All cornea/refractive surgeons/experts will admit that not cutting a corneal flap is safer than cutting one, because 90% of the potential complications involve cutting the flap, putting it back, and letting it heal.
The ONLY advantage to cutting flaps is a faster recovery. This is the ONLY advantage to the LASIK and SMILE procedures.
Dry eyes and night glare are WORSE if you cut the cornea at all, as that cuts the corneal nerves, which is the CAUSE of dry eyes after laser vision correction, and causes small (microscopic) permanent scars in your eyes that never heal, which scatter light and cause poor night vision.
So, to be honest (and Dr. Chynn is so honest he has the reputation of being “blunt”), here is the recovery time for each of these procedures.
PRK:
- Long recovery
- 1 week of pain, sometimes severe, sometimes 2 weeks, so you must take an entire week off of work with your eyes closed.
- Also prone to scarring.
- Not recommended for prescriptions past -6.00
LASEK (also non-cutting like PRK but more advanced method of epithelial removal)
- Much faster recovery than PRK (4 days)
- No dry eyes or night glare because LASEK avoids the cutting step
- Totally painless
- Can safely treat prescriptions as high as -19.00 (with intraoperative MMC)
epiLASEK (also known as epi-LASIK)
- Even faster recovery than LASEK (3 days)
- Noncutting so no dry eyes or night glare
- Totally painless
- Not prone to scarring (unlike PRK)
- Can safely treat prescriptions as high as -19.00 (with intraoperative MMC)
SMILE Eye Surgery
- Rapid recovery (2 days)
- The cornea is cut, & a pocket is created. Then, a small piece of cornea is removed and thrown away.
- Less dry eyes than LASIK but more than the above 3 surface procedures
- Can only treat myopia up to -3.00, astigmatism up to -1.00, & cannot treat hyperopia
LASIK with thick flap cut with a metal blade
- Very rapid recovery (1 day)
- Cutting always causes some dry eyes or night glare (varies from minimal to severe)
- Many possible complications in the OR or after surgery even years later
- Can safely treat up to -8.00
LASIK with thin flap cut with laser (also known as “bladeless” or femtosecond LASIK)
- Very rapid recovery (1 day)
- Cutting always causes some dry eyes or night glare (varies from minimal to severe)
- Slightly safer than using a metal blade but not as safe as non-cutting
- Possible late complications
- Can safely treat up to -9.00
