LASIK, LASEK, SMILE, or Lens Implant Surgery — Which One Is Right for You?

Hello, this is BGN Eye Clinic Jamsil Lotte World Tower.

Just yesterday, after completing a comprehensive eye examination, I had a familiar moment: I told a patient that LASIK, LASEK, and SMILE were all viable options for them, and they looked at me and said, "So… which one should I get? There are so many, I have no idea." Having multiple good options is a great thing — but it seems that's exactly what makes the decision feel overwhelming.

Today, I'd like to share the same explanations I actually give patients during consultations — walking through the pros and cons of each procedure and what factors should guide your choice.

We Recommend Based on Your Examination Results

When patients ask, "What would you recommend?" I usually respond like this:

"Since your test results show all three options are suitable for you, would you like to go with the one that involves the least discomfort and the fastest recovery?"

Almost everyone says yes — and that procedure is SMILE.

Patients whose corneal thickness, myopia prescription, and other measurements all come back within healthy ranges most commonly end up choosing SMILE.

Why LASEK Tends to Be the Most Uncomfortable

When I explain LASEK to patients, I use a comparison that seems to resonate: "LASEK basically involves peeling back the surface of the cornea — it's a lot like scraping the skin off your knee when you fall."

In practice, LASEK works by removing the corneal epithelium and then reshaping the cornea with a laser. The discomfort comes while waiting for that epithelial layer to grow back — it's a bit painful, and recovery takes comparatively longer.

LASIK, by contrast, involves creating a thin flap in the cornea, treating the tissue underneath, and then laying the flap back down. This means almost no pain and a quick recovery.

SMILE is even simpler — because only a tiny internal lenticule is extracted from within the cornea, surface disruption is kept to an absolute minimum.

So Why Would Anyone Choose LASEK?

A lot of patients wonder: "If LASEK is more painful, why would anyone choose it?" There are really two main reasons.

Cost

LASEK is generally a bit less expensive than the other procedures.

Corneal Eligibility

Some patients simply aren't suitable candidates for LASIK or SMILE — and for them, LASEK may be the only available option.

Corneal Thickness and Prescription Are the Key Factors

Many patients come in having heard that "corneal thickness is really important" — and they're right. Corneal thickness is one of the most critical measurements we evaluate.

LASEK removes less corneal tissue overall, which is why patients with borderline corneal thickness measurements are sometimes directed toward it. Patients with sufficient corneal thickness may be candidates for LASIK, LASEK, or SMILE — in which case, lifestyle and personal preferences become the deciding factors.

When the Examination Rules Out All Surgical Options

Occasionally, a patient completes the full battery of 20-plus diagnostic tests and receives the difficult news that no procedure is currently safe for them. This happens when corneal topography or thickness measurements fall outside safe surgical parameters, and there isn't enough anterior chamber depth for lens implant surgery either.

Patients are naturally disappointed, but when we walk through the measurements together and I explain the reasoning, most people respond with "Safety comes first" and understand completely.

When Is Lens Implant Surgery the Answer?

For patients who aren't eligible for LASIK, LASEK, or SMILE, lens implant surgery is the next option to consider. Rather than reshaping the cornea, this procedure places a specially designed lens inside the eye. However, it does require sufficient space within the eye to be feasible.

When Patients Push Back on LASEK

Sometimes, when I tell a patient "LASEK is the only procedure suitable for you," their immediate reaction is: "I absolutely cannot handle pain!" — and they refuse outright. This is especially common among people who can't take extended time off work. We generally recommend taking 4–5 days off after LASEK.

But when I explain, "If you want to be free from glasses, this is the only path available to you right now…" — almost everyone comes around in the end.

Accurate Measurement — and the Whole Person — Matter

What I've come to appreciate through years of consultations is that choosing the right procedure requires looking at the whole picture — not just the numbers, but the person behind them. Corneal thickness and prescription values matter, but so does occupation, lifestyle, and how much recovery time a patient can realistically afford.

For example, athletes or people who practice contact sports are often steered toward LASEK, which offers greater structural safety against physical impact. Professionals who need to return to work quickly tend to prefer SMILE or LASIK.

Summary

• To minimize discomfort → SMILE > LASIK > LASEK
• For fastest recovery → SMILE ≥ LASIK > LASEK
• If cost is a priority → LASEK is generally most affordable
• If corneal conditions are marginal → Only LASEK or lens implant surgery may be possible
• If no procedure is suitable → Seek consultations elsewhere, but never rush into a procedure that isn't safe

When you come in for your examination, sharing your lifestyle and priorities upfront makes a real difference. "I'd like the shortest recovery time possible," "Cost is a factor for me," "I play sports regularly so safety is my top concern" — that kind of information helps enormously.

Vision correction surgery is permanent and irreversible — so please take the time to get a thorough examination and make your decision carefully.