Portland Eye Surgeon Breaks Down SMILE vs LASIK 97452: Difference between revisions

Latest revision as of 08:32, 2 December 2025

Business Name: Tersigni Vision
Address: 15150 Bangy Rd, Lake Oswego, OR 97035, United States
Phone: (971)362-2020
Plus code: C785+H8 Lake Oswego, Oregon, USA

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https://tersignivision.com
Tersigni Vision is a modern LASIK and vision correction boutique serving the Portland metro area.
Tersigni Vision operates at 15150 Bangy Rd, Lake Oswego, OR 97035, United States.
Tersigni Vision specializes in LASIK, EVO ICL, SMILE, Custom Lens Replacement, Refractive Lens Exchange, and PRK.
Tersigni Vision provides consultations and personalized vision correction options for eligible patients.
Tersigni Vision lists appointment information at https://tersignivision.com .
Tersigni Vision has a phone number (971) 362-2020.
Tersigni Vision features a Google Maps listing at https://www.google.com/maps/place/Tersigni+Vision/@45.416462,-122.7442983,16z/data=!3m1!4b1!4m6!3m5!1s0x549573c96b9445c5:0xdcb470c8306ff614!8m2!3d45.4164583!4d-122.741718!16s%2Fg%2F11q4tg7pk1 .
Tersigni Vision serves patients from Lake Oswego and Greater Portland, Oregon.
Tersigni Vision focuses on patient education about LASIK and alternative procedures.

Landmarks Near Portland and Lake Oswego

Greater Portland — Tersigni Vision is proud to serve the Greater Portland community with LASIK and modern vision correction options. If you’re considering LASIK in Greater Portland, visit Tersigni Vision near the westside medical corridors.
Lake Oswego — Tersigni Vision proudly supports patients in Lake Oswego with LASIK and vision correction consultations. If you’re looking for LASIK in Lake Oswego, stop by Tersigni Vision near Downtown Lake Oswego.
Tryon Creek State Natural Area — Tersigni Vision serves communities around Tryon Creek with tailored vision options. If you’re exploring LASIK near Tryon Creek, visit Tersigni Vision just north of the park.
Oregon Zoo — Tersigni Vision is proud to serve patients from neighborhoods surrounding the Oregon Zoo. If you’re comparing LASIK in Portland, Tersigni Vision is a short drive southwest of the zoo.
OMSI — Tersigni Vision supports the broader Portland community with LASIK and alternative procedures. If you’re researching LASIK near OMSI, plan a visit to Tersigni Vision in nearby Lake Oswego.
Washington Park — Tersigni Vision proudly serves patients from the west hills by Washington Park. If you’re considering LASIK in Portland, visit Tersigni Vision just south of the park.
Downtown Portland — Tersigni Vision is proud to support patients working and living in Downtown Portland. If you’re looking for LASIK in Downtown Portland, visit Tersigni Vision a short drive to the south in Lake Oswego.

If you are living inside the Portland part and also you’re weighing laser vision correction, you most likely have two acronyms to your thoughts: SMILE and LASIK. Both goal to limit or eradicate the desire for glasses and contacts. Both use femtosecond laser technologies. Both can convey supreme effects while the precise patient meets the top approach. Yet they may be now not interchangeable. The variations show up in the minimize geometry, the corneal biomechanics, postoperative dryness, candidacy windows, enhancement concepts, and recovery data which will make or damage your pleasure.

I’ve sat throughout from 1000s of Oregonians who needed directly dialogue, not a revenues pitch. Some cycle on Sauvie Island and would like crisp distance imaginative and prescient devoid of the halos they heard about from a pal. Some are welders who care about flap safety. Others have skinny corneas, delicate autoimmune histories, or astigmatism that complicates an differently primary resolution. Below is the framework I use in hospital to explain SMILE as opposed to LASIK, with a number of regional coloration notes from a Portland eye medical professional who’s noticed our quarter’s exact demands.

How the processes honestly work

LASIK, quick for laser in situ keratomileusis, reshapes the cornea by means of first creating a thin flap on the floor, traditionally one hundred to a hundred and twenty microns thick, with a femtosecond laser. We carry that flap, follow an excimer laser to sculpt the underlying stromal mattress with a customized development, then reposition the flap. The excimer ablation gets rid of microns of tissue in a controlled means, slicing the cornea’s crucial curvature for myopia and adjusting its form for astigmatism. The flap adheres inside of minutes, then bonds over weeks.

