In ReLEx SMILE, a lenticule is cut from the eye’s cornea (outermost surface) with afemtosecond laser and then removed via a small incision.
Hyperopia treatment is not possible with ReLEx, which is used to treat myopia/shortsightedness and astigmatism only. In ReLEx SMILE, any subsequent enhancement has to be done on the surface (PRK) or converting to LASIK. Visual recovery has been reported to take longer with ReLEx. ie after surgery, ReLEx patients experience blurry vision for a longer time compared to LASIK. The chances of achieving good visual acuity with good quality of vision are better with LASIK because of cyclotorsion control (astigmatic correcting efficacy), because of the possibility of wavefront guided treatments with LASIK, and because ablation profiles are more versatile with LASIK.
Side effects wise, they will be quite similar, except for less dryness in the initial post operative period with ReLEx. When the eyes have healed in about 3-9 months time, there would be no or minimal difference in eye dryness between LASIK or ReLEx. After surgery care should be the same as well. SMILE does not necessarily result in a biomechanically stronger eye when compared with LASIK. LASIK is mature technology which is still being refined all the time. Many of the most important developments have already taken place ie advanced ablation profiles for most types of refractive errors, advanced (even predictive) eye tracking in 6 dimensions, fast laser pulse repetition rates, cyclotorsion control. In contrast, ReLEx is still a procedure in evolution, with many issues which have already been addressed in LASIK still to be dealt with in ReLEx.
All in all, LASIK remains the gold standard for refractive correction. It is the most versatile method, the machines have enormous capability to customize treatments and to make sure the treatments occur as planned. ReLEx may have a place in refractive surgery, but at the moment, the claimed advantages of ReLEx cannot compare with the proven capabilities of LASIK.