SMILE vs LASIK
Why LASIK Is the Better Laser Eye Surgery in Auckland
Looking into laser eye surgery in Auckland or beyond, and wondering whether LASIK or SMILE is best for you? At Re:Vision Laser & Cataract, we believe LASIK is the smarter choice – and here’s why thousands of Kiwis are choosing it for clearer, sharper vision.
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Successful laser eye surgeries
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Choosing the Right Laser Eye Surgery in NZ
If you’re considering laser eye surgery in New Zealand, you’ve probably seen both SMILE and LASIK come up in your research. These are the two most popular laser vision correction procedures available today, but they are not the same – especially when it comes to visual clarity, treatment flexibility, and long-term results.
Laser vision correction has come a long way in the past 30 years. Today, patients can choose between several highly advanced procedures, the most well-known being the LASIK (Laser-Assisted In Situ Keratomileusis) and the SMILE (Small Incision Lenticule Extraction) techniques. While both can reduce or eliminate dependence on glasses and contact lenses, there are important differences between these procedures – and the laser technology used – that can impact your long-term visual results.
Our Evidence-Based Approach to Vision Correction
While SMILE is often marketed as the latest advancement in laser vision correction, it’s important to look past the hype and understand what the science and outcomes actually show.
At our clinic, we prioritise tailored, evidence-based recommendations, using the most advanced diagnostic and treatment platforms available. If you’re deciding between SMILE and LASIK, here’s what you need to know to make the best choice for your eyes and understand why we often recommend wavefront-guided LASIK over SMILE for many of our patients.
SMILE vs LASIK Outcomes: What Do Studies Say ?
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Understanding the Basics : SMILE vs LASIK
What is LASIK ?
LASIK (Laser-Assisted In Situ Keratomileusis) is the most widely performed laser eye surgery in the world. Since its introduction in the 1990s, LASIK has helped over 40 million people worldwide achieve clear, glasses-free vision.
How it works:
- A thin flap is created in the cornea using a femtosecond laser (bladeless).
- A second excimer laser reshapes the cornea with extreme precision, based on your prescription and a wavefront-guided scan of your eye.
The flap is repositioned, healing begins immediately, and vision often improves within hours.
What is SMILE ?
SMILE (Small Incision Lenticule Extraction) is a more recent procedure introduced in 2011 by ZEISS. It involves using a femtosecond laser to carve out a small lenticule (disc-shaped tissue) inside the cornea, which is then extracted through a tiny incision—no flap needed.
So far, 10 million SMILE procedures have been performed globally. While promising, SMILE is primarily for myopia (short-sightedness) and mild astigmatism, limiting its use for a broader range of patients. There may be upgrades which allow for better treatment of astigmatism or hyperopia (long-sightedness) coming soon.
LASIK Delivers Better Visual Outcomes Than SMILE :
When it comes to laser vision correction, LASIK provides more accurate and predictable results. That’s because LASIK uses advanced wavefront-guided and topography-guided technology to customise the treatment to the unique shape and imperfections of your eye. In contrast, SMILE (Small Incision Lenticule Extraction) offers a more limited, one-size-fits-all correction. Studies show LASIK often results in better night vision, contrast sensitivity, and overall sharpness – especially for patients with higher prescriptions or astigmatism.
Patients who have wavefront guided treatment with LASIK often experience:
Less glare & haloes
Better contrast sensitivity
Easier night time driving
What’s our opinion?
Here are 10 reasons our surgeons at Re:Vision see LASIK as a superior procedure to SMILE:
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- SMILE treatments are more likely to be decentred as LASIK has computer controlled auto-centration whilst SMILE is manual
- LASIK provides high-definition vision, SMILE provides lower-definition vision
- SMILE has a slow vision recovery taking weeks/months to settle, LASIK has rapid vision recovery in days
- Studies have shown no difference in dryness between LASIK vs SMILE after 3months
- LASIK corrects astigmatism much more accurately than SMILE as LASIK has computer controlled auto-alignment compared to manual SMILE
- SMILE treats only 2 focus errors (myopia & astigmatism), LASIK measures and treats 25 focus errors (higher order aberrations)
- It is very difficult (and potentially dangerous for vision) to fine-tune any annoying de-focus after SMILE, laser fine-tuning after LASIK is simple, safe, and highly effective
- Night vision is better after LASIK than SMILE
- LASIK has a larger treatment diameter than SMILE, helping to enhance night vision with LASIK
- SMILE requires much more surgeon hand-held manipulation than LASIK.
The Best Procedure Is the One That Fits You
LASIK is safer, more accurate and more precise than SMILE. This results in higher-definition vision thanks to wavefront-guided and topography-guided customised precision of treatment. SMILE can only try to treat your basic prescription, while LASIK can measure and treat your basic prescription AND your more subtle focus errors called higher-order aberrations. This is why LASIK is known for its ‘super vision’ compared to SMILE.
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Invest in Your Vision with Confidence :
At our clinic, we don’t believe in “one-size-fits-all” surgery. Our experienced team uses the most advanced diagnostics to create a truly customized vision correction plan—whether that includes LASIK, SMILE, or another solution entirely.
