Refractive Laser Surgery: Is it Right for You?

by May 1, 2019

Refractive surgery, such as LASIK, is an appealing option for those who must rely on glasses or contact lenses for clear vision. Refractive laser surgeries use high energy lasers to reshape corneal tissue and correct refractive error. While LASIK is the most commonly performed refractive surgery, other options exist for the treatment of nearsightedness, farsightedness, and astigmatism.  Read on to learn more about refractive surgery options and whether or not it’s right for you.

PRK and LASIK Surgeries

Photorefractive keratectomy, known commonly as PRK, is thought of as a “first generation” laser refractive surgery.  PRK was the predecessor to LASIK, and has been performed as a laser corrective option for over 20 years. In PRK surgery, the outer layer of the cornea is gently removed, and an excimer laser is used to reshape the underlying corneal tissue and correct for refractive error.  Because the superficial corneal layer is completely removed in PRK, it has the longest recovery time of any refractive laser surgery option. Within a week, the outermost layer of the cornea grows back undamaged, and clear vision is achieved a few weeks to a month later when the corneal tissue has smoothed out.  Similar to PRK, LASIK is the most common form of refractive surgery. The main difference between PRK and LASIK is the initial step of surgery. Where PRK completely removes the corneal epithelium, LASIK uses a femtosecond laser to create a thin flap of corneal tissue. This flap is lifted, an excimer laser reshapes the deeper corneal tissues, and the flap is gently replaced.  Because the outermost corneal tissue does not have to completely regrow, the recovery time for LASIK is significantly shorter than for PRK; in fact, many people notice immediate visual improvement with LASIK. However, there are some risks revolving around the potential displacement of the corneal flap after surgery. Both PRK and LASIK have the potential to provide long-lasting clear vision without the need for glasses or contact lenses.

Minimally Invasive Surgical Options

The newest option for laser refractive surgery is Small Incision Lenticule Extraction, or SMILE.  SMILE uses a femtosecond laser create an extremely small incision and remove piece of corneal tissue.  SMILE retains much more of the corneal integrity than PRK or LASIK, reducing the risk of post-surgical complications, and it has proven to be just as accurate as other refractive laser options.  However, as SMILE is still a new procedure, can only correct for nearsightedness, and is not yet capable of correcting farsightedness or astigmatism.

Which is Refractive Laser Surgery Right for Me?

If you are interested in refractive laser surgery, ask your eye doctor if you are a good candidate.  Factors such as age, stability of vision, amount of refractive error, and co-existing ocular conditions can determine whether or not you are a good candidate.  Choosing which refractive option is best for you can take your lifestyle into consideration. If you participate in high-contact activities, such as boxing or wresting, you may be at a significantly higher risk for a flap complication with LASIK.  If you are relying on a speedy visual recovery, LASIK or SMILE will be better options than PRK. Talk with your doctor and surgeon about your visual needs and lifestyle to determine the best option for you.


Our eye doctors and staff at Nittany Eye Care excel in the treatment and care of refractive laser surgery. Call us at (814) 234-2015 or schedule an appointment online.  Our optometrists provide the highest quality eye care services in the State College, PA area.

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