How to Choose the Right Vision Correction Surgery for You

Today, people who wear contact lenses or eyeglasses have more options than ever for safe vision correction surgery.

The main vision correction procedures are LASIK, PRK, SMILE, and ICL. They all improve vision in slightly different ways.

LASIK has garnered most of the attention over the years. However, one of the other procedure options might be better for correcting your refractive errors.

Your ophthalmologist will make a recommendation on the best procedure for you based on:

• Your anatomical structure.
• Your eye health.
• Your health history.
• Your lifestyle.
• Your priorities.

Still, it can help to know the basics of all the vision correction surgery options. That way, you can make an informed and confident decision on your journey to improved vision.

What Does Surgical Eye Correction Do?

Surgical vision correction is a procedure to improve or eliminate refractive errors.

But to understand how these surgeries correct vision, it helps to understand how the eye works.

To see properly, light must travel through the cornea and lens and refract (bend) to land on the retina. When light doesn’t focus properly on the retina, the result is myopia (nearsightedness) or hyperopia (farsightedness). Abnormal cornea shapes cause astigmatism.

All three of these conditions are types of refractive errors.

What Is LASIK?

LASIK stands for laser-assisted in situ keratomileusis. It's a minimally invasive laser eye surgery to correct vision problems.

To begin, the surgeon numbs the eye and uses a blade or laser to open a flap in the cornea. Then they use a bright laser light to reshape the cornea. The flap is then folded back over and naturally reattaches itself in a few minutes.

LASIK has high success rates. Over 90% of people who undergo LASIK have 20/20 or 20/40 vision without the use of contact lenses or eyeglasses.

To be eligible for LASIK, you must be over the age of 18. However, many ophthalmologists prefer to wait until at least 21 years of age. Your eyes also need to be in healthy condition with a prescription that hasn’t changed in more than a year.

LASIK isn't recommended if you have:

• Cataracts.
• Cone-shaped corneas (keratoconus).
• A high risk of eye trauma, such as from playing contact sports.
• A history of eye infections or other eye problems.
• Moderate to severe dry eyes.
• Severe cases of refractive errors.
• Severely dry eyes, as this procedure could make them worse.
• Thin corneas or corneas with any kind of disease or scarring.
• Uncontrolled diabetes or other health problems.

The risks from LASIK are relatively mild and temporary, including:

• Blood in the whites of the eyes.
• Blurred or foggy vision.
• Double vision.
• Dry eyes.
• Halos or starbursts around lights.
• Infection.
• Light sensitivity.
• Painful eyes.
• Worse vision, even with corrective lenses.

Although rare, some people end up with over- or under-corrected vision. These people require another laser surgery to tweak the new prescription.

Recovery typically takes up to three days and is minimal.

Because the flap can dislodge with trauma to the eye, LASIK isn't the best fit for people who may experience extreme physical contact. This includes people who play contact sports or are in active military service.

Depending on your care provider, they may offer a few different types of LASIK surgery options. Be sure to talk with your provider about the differences to find out which procedure option best suits your specific needs.

What Is SMILE?

SMILE stands for small incision lenticule extraction. SMILE eye surgery also involves lasers to correct vision but uses a different method.

During SMILE, the ophthalmologist numbs the eye and uses the laser to cut a disc into the cornea to create a lenticule. They then remove the lenticule through a tiny incision alongside the cornea.

SMILE is a great option over LASIK for people with moderate to severe dry eyes or strong nearsightedness. It has a high success rate, with more than 85% of people achieving 20/20 status after surgery.

SMILE is ideal for people who:

• Are over 22 years of age.
• Have a prescription that hasn’t changed in more than a year.
• Have good eye health and overall health.
• Lead active lifestyles due to sports or work environment.
• Suffer from dry eyes.

SMILE isn't recommended for people who:

• Are pregnant or nursing.
• Form keloids easily or suffer from excessive scarring.
• Have any underlying eye conditions, infection, or complications.
• Have cataracts.
• Have other health conditions, including skin conditions, that may interfere with surgery or recovery.

Healing from SMILE is fast. It typically involves two or three days of resting at home before you can resume everyday activities.

What Is PRK?

Photorefractive keratectomy (PRK) has been around even longer than LASIK. But it's not as well-known.

During PRK, the surgeon numbs the eye and removes a layer of cells on the outside of the cornea using a laser, blade, or brush. Once they've removed the cells, the surgeon uses a bright laser light to reshape the cornea, which heals on its own.

PRK may be the best option for vision correction if you:

• Are at risk of flap complications or dislodging (used in LASIK).
• Have extra thin or irregularly shaped corneas.
• Have previously had LASIK and need another surgery to correct the previous procedure.
• Lead an adventurous, active lifestyle.
• Play contact sports.
• Work or live in high-risk environments.

While PRK preserves more corneal tissue than other procedure options, the recovery time is a bit longer — typically five to seven days. It can also be a more uncomfortable healing process as the cornea regenerates itself.

PRK is a successful surgery. Over 90% of people achieve 20/40 vision or better after recovery.

What Is ICL Surgery?

Implantable Collamer® Lens (ICL) surgery is a minimally invasive procedure. It involves inserting a thin lens between the natural lens and iris of the eye.

ICLs, also known as phakic intraocular lenses (IOLs), can treat myopia and astigmatism. ICL is another option for people who don't qualify for LASIK or the other laser correction methods.

Like other laser surgeries, the procedure begins with numbing the eyes, keeping them open, and making a tiny cut on the surface. A surgeon then inserts the lens behind the iris and unfolds it in front of the eye’s natural lens.

ICL isn't the right procedure for you if you:

• Are pregnant or nursing.
• Have an autoimmune disease that could interfere with the healing process.
• Have irregularly shaped eye anatomy that wouldn’t fit the lens well.

ICL may be a good option for people who cannot undergo LASIK, SMILE, or PRK because:

• Their cornea is in poor condition.
• Their prescription is too strong (over -10 diopters).

Which Eye Surgery Procedure Is Right for Me?

Choosing the right vision correction procedure is an important decision. It's important to consider the guidance of your ophthalmologist and care team.

When you meet with your provider, be sure to share your entire health history. Also give them any information that you think would be important for making this decision.

Some questions you can bring with you to ask your eye doctor include:

• Do I have any other health or eye conditions that might rule out a certain procedure?
• How long will recovery be?
• Is this an optimal time for me to be having this surgery?
• Is there a certain vision correction procedure that seems better for my eye health/lifestyle?
• What are the side effects and risks involved?
• What results can I realistically expect?
• Would any medications I’m currently taking interfere with my results?

Asking questions and being honest with your provider will help steer you in the right direction for surgery. At the end of the day, the best decision is the one you feel most comfortable and confident about.