LASIK, LASEK & SMILE — Do You Really Know What You're Getting Into? Ask a Practicing Surgeon!

BGN Eye Clinic · Dr. Kim Jeong-wan

Hello, I'm Dr. Kim Jeong-wan of BGN Eye Clinic, Jamsil Lotte World Tower.

Today, I want to address some of the questions I've heard most often over the years of performing and consulting on LASIK and SMILE procedures. I'll be digging into them one by one right here on the blog.

Because vision correction procedures — SMILE, LASIK, LASEK, and the like — have a clear purpose and a well-defined process, the questions patients and their families ask tend to overlap a lot. So much so that midway through a consultation, I can usually sense exactly what someone is about to ask before they even say it. (I've just done too many of these… 😅)

With that in mind, I decided to write this up properly — so thoroughly that next time someone asks, I can just send them the link instead of answering from scratch. Here are my honest answers as a practicing surgeon.

Fun fact: one of my old friends — someone I personally performed SMILE on last year (2024) — asked three of the exact same questions I'm covering today. That was all the confirmation I needed that patients' concerns are remarkably universal.

Alright, let's get into it!

Q1. If You've Worn Contact Lenses, You Can't Get LASIK?

NO!

During our busy winter and summer seasons when patients come in for pre-operative exams, one of the very first things I hear is something like this:

"Doctor, I've been wearing contacts for years… is that going to be a problem? 😢"

The short answer: absolutely not! 😄 To be precise, whether contact lens use will affect your eligibility for surgery is something we simply "cannot determine in advance" — because there is no direct causal relationship between the two.

For example, if all other factors (corneal thickness, degree of dryness, etc.) are within acceptable ranges, the fact that someone has worn lenses for a long time does not disqualify them from surgery. Conversely, someone who has never worn a lens in their life is not automatically eligible if other conditions aren't met. Simply put: contact lens history and surgical eligibility are completely independent of each other.

That said, there is one thing worth noting: in some cases, the physical habit of inserting and removing lenses has caused significant corneal damage over time. If that process repeatedly stressed the cornea in an unhealthy way over many years, then the cornea's health and resilience need to be carefully assessed before proceeding with LASIK or SMILE.

The good news: this is almost always caught during the pre-operative examination phase, so there's really no need to worry ahead of time. At our clinic, one of our 11 diagnostic machines is the Pentacam — when a patient goes through that test, the results come directly to me or one of our other surgeons, and that's where we'd identify any issues of this kind.

So to summarize: wearing contact lenses has no bearing on your eligibility for SMILE, LASIK, or LASEK. The exception: if prolonged improper contact lens use has weakened the cornea to a problematic degree, that will show up in the examination.

As long as you've been wearing lenses the right way — stopping lens wear for just a few days to a week before surgery is typically enough for the cornea to recover its natural shape. Nothing to worry about! (Note: that timeline applies to soft lenses. Hard lenses take a bit longer — plan for about 2 weeks.)

Conclusion: Even if you've worn contacts for 20 years — as long as you stop wearing them and give your cornea enough time to return to its natural shape before surgery, LASIK, SMILE, and LASEK are all perfectly fine. (The only exception: if improper lens use has caused extensive corneal damage, that becomes a separate issue to address.)

Q2. Are Dedicated Eye Clinics Better at LASIK Than Large General Hospitals?

It depends…

This one is both a No and a Yes at the same time. What I mean is: the single most important factor in vision correction surgery — SMILE, LASIK, LASEK — is the operating surgeon's experience.

Here's an analogy. I'm a doctor, but I get sick too. When I do, I naturally want my doctor to have as much experience and clinical mileage as possible. It just builds trust. The same logic applies to LASIK, LASEK, and SMILE.

What makes vision correction surgery particularly interesting is that it's performed at an exceptionally high volume in Korea every year. That means certain clinics have built up a truly overwhelming accumulation of surgical experience. The sheer number of SMILE, LASIK, and LASEK procedures performed annually far exceeds that of something like spinal neurosurgery.

With that depth of experience, a seasoned clinic and surgeon have seen it all: the full range of pre-operative data, the statistical variance, the edge cases, the potential risks, and even the unexpected patient movements mid-procedure. Every small detail — the patient flow, the way instructions are phrased, the surgical tools, the examination sequence — is refined through data and repetition. That's why, as a practicing surgeon, I'm confident saying: experience-rich clinics are simply the best option.

When It Comes to Your Eyes, Thorough Examination Is Non-Negotiable

There's another term that tends to carry an unfair stigma: "assembly-line surgery." Apply that phrase to someone's eyes, and it understandably sounds alarming — cold, impersonal, rushed.

But if you actually look at what's being described, "assembly-line" is really shorthand for:

• A perfectly defined procedure followed from start to finish
• Established through extensive research and trial and error
• Representing the safest, most reliable surgical pathway
• Executed consistently and without deviation, like a well-oiled machine

Even the most experienced expert in any field can have an off day — skipping steps, cutting corners based on mood or circumstances. In most fields, that's unfortunate. In medicine, it can be catastrophic. That's why adhering to a defined, safe, and precise process matters enormously — and that kind of consistency is only possible when the volume of procedures is high enough to truly systematize the process.