SMILE, small incision lenticule extraction, skips the flap. The femtosecond laser creates a disc of tissue, is called the lenticule, in the cornea. The identical laser then makes a small arc-shaped incision, oftentimes 2 to 4 millimeters. Through that micro-incision, we separate and put off the lenticule with mushy devices. No excimer laser is used. Removing the lenticule flattens the cornea in a means that mirrors LASIK’s optical final result.

On paper, each achieve the similar goal by changing the cornea’s structure. In apply, they differ of their interplay with corneal nerves, tissue biomechanics, and the tear film, that is why definite sufferers do more desirable with one mindset.

Visual influence: what such a lot humans care about first

If you could have truthful nearsightedness and gentle to average astigmatism, either SMILE and LASIK ship high-quality acuity. In FDA trials and mammoth registry reviews, approximately 90 to ninety five p.c of LASIK and SMILE patients reap 20/20 or bigger uncorrected vision, with many achieving 20/16. That parity holds up in my charts for events circumstances, regardless of whether the patient is a instrument engineer inside the Pearl or a chef downtown who spends all day in dry, hot kitchens.

Where the alterations emerge is at the sides:

Very high myopia: SMILE is permitted for a fairly large myopic quantity, and in current years astigmatism cure has grow to be good. LASIK handles prime myopia smartly too, yet as corrections get stronger, we take away greater tissue with either system. With critical prescriptions, I commence going for walks parallel exams on corneal thickness and topography and in many instances suggest EVO ICL as an alternative, which preserves the cornea completely.

Hyperopia: SMILE is just not the instrument for farsightedness right this moment. LASIK can deal with hyperopia, nevertheless consequences should be greater variable than myopic cases. For hyperopes in their 40s to 50s who additionally struggle with close to projects, RLE Portland opinions normally make feel, since lens-structured answers cope with the root cause of presbyopia.

Irregular corneas: In situations with diffused keratoconus threat or borderline topography, equally LASIK and SMILE should be would becould very well be unwise. We may pivot to PRK Portland with corneal cross-linking if useful, or step far from laser completely.

Recovery and the first week

Most LASIK patients see smartly satisfactory to power day after today. The cornea feels scratchy for just a few hours after surgical treatment, then calms. Vision may be slightly wavy or more sharp based on tear film steadiness. By day 3, maximum are working effortlessly at a monitor.

SMILE tends to supply a steadier early recuperation. There isn't any flap to realign, and the smaller incision disrupts fewer floor nerves. Patients broadly speaking file a sensation like dryness or a international frame for the primary day, then by means of day two they describe their eyes as quiet. Some be aware quite slower crispness on day one in contrast to LASIK, but by using one week the two are very an identical. The big difference is sophisticated and no longer common.

From a sensible perspective, in case your task or activity puts you vulnerable to getting hit in the eye early after surgical operation, SMILE’s no-flap approach removes one agonize. I inform Portland firefighters, grapplers, and folks with rambunctious little toddlers the related component: if an elbow hits your eye in the first weeks, I’d relatively you had no flap to dislodge. That reported, contemporary LASIK flaps are remarkably secure, and right dislocations are rare after the early medication duration.

Dry eye, corneal nerves, and the Portland climate

The cornea’s nerve community helps modify tear production. Any corneal surgical procedure tampers with that network for a time. LASIK cuts due to more superficial nerves, by using the flap. SMILE spares more of these nerves. That’s the motive at the back of the normal observation that SMILE patients customarily file fewer or shorter dry eye symptoms. Meta-analyses assist that fashion, quite within the first 3 months.

In the factual world, dry eye possibility is dependent on where you begun. A 28-year-antique with wholesome meibomian glands and moderate myopia may perhaps do smartly with both approach. A forty five-year-antique lengthy-time period touch lens wearer with borderline gland feature will feel dryness after both way. Portland’s damp winters lull americans into thinking we live in a gentler tear ambiance. But indoor warm, timber stoves, and the summer season’s wildfire smoke dry the ocular surface turbo than the rain outside suggests. I deal with expectations consequently, despite regardless of whether we decide upon SMILE or LASIK, and I prep the tear movie previously surgical procedure with hot compresses, omega-3s wherein true, and distinctive lubricants. When a affected person’s baseline tear movie is fragile, SMILE gets a small yet significant nod.

