Refractive Surgeries: LASIK, PRK, SMILE. Everything You Need To Know.


If you have nearsightedness (myopia), farsightedness (hyperopia), astigmatism or presbyopia, and considering correcting and improving your vision with a refractive surgery. This article is for you.

Prior to any refractive surgery, numerous tests will be performed on your eyes to determine the amount of correction needed.

This are some of those tests.

  • Corneal topography & Corneal thickness
  • Dry eye testing
  • Visual acuity and refractive error
  • Screening Visual Field
  • Pupil size in low & medium light
  • Ocular pressure
  • The general health of the eyes

What are the benefits of a refractive surgery?

  • Clear, natural vision
  • Decreased dependency on glasses or contacts
  • Major lifestyle advantages with sports
  • Convenience with travel
  • Ability to get up and GO!
  • No hassle with contact solutions
  • Improved appearance with NO glasses

Refractive surgery might be a good option for you if you:

  • Want to decrease your dependence on glasses or contact lenses;
  • Are free of eye disease;
  • Accept the inherent risks and potential side effects of the procedure;
  • Understand that you could still need glasses or contacts after the procedure to achieve your best vision.
  • Have an appropriate refractive error

There is no universally-accepted, best method for correcting refractive errors. This are the best laser vision correction options. LASIK, PRK – Trans PRK, SMILE

LASIK: Laser-assisted in situ keratomileusis,

Is a non-invasive eye surgery using the technology of the excimer laser to reshape the cornea. A computer, controlled by your eye surgeon, is used to precisely calculate the exact amount of cornea that needs to be removed for each person’s individual eyes. He does this with the use of a beam of cool light to reshape the top layer of the cornea (epithelium), so that light rays focus correctly and precisely on the retina and thus improving your vision. It’s painless and a very quick procedure.

LASIK corrects myopia, hyperopia and astigmatism. The FDA approves the surgery from people over 18 years of age. Although some ophthalmologist will say its best to wait until 21.

LASIK lasts and is a permanent vision correction procedure. Some potential complications include conditions such as dryness, night glare, under or over-correction, and loss of best-corrected vision.

The risks of surgery should be discussed fully with your surgeon. Additionally, proper post-operative care will identify and address any potential healing complications.

PRK/ASA: Photorefractive Keratectomy, also known as ASA (Advanced Surface Ablation)

Is an excellent LASIK alternative for those who are considering vision correction. An especially good option for people who have been previously advised that their eyes are not suitable for LASIK.

Patients who are often recommended for PRK/ASA are those who:

  • Have a thinner cornea than what is advised for LASIK
  • Are prone to dryness of the eyes
  • Are involved in high contact sports and more likely to take a hit to the eyes

Benefits of PRK/ASA

  • Preserves the Structural Integrity of the Cornea.
  • Puts Patients at less risk of Corneal Complications.
  • Better for Patients with Thin Corneas.
  • Less Likely to Induce or Worsen Dry Eye: PRK/ASA is gentler on corneal nerves and thus diminishes the possibility of inducing or worsening dry eye syndrome.

Healing expectations

A person who had PRK/ASA can expect to see every bit as well as a LASIK patient in the long run. The initial healing, however, is much slower. Patients are often recommended to have one eye done at a time. The surgeon may recommend waiting anywhere between a week to a month between eyes. In most cases, a PRK/ASA patient will wear a contact lens during the first 5-8 days of healing.

PRK can treat myopia, hyperopia, and astigmatism. The treatment takes about 5 minutes per eye, and it’s a quick painless outpatient procedure. If there’s a downside to PRK/ASA, is the time it takes to heal.
Patients often are blurry for up to three weeks.

Trans PRK (Transcend laser surface ablation),

Reshapes the cornea by using an excimer laser after removing its outermost layer (epithelium). Instead of using an alcohol solution to scrape off the epithelium, a special brush is used in trans PRK. The cornea is then reshaped with a laser and a contact lens is used as a bandage to speed healing.

In terms of efficacy and success rate, both PRK and Trans PRK work in a similar way. Gentle removal of the epithelium with a brush may cause less tissue damage with Trans PRK, which may lead to faster healing and less discomfort for some people compared to PRK. It has also been suggested that Trans PRK may provide superior visual results to PRK.

To make an informed decision, you and your ophthalmologist should review the pros and cons of PRK and Trans PRK.

SMILE, Small Incision Lenticule Extraction

A corrective eye procedure that takes just 10 minutes to perform and hours to heal. It’s quick recovery time allows you to get back to enjoying the activities you love sooner. It’s less invasive than LASIK. The procedure also takes about 10-15 minutes. SMILE is the newest laser vision correction procedure and is FDA approved. The healing is quicker than PRK but takes longer than LASIK.

The main procedural difference between a SMILE procedure and other procedures is that an excimer laser is not used. A femtosecond laser cuts a tiny incision in a patient’s cornea where the lenticule (a small piece of corneal tissue) is then removed through that incision. This helps to reshape the cornea and improve vision thus incorporating the benefits of both LASIK and PRK.

SMILE can be used to correct myopia and astigmatism.

Ultimately, determining which procedure is right for you is going to be a joint decision between the patient and their doctor. A comprehensive eye exam and pre-operative consultation in order to determine which procedure is right for your unique set of priorities and eye characteristics.

Share this article

Subscribe to our Newsletter

Stay informed about our next eye surgery schedules and our latest news right in your inbox.