So rather than "assembly-line surgery," I'd call it "protocol-driven surgery." When every step is pre-set and calibrated to the patient's individual examination results, it becomes possible to perform surgery safely across a very wide range of patients — and that translates directly into an ever-growing archive of clinical experience.

To wrap up: whether it's a large general hospital, a university hospital, a neighborhood eye clinic, or a dedicated LASIK center — the best place to go is simply the one with the most surgical experience.

Conclusion: The best clinic for surgery is one with a high surgical volume, an experienced surgeon, and the infrastructure and systems in place to let that surgeon perform at their best — without interference.

Q3. Do Clinics Run Too Many Tests Before SMILE or LASIK?

NO!

On this one, as a practicing surgeon, I want to say unequivocally: absolutely not. Never.

Even at our own clinic, the full pre-operative examination for SMILE, LASEK, LASIK, and ICL follows a set course — and yes, it involves a lot of steps and takes some time. We run about 11 different tests, including Optos imaging and Pentacam. Occasionally, something unusual or unexpected is detected during testing — something the patient had no idea about — and we may need to refer them for additional tests or to another specialist.

But skipping tests? If someone asked me to do that, I wouldn't perform the surgery. It's not that I wouldn't — I genuinely can't. As a doctor, this is not a matter of preference; it's a matter of basic medical responsibility.

Without knowing the precise state of your eyes, it would be medically indefensible for me to say "LASIK is fine" or "SMILE is the better choice." To make any kind of medical judgment without that data — or with incomplete data — would violate the very oath every doctor takes when they receive their license.

Take the Pentacam, for example — one of the essential pre-operative tools. With it, we can evaluate:

• The full shape of the cornea
• The curvature of the entire cornea and its precise angles
• The condition and morphology of both the anterior and posterior corneal surfaces
• The anterior lens interface and every surrounding boundary zone
• Corneal thickness, volume, and depth across multiple layers

And the reason we need all of that? Because we are literally reshaping that cornea. The core action in LASIK and SMILE is removing a precise layer of corneal tissue. To do that safely, we need to know the exact topography and dimensions of what we're working with — otherwise:

• Remove too much → We may encroach on unsafe territory, leading to potential complications later.
• Remove too little → Vision may not reach the desired level of correction.
• Remove incorrectly → Light refraction and visual quality may be compromised.

Comprehensive testing is what allows us to avoid all of the above. So even if the examination process feels long and a little tedious, I hope patients and their families can embrace it with patience. After all — this is your eyes we're talking about.

Conclusion: Vision correction examinations are never excessive — if anything, doing too little is the real risk! Even if the process feels lengthy, every single test is necessary for a safe outcome and the best possible vision.

Q4. Is Winter Better for Surgery? Should You Avoid Getting It Done in Summer?

NO!

There is no meaningful difference. The surgery itself — LASIK, SMILE, LASEK — is completely unaffected by the season. Someone once asked me: "Isn't it true that summer humidity makes the cornea expand after surgery, so you shouldn't get it done then?" Nope. That's not a thing.

The procedure itself is not influenced by whether it's summer or winter. Within the temperature range that humans inhabit, there's simply no issue. So why is there a small nuance when you look at the full picture?

The answer is lifestyle habits. In summer, compared to winter, there are far more opportunities for things to get into your eyes — and more chances to rub or touch them. What kinds of things end up in your eyes in summer?

• Sea water
• Sweat
• Rain

In summer, people shower more frequently, there are more insects, and when it's hot and itchy, people reach for their eyes without thinking. The surgery in summer is perfectly fine — but the lifestyle that comes with summer carries a slightly higher potential for accidental eye contact.

Think about how much more we're outdoors in summer — riverside hangouts, beer gardens, barbecues, vacations, the beach, water parks… All of that excitement puts people in an elevated, carefree mood, which means they're more likely to absentmindedly rub their eyes. And that's precisely why summer deserves a bit more caution post-surgery.

Conclusion: Temperature and humidity in summer vs. winter? Not an issue at all. But the energy and excitement of summer can lead to unconsciously touching your eyes more often — and that's the real concern! (If you have the self-discipline to resist that… then you have nothing to worry about.)

Wrapping Up…!

I've done my best here to tackle four of the most persistent myths and misconceptions I encounter about SMILE, LASIK, and LASEK — with as much detail as I could pack in as a practicing surgeon. There's always so much more I want to say during consultations, but the nature of clinical appointments means sticking to what's directly relevant to each patient. This blog is where I get to ramble a little, connect the dots, and give you the full reasoning behind each answer.

As I was writing this, a few more frequently asked questions came to mind:

• Is there a big difference in visual outcomes between LASIK and SMILE?
• Can your vision deteriorate again after LASIK?
• Does it cause early-onset presbyopia?

Since this is already getting quite long, I'll stop here and continue with more myths and questions in Part 2. It's peak surgery season right now, and seeing so many patients leave our clinic with a whole new perspective — literally — is one of the most rewarding parts of this work. Wishing everyone bright, healthy eyes!