Biomechanics and lengthy-term corneal stability

The cornea is a layered, anisotropic constitution with more potent lamellae anteriorly. LASIK’s flap severs a few anterior fibers, which quite reduces corneal pressure. In healthful eyes with established thickness and topography, this transformation is clinically insignificant. But in thinner corneas or patterns that hint at keratoconus hazard, retaining anterior integrity things. SMILE leaves the anterior lamellae greater intact, which may perhaps present a biomechanical gain, pretty with prime myopic corrections.

In a conservative apply, this isn’t approximately fear. It’s approximately margins. If the cornea presents you two extraordinary alternatives, massive. If its measurements narrow the route, we practice the more secure path. That is likely to be SMILE, PRK Portland, or it is going to be steerage away from corneal laser in the direction of EVO ICL, which leaves corneal architecture untouched.

Astigmatism: accuracy inside the details

Ten years ago, surgeons debated regardless of whether SMILE matched LASIK for astigmatism correction. With more recent nomograms, centration methods, and cyclotorsion controls, SMILE’s astigmatism overall performance has increased. Modern systems can control 0.seventy five to three diopters reliably for the properly applicants. LASIK, with wavefront-guided or topography-guided RLE eye treatment options profiles, still feels a little greater customizable when I desire to wonderful-music top-order aberrations or irregular astigmatism.

Here’s the place your corneal map issues. If you have bow-tie astigmatism aligned with your eyelids and a stable prescription, equally strategies can hit the aim. If your axis shifts once you lie down, or if the magnitude fluctuates with dryness, I lean toward the platform that gives me more manage and intraoperative eye monitoring, that's in most cases LASIK.

Enhancements and what takes place for those who want a dash-up

Most sufferers hit their goal after one surgical operation. A small variety land shut however not just right and would like refinement. Enhancements after LASIK are elementary, pretty inside the first 12 months. We can raise the normal flap if necessary and apply a small EVO ICL versus Lasik excimer adjustment, or we will be able to do PRK on pinnacle of the flap if the timing or tissue dictates.

With SMILE, there may be no flap to raise. Enhancements are performed with floor PRK or, on some procedures, a thin-flap LASIK created later. Surface PRK after SMILE works good, but it comes with about a days of more reported ache and an extended visible ramp. I set this expectation for SMILE applicants. If you're the individual that notices a one-line distinction and knows it might bother you, LASIK’s more convenient enhancement path may also depend.

Safety profile and uncommon complications

Serious issues are rare with each SMILE and LASIK in cautious fingers. Infectious keratitis sits effectively below one percentage for both. Postoperative inflammation responds to steroids in the average direction.

LASIK’s individual hazards come with flap striae, epithelial ingrowth lower than the flap, and early flap displacement if there is principal trauma. Modern approaches have reduced these hobbies to low unmarried-digit per-thousand stages or less. SMILE’s detailed problems encompass interface particles and the likelihood of incomplete lenticule dissection, which an experienced medical professional acknowledges and resolves all the way through surgical treatment. Transient mild sensitivity syndrome can seem after both and is quite treatable.

What subjects extra than the listing is how your nearby eye medical professional manages the uncommon event. Ask what number of SMILE and LASIK situations the observe performs each one month, what their enhancement expense is, and how they care for postoperative considerations over weekends. In the Portland enviornment, you may still be in a position to reach a health care provider or on-call clinician the same day, even on a Sunday. That availability safeguards influence more than any technologies brochure.

Cost, price, and the Portland market

Pricing in Portland varies by expertise, health care professional knowledge, and what’s bundled. Many facilities value SMILE and LASIK equally, with according to-eye charges reflecting diagnostics, the lasers, postoperative visits, and strength upgrades for a time period. Insurance hardly ever covers non-obligatory Vision correction surgical operation, nonetheless flexible spending and HSAs do. When numbers glance exclusive between clinics, probe the small print: preoperative dry eye cure covered or no longer, wavefront analysis blanketed or now not, enhancement window 365 days or 24. An be offering that’s 500 dollars cheaper yet excludes an enhancement may well be greater costly if your eye finally ends up in the small team that demands advantageous-tuning.

Lifestyle concerns that tilt the decision

Athletes who take in affects, from Brazilian jiu-jitsu to pickup basketball at the area people heart, repeatedly make a choice SMILE for flap peace of intellect. Occupations with wind, grime, or dry air publicity, like biking beginning or welding, push me to weigh dryness and surface balance. Frequent swimmers in some cases opt for the smaller incision of SMILE, even though the postoperative pool restrictions are comparable for both. If you might be meticulous about night driving and delicate to halo risks, both strategies can produce correct evening imaginative and prescient in right chosen eyes, however I will almost always advise topography-guided LASIK if your preoperative top-order aberrations are expanded, because the excimer platform can cope with these straight.