Your consultation includes:
- 3D eye mapping
- Wavefront diagnostics
- Surgeon-led recommendations
FAQs: SMILE vs LASIK in New Zealand
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What is the main difference between SMILE and LASIK?
The core difference lies in how the cornea is reshaped:
• LASIK uses a femtosecond laser to create a thin corneal flap, which is then lifted to allow a customised excimer laser to reshape the underlying tissue. This allows precise correction of both lower-order (glasses-style) and higher-order aberrations (unique optical imperfections).
• SMILE is a flapless procedure. A femtosecond laser cuts a small lenticule (disc of tissue) inside the cornea, which is then removed through a small incision. However, SMILE uses no excimer laser, meaning it can't correct higher-order aberrations or be wavefront-guided.
SMILE surgery demands much more manual dissection of corneal tissue by the surgeon, than LASIK. The SMILE dissection has a rougher interface than LASIK – this accounts for the slower visual recovery and lower quality of vision with SMILE.
Is LASIK more accurate than SMILE?
Yes—especially when using wavefront-guided LASIK platforms such as the SCHWIND AMARIS 1050RS or Wavelight EX500. These systems map the eye with thousands of individual data points to design a fully personalised treatment.
SMILE is based on your glasses prescription and corneal thickness only. It does not account for internal distortions of the eye (higher-order aberrations), which can impact night vision and fine detail clarity.
As a result, LASIK can deliver sharper, more refined vision—especially for patients who drive at night or need high-performance visual acuity.
Is SMILE less risky than LASIK?
Both procedures are extremely safe when performed by experienced refractive surgeons using modern technology.
SMILE has a slightly lower risk of dry eye (for the first 3–6 months).
There is no difference in dry eye after 6 months with LASIK vs SMILE. Modern bladeless LASIK flaps created with femtosecond lasers (like Zeimer Z6) are extremely thin and smooth, minimising this risk.
Other risks like glare, halos, or regression depend more on the laser platform used and the surgeon’s precision than on the procedure type itself.
Can SMILE treat astigmatism or long-sightedness (hyperopia)?
SMILE is approved for:
- Myopia up to -10.00D
- Mild to moderate astigmatism (up to -3.00D depending on country)
SMILE cannot currently treat:
- Hyperopia (farsightedness)
- Mixed astigmatism
- Higher-order aberrations
- Small focus enhancements should your focus naturally change in the future
By contrast, LASIK is FDA-approved and widely used for all of the above, and allows for customised ablation patterns based on your unique eye structure.
If you have astigmatism, long-sightedness, or night vision issues, LASIK is often the superior choice.
Is SMILE laser eye surgery pain-free? What about LASIK?
Both SMILE and LASIK are virtually painless. Numbing eye drops are used for both procedures.
• During LASIK, you may feel mild pressure for 10–20 seconds when the flap is created, followed by light sensations during the excimer laser treatment.
• During SMILE, patients usually feel a similar pressure as the lenticule is created. Some may feel a sensation when the lenticule is manually dissected and removed through the micro-incision.
Afterwards, most LASIK patients report only mild irritation or tearing for a few hours. SMILE patients may experience similar symptoms but often for a slightly longer period (up to 24–48 hours).
Can SMILE or LASIK be redone (enhancement surgery)?
Yes, but LASIK is easier to enhance.
Because SMILE leaves no flap, re-treatments are much more complex.
Options include:
• Converting the eye to LASIK (creating a flap)
• PRK enhancement (surface ablation)
LASIK enhancements are typically easier: the original flap can be lifted and refined with additional excimer laser treatment.
This makes wavefront LASIK more flexible long-term, especially for patients with high prescriptions or changing vision.
How long does it take to recover from SMILE vs LASIK?
• LASIK recovery is rapid. Many patients report 80–90% of their final vision within 24–48 hours. Driving, working, and exercising can resume quickly (often within a few days).
• SMILE recovery is slower in some patients. Visual clarity improves gradually over 3–30 days, especially in patients with higher prescriptions or larger corrections.
Wavefront LASIK often results in crisper early vision, making it the preferred choice for those needing fast recovery.
Is LASIK or SMILE better for night driving?
Wavefront-guided LASIK is generally better for night vision and contrast sensitivity. Because the laser correction can be customised to eliminate subtle optical imperfections, and the treatment zone is larger in LASIK patients, many patients report fewer halos, glares, and starbursts at night with LASIK.
SMILE may not fully address these visual aberrations, especially in patients with larger pupils or higher prescriptions
How much does SMILE vs LASIK cost in New Zealand?
Costs vary by clinic, surgeon, and the technology used. At most clinics, LASIK and SMILE are similarly priced, but wavefront
LASIK offers broader value due to its customisation, faster recovery, and future flexibility.
How do I know which laser eye surgery is best for me?
Your suitability depends on:
• Prescription type and stability
• Corneal thickness and shape
• Pupil size
• Night vision performance
• Lifestyle needs (e.g. sports, night driving)
• Long-term vision goals
The best way to find out is to have a comprehensive laser vision assessment with wavefront diagnostics and corneal topography.
At our clinic, you’ll receive a tailored recommendation based on your eyes—not just what’s popular.
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