Types of Laser Refractive Eye Surgery (LASIK, PRK, SMILE)

In the not so distant past, if you couldn’t see well, you didn’t really have much of a choice. You wore glasses. 

Then along came contact lenses, and as they’ve evolved over the years, they’ve done an excellent job of providing an alternative to people that don’t like wearing glasses. In fact, contacts are still an excellent option and continue to advance in technology and effectiveness. They are available in virtually all prescription ranges these days and also for people of all ages, including those that need bifocals. 

Still though, every individual has their own preferences and unique situation in terms of vision challenges. A newer option to consider is refractive surgery. 

Even though people have been getting refractive surgery for decades now with excellent results, there are still a lot of questions from patients regarding how it works and if it’s right for them.

What is Laser Refractive Eye Surgery?

Laser refractive surgery refers to a procedure that is done using a laser to reshape the front surface of the eye, the cornea, in order to bend light differently so that images are in focus without the need for glasses or contacts. 

One way to think of it is that the laser builds the prescription from the glasses right into the front of the eye by reshaping it.

Is Laser Refractive Surgery Safe?

In general, yes, very much so. Tens of millions of these procedures have been done around the world with amazing results. But as with any surgical procedure, there is always risk involved. 

Risks of Laser Refractive Surgery

The most common complication is under or over-treatment. Usually this is very mild and manageable with either part time glasses, or a retreatment procedure. 

Another issue with refractive surgery is dryness of the eyes afterward. This is frequently treated with lubricating eye drops and usually gets better in time, but can take several months to resolve, and in some cases, never fully resolves and is a chronic issue. 

Other complications are very rare, but could include post-operative infections or prolonged inflammation which could potentially affect the visual outcome.

What Are Different Surgery Procedure Options?

There are currently 3 main types of laser vision correction:

• PRK (photorefractive keratectomy)
• LASIK (laser-assisted in situ keratomileusis)
• SMILE (small incision lenticle extraction)

There are also 2 main types of non-laser vision correction, ICL and refractive lens exchange surgery.

Alternative Procedures to Laser Refractive Eye Surgery

ICL (intraocular collamer lens) and refractive lens exchange are both

alternatives for patients that are not candidates for laser refractive surgeries, but both are more invasive and less precise than the laser options, and therefore will not be covered in depth here. 

ICL surgery is similar to surgically placing a contact lens inside the eye, and refractive lens exchange surgically removes your natural crystalline lens inside your eye and replaces it with an artificial lens. This is essentially the same as what is done during cataract surgery, but without waiting for old age and cataracts.

Of course, another alternative to laser eye surgery is to wear contact lenses. Though it does require more of a regular routine to wear contacts, they can be an extremely effective alternative to surgery.

Which Type of Laser Refractive Surgery is Best?

Unfortunately, there’s no easy answer to this. Each individual should weigh their options and consult with an eye care professional during an eye exam. Certain vision conditions, accompanied by your preferences, may guide you towards a certain method of vision correction.

There are so many good contact lens options these days that can fit just about any eye, so giving them a try first might be right for you if you’re not sure about surgery. 

Keep in mind, there’s no harm in waiting for surgery. It’s only going to get better and better as time goes on and newer technology and techniques improve upon existing methods. But, if contacts just aren’t for you, then now may be the right time for surgery. 

Over 80% of adults that wear glasses are good candidates for surgery. (1) To find out if you’re one of those people, talk to your eye doctor to see what option may be best for you.