Most of the screening tests done before you have your laser eye surgery are to determine if you appear to have more than enough corneal strength to undergo laser eye surgery. If you are told you are not a candidate, it is usually because your surgeon fears that you do not have enough strength to handle the amount of correction you will need. This could mean you have a big prescription, a thin cornea, or evidence of a weaker than normal corneal. The goal is to end up with a cornea that can hold its strength and shape for the rest of your long and wonderful life.
The eye is stronger after SMILE than LASIK. The front part of the cornea (anterior) is the strongest part of the cornea. LASIK and SMILE both remove a thin lenticule of tissue from the weaker middle part of the cornea. This results in a minimal and inconsequential weakening in appropriate candidates.
Creating the LASIK flap cuts across the stronger anterior cornea for 320 degrees whereas SMILE leaves all but 60 degrees of this tougher anterior cornea untouched. Appropriate candidates for LASIK have more than enough strength reserve for this procedure, but all other factors being equal, the great biomechanical strength left by SMILE is compelling.1,2