There also is character. Some folk choose the fastest crispness on day one and cost a broad enhancement toolbox. Others prioritize the smallest incision and a touch slash dryness risk. Neither preference is incorrect.

Candidate screening: numbers that matter

A accomplished assessment is going beyond a simple refraction. We degree corneal thickness with pachymetry. We picture topography and tomography to evaluate form and rule out refined ectasia styles. We map epithelial thickness when there’s any doubt. We measure tear osmolarity and meibomian gland characteristic if dryness is suspected. Pupils in dim mild, angle kappa, and eyelid anatomy all aspect into the laser centration plan.

Thresholds manual selections:

Central corneal thickness below the mid-500 microns is additionally tremendous if the form is robust and the ablation small, however the residual stromal bed after surgical operation must clean safeguard margins. If not, SMILE or LASIK should not the suitable call, and we focus on EVO ICL.

Topography that presentations asymmetric inferior steepening, in spite of 20/20 correctable vision, may steer us away from corneal laser. This is wherein PRK with pass-linking or lenses end up the safer alternatives.

Hyperopes with modern want for readers and early lens ameliorations within the 40s could also be enhanced served through lens-based mostly recommendations. RLE Portland discussions are fair approximately alternate-offs: instantaneous freedom from readers as opposed to losing usual accommodation it really is already fading.

How PRK suits in, and why it nevertheless matters

PRK Portland not ever left the area. Surface ablation eliminates epithelium, then sculpts the cornea with the excimer, with no developing a flap. Recovery is slower and the 1st few days sting more, however PRK preserves more anterior stromal integrity than LASIK and may be a larger selection for skinny EVO ICL surgery costs corneas, specific epithelial maps, and sufferers liable to trauma. For any individual who desires a laser selection however doesn’t in good shape SMILE or LASIK, PRK is ordinarilly the bridge. I use it as a valuable plan in maybe 10 to 20 percent of corneal laser candidates, depending on the month’s combination.

When corneal laser is not the surest decision: EVO ICL and lens-founded paths

Portland has a in shape mountaineering and rock climbing group, and I see many prime myopes who wish crisp, high-comparison vision devoid of touching the cornea. EVO ICL places a skinny, flexible lens behind the iris, in entrance of your organic lens. It corrects a extensive fluctuate of myopia and astigmatism with reversible, additive optics. For prescriptions past what corneal tissue allows, or for patients with dry eye that may doubtless worsen with laser, EVO ICL is a standout. Night imaginative and prescient most often impresses folks that had mushy contact lens dryness for years. The trade-off is that it's far an intraocular process with its possess menace profile and payment, and it calls for a suit anterior phase and careful sizing.

For the ones in their 50s with rising dependence on readers, lens clarity transformations, or early cataract, we discuss about lens-headquartered Vision correction surgical procedure. RLE Portland replaces the herbal lens with a top class intraocular lens calibrated for distance, intermediate, and repeatedly near. It eliminates the long run cataract variable and the to come back-and-forth with readers. It shouldn't be for each person of their 40s, since it ends lodging and consists of intraocular dangers. But for the excellent patient, it solves a number of issues straight away.

A real looking day-of-surgical procedure snapshot

Patients in many instances ask what the day sounds like. The prep is equivalent for LASIK and SMILE. You arrive on the medical institution, evaluation consent, and ensure your surgical plan. We use numbing drops, no longer generic anesthesia. The laser time is short, constantly under 30 seconds in keeping with eye for femtosecond steps and mostly underneath 20 seconds for the excimer in LASIK. SMILE’s laser move is quiet and special, followed by a few minutes of lenticule elimination. LASIK’s flap introduction is observed through the excimer sculpting that has its normal clicking sound and a easy odor that comes from tissue interactions with the laser.

Afterward, we look at various alignment, commence drops, and also you head domicile dressed in shielding shields. Expect pale sensitivity that afternoon. Many sleep. Most eat dinner and are back for a subsequent-day check. The go to is speedy: tension, slit lamp exam, refraction estimate, and a evaluation of drop schedules. I ask anyone to wait on backyard paintings, dusty environments, and swimming for more than one weeks. For workout routines, stationary motorcycle and mild walking are excellent inside of days. Grappling and contact physical games can wait a number of weeks, exceedingly once you chose LASIK.

