pros and cons which is better smile versus Lasik versus PRK let's hit it alright so some of the
pros of having the PRK surgery is first that it is great for people with thin corneas or people with
a high prescription in fact here in the United States the FDA has approved PRK for people up
to 12 diopters of nearsightedness six diopters of astigmatism and up to five diopters of hyperopia
that may not qualify for everybody but they are pretty large parameters and for people who
maybe don't qualify for Lasik because they don't have enough tissue on their eye then oftentimes
PRK may be offered as a substitute PRK is also excellent for people who are Fighters officers
or maybe in the military and PRK can be good for people who with coexistent eye issues such
as scars or loose tissue on the eye the biggest downsides to PRK really falls down to healing
time and then kind of pain or discomfort during the healing the procedure itself is virtually
painless because they numb everything up but the healing time for the tissue to grow back
and that's usually the uncomfortable irritating problem yes people definitely get through it and
say that it's worth it but if you ask anybody who's had the procedure before they will say
yes they were pretty uncomfortable and in pain for at least a few days to a week now when it comes to
the pros and cons of Lasik some of the big pros of Lasik is number one that it is a very fast healing
procedure again right away after the procedure is done most people are seeing very well it does have
a similar range of Corrections similar to what we mentioned in PRK and a lot of the surgeons
out there this is something they've been doing for a long time and they are just incredibly
accurate and very good at this procedure probably the biggest con about getting laser guy surgery is
that of dry eyes afterward about 20 to 40 percent of people who get Lasik immediately start having
dry eye symptoms however it does often resolve within the first three months but there are some
people who those symptoms continue on for the next six and up to 12 months and about 20 percent or
one-fifth of people Studies have found continue to have long lasting symptoms of dry eye after lasik
that's exactly why you'll have so many Lasik eye surgeons telling patients hey you need to
be using artificial tears frequently after the procedure and it's something that we even look
for before having our patients go for Lasik eye surgery we do a very thorough dry eye evaluation
to make sure there's no existing dry eye before the procedure the smile eye surgery does carry
some pros in that it is virtually painless and it's very quick so very similar to LASIK in
those regards it then also keeps the biochemical structure of the cornea more intact which is more
of a safeguard for people who have eye pressure or Glock comma that runs in their family and then at
this time smile May in fact be better for people with dry eye issues in that after lasik again dry
eye is about 95 percent incidents at that first week after this after a Lasik procedure but it's
only about 56 incidence after somebody who gets smile and then at least in one study after having
smile most patients did have a return to Baseline of the dry eye symptoms after three months as far
as the negatives for smile that includes the fact that it's only approved right now for people with
nearsightedness or myopia and then for astigmatism so if you're far-sighted I'm sorry a smile may not
be a good option for you and then finally it is a new procedure so sometimes finding a surgeon
who's even offering to do smile on patients is pretty low and then finding a surgeon who has a
lot of experience doing the smile procedure can also be challenging so just some things to keep
in mind next up I do just want to share some general information and statistics about all
of these procedures just a better kind of Aid you in your thoughts about pursuing any form of
refractive eye surgery including Lasik smile or PRK and then finally some tips just to help you
with your overall experience getting prepared if you're going to carry through with getting
one of these procedures first of all all these procedures do offer excellent vision and helping
reduce someone's dependency on glasses and contact lenses right that's the whole purpose of having
refractive eye surgery and Studies have shown that smile Lasik and PRK all result in very similar and
excellent outcomes in terms of their safety their efficacy their predictability and their
stability just some interesting statistics of note especially for smile is that one study did report
that smile versus PRK that at one month period patients who receive smile did have slightly
better visual outcomes versus PRK but after three months PRK did have just a very slight advantage
in terms of patients hitting 2020 versus smile however in another study that compared smile
versus Lasik after three months the patients who received smile did achieve slightly better visual
outcomes just because a few more patients in that study did achieve 2015 Vision better than 2020.
however for all of these procedures depending on what your doctor thinks may be best for you in
my experience in the clinic most people almost always hit pretty close to 2020 if not a little
bit better no doctor can guarantee that for you but they're aiming for that and again at least in
my experience most people have just outstanding Vision after the procedures now there are just
a few cons or really things I think people should know about or consider before having
any refractive procedure number one is that of regression Lasik PRK and smile have all shown
great outcomes and stability for at least 10 to 15 years following the procedure however do keep
in mind once people hit about the age of 45 that's when the medical condition of what's called press
biopia begins to ensue and that's when people start to be more dependent upon reading glasses
or bifocals things like that so if your whole goal of getting refractive surgery is to get
rid of glasses contacts for the rest of your life you won't ever need anything again unfortunately
that's just not realistic the eyes do continue to change as you get older next is that on kind
of this halo effect for the first four to six weeks following the procedure this is kind of
this worsening glare especially at night time of oncoming headlights and things like that
this is definitely a risk for basically all these procedures especially people who have really large
pupils or high prescriptions however over time because of improvements in the Laser Technology
and the surgeon's skills this is something that we just don't see as often anymore but if you are
somebody who's young and has a large pupil size then something your doctor may just discuss with
you about and then finally when it does come to dry eye issues right now it seems like at least
in the literature smile may have the advantage of having less complications due to dryness this is
mostly because again the Lasik procedure Cuts more of the corneal nerves where the smile procedure
only Cuts about two to three millimeters of it there's also a possible benefit because the smile
procedure doesn't use as much suction pressure as the Lasik procedure does that means less surface
is kind of disrupted or irregular that means less tissue damage and disruption leading to
better healing and less inflammation but again that's all based off of studies and reports that
are published at the timing of this video so as science and medicine kind of improves and we get
more information who knows this may change all right now I do have a couple of tips for you that
I want to share because if you are considering having any form of refractive surgery I think
these tips are going to help you out but before I jump into that please let me know in the comment
section if you do have any other questions about any of these procedures specifically I'd love to
be able to read those and get back to you also if you are finding this information valuable please
hit the like button for us and subscribe to the channel so that you can keep learning about the
eyes and seeing your best my first tip for you is to consider going through a thorough dry eye
evaluation before going ahead with having any of these procedures as we've talked about dry
eye is a major part of kind of the consequence or negative effect effects of having some of
these procedures and Studies have shown that 30 percent of candidates for a refractive procedure
are already having dry eye symptoms and about 50 percent of those people already have dry eye signs
on the surface of their eye that means that there is this disconnect there's more people who have
dry eye than they realize it or even feel their symptoms so again this is super important to have
things thoroughly evaluated before going ahead of the surgery even if you think you don't have
dry eye and tip number two and it sounds funny to say this but definitely go see a respected
eye surgeon in your area there are people or places that offer like special cheap discounts
and just the reality is these are your eyes you only have two of them and these procedures are
permanent so I just don't recommend going to like a super cheap place because you know they
had like a Groupon deal or something like that if you do want to save some money on these procedure
sometimes checking with your medical insurance or if your vision discount plan they sometimes will
take a few hundred dollars off but definitely ask your surgeon or wherever you're going for possible
payment plans military discounts first responder discounts those sort of things and then finally
there is another procedure that we didn't cover in this video but I have done in a previous video All
About ICL implants to learn more about ICL and if that is a procedure that may be even better
for you go ahead and click or tap the screen over here to the side and check that one out otherwise
thanks for hanging out with us again this is Dr Allen keep an eye on it and we'll talk to you soon