LASIK vs SMILE vs SILK vs Contoura: Which Eye Surgery is Right for You in Mumbai?
Dr. Nikhil Nasta
7 min read
All Four Are Laser Vision Correction: Here Is How They Differ
LASIK, SMILE, SILK, and Contoura LASIK are all forms of laser refractive surgery available in Mumbai. All four permanently reshape the cornea to reduce or eliminate dependence on glasses and contact lenses. They differ in the surgical technique used to access the corneal tissue, the laser platform involved, and the types of prescription they best address. There is no single 'best' option for everyone, the right procedure depends on your corneal thickness, prescription, lifestyle, dry eye risk, and personal preferences. This guide explains each in plain language so you can have a better-informed conversation with your refractive surgeon in Mumbai.
Full Comparison: LASIK vs SMILE vs SILK vs Contoura (Mumbai, 2026)
The table below summarises the key differences. Use it as a starting framework, not a substitute for a personalised clinical assessment.
| Procedure | How It Works | Flap? | Recovery | Best For | Approx. Cost per Eye (₹) |
|---|---|---|---|---|---|
| Standard LASIK | Blade creates corneal flap; excimer laser reshapes stroma; flap replaced | Yes (blade) | Vision stable within 24–48 hrs; full stabilisation 1 month | Moderate myopia/hyperopia, adequate corneal thickness, cost-sensitive patients | 20,000 – 40,000 |
| Bladeless / Femto-LASIK | Femtosecond laser creates flap (no blade); excimer laser reshapes stroma | Yes (laser) | 24–48 hrs for functional vision; full stabilisation 1 month | Patients wanting higher precision flap, slightly thinner corneas | 40,000 – 65,000 |
| Contoura / Topography-Guided LASIK | Corneal topography map personalises excimer laser treatment; femtosecond flap | Yes (laser) | Similar to bladeless LASIK; often superior quality of vision | Irregular corneas, higher prescriptions, night vision concerns, quality-of-vision priority | 55,000 – 80,000 |
| SMILE LASIK | Femtosecond laser creates lenticule inside cornea; extracted through small keyhole (no flap) | No (flapless) | Slightly slower initial clarity; full stabilisation 4–6 weeks | High myopia (up to -10D), active lifestyle, dry-eye-prone patients | 60,000 – 90,000 |
| SILK LASIK | Next-generation solid-state laser creates lenticule flaplessly using continuous beam technology | No (flapless) | Early vision stability comparable to SMILE; ongoing clinical data | Patients wanting the newest flapless platform, myopia up to certain range | 70,000 – 1,10,000 |
Standard LASIK: The Most Established Procedure
Standard LASIK has been performed for over 25 years and has the largest global evidence base of any refractive procedure. A microkeratome blade creates a thin hinged flap in the outer cornea; an excimer laser then reshapes the underlying stromal tissue; the flap is repositioned. Procedure time is approximately 10 minutes per eye. In Mumbai, this is the entry-level option, appropriate for straightforward prescriptions and adequate corneal thickness. Its main limitations are the use of a blade (which some patients prefer to avoid), the presence of a permanent flap (relevant for contact sport participants), and less customisation compared to topography-guided approaches.
Bladeless LASIK (Femto-LASIK): Higher Precision Flap
Bladeless LASIK replaces the microkeratome with a femtosecond laser to create the corneal flap. This allows greater precision in flap thickness and diameter, which is particularly relevant for patients with thinner corneas or irregular corneal curvature. The excimer laser step is identical to standard LASIK. In Mumbai, most high-volume refractive centres have moved to bladeless as their default. The main benefit over standard LASIK is flap quality; the main limitations (flap existence, dry eye risk) remain similar.
Contoura / Topography-Guided LASIK: Personalised to Your Cornea
Contoura LASIK, also called topography-guided or wavefront-optimised LASIK, uses a detailed map of your cornea's surface irregularities to personalise the laser treatment. Rather than applying a standard correction based only on your spectacle prescription, the laser treats the unique profile of your cornea. Clinical data consistently shows superior quality-of-vision outcomes compared to standard LASIK, fewer halos, sharper night vision, better contrast sensitivity. In Mumbai, this is the preferred option for patients with irregular corneas, previous corneal procedures, higher prescriptions, or significant quality-of-vision concerns. It is performed with a femtosecond flap and the Contoura-specific excimer laser software.