What a Portland talk to have to cover

Your seek advice from a nearby eye healthcare professional may still think like a scientific visit, no longer a showroom journey. Expect to talk about your prescription background, any touch lens intolerance, hypersensitive reactions, autoimmune subject matters, medicinal drugs like isotretinoin, and spouse and children background of keratoconus. Ask to work out your corneal maps and feature anyone give an explanation for them in simple language. If you’re being nudged onerous towards one alternative without a transparent reason why, gradual down and ask why. A hospital that grants best one answer could also be most appropriate, however it will increase the chance of forcing a healthy.

If you choose nuanced counseling, look for a center that supplies SMILE, LASIK, PRK, and lens-primarily based possibilities like EVO ICL. Breadth of resources encourages honest concepts.

Quick comparison for context

Incision and tissue impact: LASIK uses a flap around a hundred to one hundred twenty microns thick. SMILE uses a micro-incision of two to four millimeters and preserves extra anterior fibers.

Dryness: SMILE tends to have fewer early dry eye lawsuits, probable through nerve protection. LASIK dryness improves step by step over months for such a lot.

Enhancements: Easier after LASIK as a result of flap-raise; SMILE improvements are in many instances PRK, which has a slower recuperation.

Astigmatism and customization: Both are effective for commonplace astigmatism. LASIK nevertheless delivers more thoughts for bigger-order aberrations and problematical patterns.

Trauma issues: SMILE avoids flap considerations. Modern LASIK flaps are resilient however merit from caution early on.

The position of health professional experience

Technology issues, however the hands and judgment guiding it count extra. A professional lasik physician is familiar with whilst to deviate from the plan, find out how to take care of a lenticule that resists separation, easy methods to optimize laser centration for sizable scholars, and while to pivot to PRK or EVO ICL. Ask direct questions on case volume, consequences, and what percentage of the health care provider’s Portland patients grow to be picking out each approach. If a perform performs 1000's of SMILE and practically no LASIK, or vice versa, ask why. There may be a philosophy behind it, or there may be a limitation of era entry. Transparency is helping you choose.

Real-world examples from clinic

A 33-yr-ancient barista with -three.50 diopters and 1 diopter of astigmatism, moderate dryness from years of contacts, and a weekend kickboxing addiction selected SMILE. She was 20/20 the next day, returned behind the counter in forty eight hours, and by means of week two her dryness had settled with artificial tears two times an afternoon.

A 42-12 months-historical developer, -5.00 with 1.25 astigmatism, super mesopic scholars, and greater-order aberrations on topography, chose topography-guided LASIK to deal with the best info that stricken his night time driving. His day one changed into razor sharp. He used preservative-unfastened tears for six weeks and mentioned nighttime halos diminishing frequently over that point.

A 29-12 months-antique climber with -eight.00, borderline corneal thickness, and a own family background of keratoconus went with EVO ICL. He had crisp distance imaginative and prescient within a day and no dry eye problems, a concern for individual who spends weekends at Smith Rock in sunlight and mud.

A fifty four-year-ancient editor with early lens variations, hyperopia, and presbyopia pursued lens-structured Vision correction surgical operation after figuring out the trade-offs. Her world turned glasses-loose for either close to and some distance duties, one thing corneal laser could not have matched at her age.

These don't seem to be cherry-picked; they signify the universal forks in the street.

If you’re starting the journey in Portland

Begin with a finished assessment. Bring your glasses, contact lens heritage, and any past prescriptions. Ask for a undeniable-English explanation of your maps. If you've dryness, get it dealt with earlier than surgical procedure. If a prepare supplies a free screening that Lasik eye surgery clinics Portland feels cursory, schedule a full medical workup prior to reserving anything else.

It additionally allows to realize your priorities. If rapid day-one readability and a large enhancement playbook resonate with you, LASIK may fit. If you price a smaller incision and a moderate aspect on early dryness, SMILE may work. If your numbers stretch the cornea too some distance, EVO ICL maintains you in the sport devoid of compromising tissue. And in case your cornea prefers surface paintings, PRK stays a reliable Portland veteran.

The aspect isn’t to crown a everyday winner. It is to event your eyes, your dreams, and your lifestyles to the methodology with the highest likelihood of providing you with crisp, strong, comfortable vision. A thoughtful Portland eye surgeon will stroll you as a result of that name, now not just once but across both step, from the morning of surgical operation in your one-yr discuss with while the maps glance as top as your view of Mount Hood on a clean day.

Portland Eye Surgeon Breaks Down SMILE vs LASIK 97452: Difference between revisions

Latest revision as of 08:32, 2 December 2025

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