Comparing Approaches to Refractive Laser Eye Surgery

Laser eye surgery is one of the most common outpatient ophthalmic procedures performed in the United States. Most patients choose laser eye surgery because they want to decrease the need for daily glasses or contact lens wear. In the past 10 years, over 700,00 eyes have been treated with some type of laser surgery (1).1 While colloquially known as “LASIK,” there are three major types of laser eye surgeries: Photorefractive Keratectomy (PRK), Laser in Situ Keratomileusis (LASIK), and Small Incision Lenticule Extraction (SMILE). These surgeries all fundamentally rely on the same concept of using a laser to reshape the cornea (the clear surface layer of the eye), allowing the patient to have better vision (2).2 Other approaches to correcting refractive error include Implantable Collamer Lenses (ICLs) and Intraocular Lenses (IOLs), which involve operating inside of the eye and implanting a lens, making them more invasive and expensive options. This article focuses on the laser procedures available for correcting refractive error. PRK, LASIK, and SMILE are all similar in that they treat the cornea, but each utilizes slightly different techniques to reach their desired goal and may provide different benefits to each patient.