Laser vision correction - is the Smile method really effective?

My initial data: a small myopia, -1 diopters, but only 20% of sharpness - I saw only two lines. I was not comfortable with glasses or lenses, so I decided to have an operation. The choice was reduced to just two types - Femto lasik or Smile.

Femto is a proven and reliable method, and about;) I learned through articles from the Shilova clinic. However, when I began to dig further, I realized that the Smile method has one serious drawback - the human factor.

2 years ago I had a femto lasik operation and I am still pleased with it - right after the operation my vision was 120% sharp, and now it is in the region of 100%. My friends and acquaintances are interested and ask if they should do;). I'm a little tired of explaining the same thing to everyone, so I decided to write an article on Habré in which I collected all the information I could find.

For those who do not know, I will tell you briefly about the types of operations performed in our time:
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1. PRK - the oldest and traumatic. The laser completely removes the layer of epithelium. It is used only when it is not possible to make Lasik / Smile. The risk of complications is about 15%.
2. Lasik - the blade makes a cut, called “flap”, it rises, then the laser forms a lens. The risk of complications is about 6%.
3. Femto Lasik - the procedure differs from Lasik only in that the flap is not cut off by a blade, but by a laser. Less traumatic, less risk of complications - about 2%.
4. Smile - the lens is also formed by a laser, but instead of cutting the flap, small cuts are made in the eye, through which the surgeon removes the remnants with a tweezers, the so-called “lenticule”. The stated risk of complications is less than 1% (for Shilova’s articles).

How much is it? Weighted average prices for several clinics in Moscow, just behind both eyes.

PRK: 50 000r
Lasik: $ 50
Femto-lasik: $ 100
Smile: 200 000r

3 claims to the method;)

1. Smile has no significant advantages in terms of accuracy and speed of recovery. I made a femto, and immediately after the operation I drove myself home by taxi, and the next day I used a computer. Where is faster?
2. The operation is very demanding for the surgeon’s direct arms. For example, if the doctor does not succeed in removing the lenticle completely - a small piece will remain in your eye forever, because of which the vision in one eye may be worse than in the other. Are you ready to take that risk?
3. High price. Femto is 2 times cheaper, but at the same time the human factor is minimized, because the operation itself is almost entirely automatic.

What do patients say?

Any information you read should be rechecked on your own. Therefore, I will not write further my subjective opinion and share with you one curious fact. I found a forum where people leave feedback on operations and conducted an analysis. I distribute each review into groups:

Positive - the operation was successful, the vision was restored to almost one, the side effects (double vision, halo, dry eye) were either imperceptible, or quickly passed.

Neutral - the operation was successful, but the vision subsided a little further, or some side effects still remain.

Negative - vision recovered poorly, side effects appeared that did not exist before, and they interfere strongly.

I understand that the technology;) is relatively young - it would not be logical to analyze feedback from the moment of its appearance. Therefore, I watched only those that have been left since 2017.

Subject for reviews by Smile
Femto theme

Here's what I got:
Smile: 6 positive, 7 negative, two neutral. Total negative: 46%
Femto: 12 positive, one neutral, no negative. Total negative: 0%

There are very few reviews, of course, and this sample cannot be called representative. But even taking into account the fact that people more often leave negative reviews on the forums, how did it happen that Femto does not have them, and almost half has a smile?

An example of a negative feedback on Smile from a person who also read about the method on the browser:

He performed the operation in Petersburg in the middle of November. At the moment, more than 3 months have passed. I am 35, I wore glasses from 10th grade. The correction was -4.5 and -4.0 and has not changed in 19 years. In such glasses I always saw 10 lines. I decided to make a correction.

First I planned to go to femtolasik. In the same clinic, 5 of my acquaintances underwent an operation, only one has a remark - after 3 years visual acuity dropped to 0.7.

He planned to go there, but then a kind person told about the “new exact super-sparing technology” SMILE. On Habré there is a whole series of articles notorious on this site of the doctor. I was inspired, learned that SMILE in St. Petersburg is being done only in one clinic and decided to go there. On examination, the doctor warned that I have a big pupil, and the halo effect will be disturbed for about six months. He also said that recovery after a smiley takes longer - “not in one or two days, but in a week or two”. I accepted all this and agreed.

About the course of the operation already told many times. It did not hurt, only a couple of hours hurt the eyes and they were a little watery. On the second day, the visual acuity test showed 0.2 / 0.7. There was no limit to my disappointment. However, after a week, the severity was 0.9 / 0.7. In principle, it’s okay to give, but I noticed that it’s very uncomfortable for me to work behind a monitor or to read at a distance of about 60 cm. The doctor said that I should read more and strain my eyes - my eyesight would recover. There was no halo effect by the way. A month later, the severity was 0.7 / 0.6. The next inspection was scheduled after a year (!). Hung at home table to test vision. After 3 months the situation is as follows. Visual acuity of about 0.7 in both eyes, if you look at the letters. If you look at the circles with cuts - about 0.4. It is still easier to distinguish W from B. The thing is that the image is split right down in one eye and up in the other. Doubling is noticeable on contrasting objects, and low contrast ones simply merge into porridge (I look at the traffic light — I see two / three traffic lights, I look at the text — I see porridge). Previously, with glasses, he saw him far away and up close as an eagle, now it is only on a “C grade”. I do not even know whether to wait a year until the next appointment, because if there are no improvements in 3 months, then where will they come from after 9 months. The operation is extremely dissatisfied, I regret that I did not find this forum before the operation - I would have thought a hundred times.

If there are improvements, I will definitely write an update on my story.

That is; Smile is definitely worse and you shouldn’t do it?

No, I do not consider the method itself;) bad. He has no risks of complications associated with the flap, as well as with proper performance, you can achieve fewer abbers than after lasik. In 2017, it was approved by the FDA and is held in the USA. I am very respectful towards Dr. Shilova, and I do not set goals to insult her. If complications do occur in her clinic in less than 1% of patients, this is a great result. But I would not advise telling people that;) has no flaws that lasik has. They can understand this in such a way that the operation of Smile in a cheap clinic for an inexperienced doctor will be much better than a femto with good equipment.

Therefore, if you plan to make a correction using the Smile method, do not look for a clinic where it is cheaper, and pay attention primarily to the experience of the surgeon who will conduct it.