SMILE LASIK: Flapless, Keyhole Extraction
SMILE (Small Incision Lenticule Extraction) is a fundamentally different approach. A femtosecond laser (VisuMax platform) creates a disc of corneal tissue (lenticule) inside the intact cornea. The surgeon then removes this lenticule through a 2–4mm keyhole incision, no flap is created at any stage. Benefits: significantly lower dry eye incidence compared to flap-based procedures (corneal nerves are less disrupted), suitability for high myopia up to approximately -10 dioptres, and greater corneal biomechanical stability (relevant for contact sport athletes). Limitations: currently approved only for myopia and myopic astigmatism in most platforms (not standard hyperopia), slightly slower initial visual clarity compared to flap-based LASIK, and higher cost. In Mumbai, SMILE is the preferred option for high myopia and dry-eye-prone patients.
SILK LASIK: The Newest Flapless Platform
SILK (Smooth Incision Lenticule Keratomileusis) is the most recently introduced flapless laser vision correction procedure available in Mumbai. It uses a continuous-wave solid-state laser (rather than the pulsed femtosecond laser in SMILE) to create the lenticule, which developers claim results in smoother tissue surfaces and potentially faster visual recovery. Early clinical data is encouraging. As with any newer technology, the long-term outcome database is smaller than for SMILE or Contoura. SILK is currently the premium-tier option in Mumbai for patients who specifically want the latest flapless platform and are within the eligible prescription range.
Which Procedure Is Right for You? A Decision Framework
- High myopia (above -6D to -10D): SMILE or SILK, flapless procedures handle higher prescriptions with better biomechanical outcomes
- Dry eyes or dry-eye risk: SMILE or SILK, lower corneal nerve disruption reduces post-op dryness
- Active lifestyle / contact sports: SMILE or SILK, no flap means no flap-dislodgement risk from impact
- Night vision concerns or irregular cornea: Contoura topography-guided LASIK, personalised treatment delivers better quality of vision
- Moderate myopia or hyperopia, adequate corneas, cost-sensitive: Bladeless LASIK or Standard LASIK
- Priority: the latest technology available in Mumbai: SILK (with the understanding that it has a shorter outcome record)
- Thin corneas: Discuss carefully with your surgeon, minimum residual stromal bed requirements differ slightly by procedure
Who Is NOT a Candidate for Any of These Procedures?
- Corneal thickness below safe minimum for the chosen procedure
- Keratoconus or forme fruste keratoconus (irregular corneal thinning), this is a disqualifying condition
- Uncontrolled dry eye disease that does not respond to treatment
- Unstable prescription, vision must have been stable for at least one year
- Pregnant or breastfeeding at time of surgery
- Certain autoimmune conditions affecting corneal healing
- Age under 18 (typically, final assessment is always clinical)
How to Find Out Which Procedure You Are Eligible For in Mumbai
Only a full pre-operative workup, corneal topography, pachymetry, dry eye assessment, wavefront analysis, pupillometry, and a surgeon consultation, can determine which procedure you qualify for. Many Mumbai centres offer complimentary initial screenings. The surgeon will explain what they found and which options are open to you, and why. Start your assessment at Lasik Surgery Mumbai or book at Consult.
Dr. Nikhil Nasta
Dr. Nikhil Nasta is the Founder & Lead Surgeon at iSight Eye Care. With over two decades of experience, he specializes in advanced cataract surgery and comprehensive eye care, dedicated to restoring vision and improving patients' quality of life.
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Frequently Asked Questions
SMILE is not universally better, it is better for specific patients: those with high myopia, dry eye risk, or active lifestyles. For moderate prescriptions with healthy corneas, topography-guided LASIK can deliver equivalent or superior quality-of-vision outcomes. The right procedure depends on your individual anatomy.
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Disclaimer: This information is for educational purposes only. Individual cases vary; consult a specialist for personalized advice.