LASIK is the brand name everyone knows; SMILE is the newer procedure quietly dominating the conversation in China, where it was first performed and where volumes are among the world’s highest. If you are comparing refractive surgery options across countries — or just deciding which one to ask about — the honest picture has three parts: what each procedure physically does, what the price picture looks like on each side of the Pacific, and who qualifies for either. One warning applies to everything below: no website can tell you which procedure fits your eyes. That answer comes from the measurements.
The two procedures, mechanically
| Aspect | LASIK | SMILE |
|---|---|---|
| How the eye is opened | A hinged flap is created in the cornea (by femtosecond laser), lifted, then the excimer laser reshapes the tissue beneath. | No flap. A femtosecond laser cuts a small lens-shaped disc inside the cornea, removed through a tiny incision. |
| Corneal impact | Larger area disturbed; flap heals back but remains a long-term consideration. | Smaller incision; corneal surface mostly untouched — the basis for its dry-eye claims. |
| Range of correction | Widest — handles a broad range of nearsightedness, farsightedness and astigmatism; customised ablation profiles available. | Narrower — primarily nearsightedness with astigmatism; limited farsighted capability. |
| Equipment | Two lasers (femtosecond + excimer) from several manufacturers — competitive equipment market. | One proprietary platform (Zeiss VisuMax) — the equipment market is a monopoly by design. |
Both share the same fundamental limit: they reshape the cornea, they do not treat the eye’s aging. Presbyopia still arrives in your forties either way, and future cataract surgery still needs lens planning.
The price picture — and its asymmetry
This is where our sourcing rule bites. On the US side, the American Refractive Surgery Council — the industry’s own statistical body — publishes an average of $4,492 for both eyes (2023 data). That is a source with a methodology behind it, and we cite it as such.
On the China side, refractive surgery prices are set by private-heavy markets and competitive positioning; we found no government publication or industry survey with a defensible national figure — the English-language internet’s “$1,000–$2,500 in China” ranges trace back to clinic marketing quoting each other. So this article publishes no China price. The honest move is the one the deposit checklist teaches: get an itemised written quote from the specific hospital, and ask what drives the spread — the equipment generation, the surgeon grade, the pre/post-op bundle.
Who qualifies — the part no brochure leads with
- Stable prescription. Refractive surgery waits for your correction to stabilise (typically measured as little change over the prior year or two). Rushing it means redoing it.
- Enough cornea. Both procedures remove tissue; thin or irregular corneas disqualify. The measurement (corneal topography, pachymetry) decides — not preference.
- Healthy eye surface. Severe dry eye is a disqualifier for many candidates — and the reason SMILE’s dry-eye profile matters for borderline cases.
- Realistic expectations. Surgery aims at reduced dependence on glasses, not guaranteed perfect unaided vision at every distance, and reading glasses may still arrive on schedule.
The screening exam is the product before the product. Any provider — in any country — willing to schedule surgery without a full qualification workup is answering your safety question for you.
Questions that separate good quotes from sales
✓Ask every provider
- “Which procedure do my measurements support — and which would you not do for me?”
- “What exactly is in the quoted price — screening, enhancement policy, medications, follow-ups?”
- “Who operates, and what is their registration?”
- “What happens if my result needs enhancement — at what cost?”
×Walk away from
- Same-day screening-to-surgery without full testing
- Prices that only exist inside a tourist package
- “Painless, riskless, permanent” language
- No named surgeon at the quote stage
Eye pricing, the sourced version
Cataract lens prices are where China publishes hard numbers — central procurement put them on the record: