April Newsletter: Refractive Eye Surgery Options Beyond LASIK

April Newsletter: Refractive Eye Surgery Options Beyond LASIK

Laser eye surgery and snellen chart

Refractive Eye Surgery Options Beyond LASIK

Wish you could get rid of your eyeglasses or contact lenses, but laser-assisted in situ keratomileusis (LASIK) surgery isn't an option? Several other types of refractive eye surgery can also permanently improve your vision, including these options:


LASEK (laser subepithelial keratomileusis) and LASIK sound the same, but they have a few important differences. During LASIK, your ophthalmologist uses a blade or laser to create a flap in the epithelium (outer layer of the cornea) and some of the deeper layers of the cornea. (The clear, rounded cornea covers the iris and pupil.) After shaping the cornea with a laser, the flap is replaced and begins to heal.

In LASEK, an alcohol solution loosens the epithelium. The thin layer of cells is pushed aside while reshaping begins with a laser. At the end of the procedure, your ophthalmologist moves the epithelium back into place and puts a soft contact lens over the cornea. LASEK may be recommended if you have thin corneas or severe myopia (nearsightedness).

Photorefractive Keratectomy (PRK)

PRK also reshapes your cornea without creating a flap. The eye doctor uses a laser to change the shape of the cornea after removing the epithelium with a special instrument, alcohol solution or brush.

Reshaping the cornea keeps light rays focused precisely on the retina. If you're nearsighted or farsighted, the rays focus behind or in front of the retina, causing blurred vision.

After the refractive surgery, the epithelium reforms within 5 days, according to the American Refractive Surgery Council. PRK may be recommended if you have thin corneas, suffer from dry eye, or play contact sports.


Your eye doctor separates the epithelium from the inner layers of cornea with a tool called an epithelial separator during EPI-LASIK. The epithelium is then folded to the side while the ophthalmologist reshapes the cornea with a laser.

If you choose this type of refractive surgery, you'll wear a soft contact lens over your cornea while it heals. EPI-LASIK surgery can be a good idea if your corneas are too thin or irregular for LASIK surgery or are concerned that LASIK may weaken your corneas.


During small incision lenticule excision (SMILE) refractive surgery, your doctor removes a thin slice of the cornea, called a lenticule, with a pulsating laser. Removing the lenticule changes the shape of the cornea and sharpens your vision.

Unlike other types of refractive surgery that are used to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism, SMILE only treats nearsightedness. The procedure may be a good option if you have a high degree of nearsightedness and don't meet the requirements for other types of refractive surgery.

Implantable Collamer Lens (ICL)

ICL is another option if severe myopia means you're not a candidate for LASIK. During the surgery, your eye doctor places a contact lens inside your eye to improve your eyesight.

After making a small cut in the cornea, he or she slides the contact lens between your iris (colored part of the eye) and the clear, disc-shaped lens inside your eye. Although the ICL can improve your vision for years, you may eventually need to wear reading glasses for reading or close work.

Conductive Keratoplasty (CK).

CK is an option for people who have mild to moderate hyperopia and are over 40. Your eye doctor uses a special device that emits radiofrequency energy to heat the outside edges of the cornea. The heat causes a change in the shape of the cornea as the outer edges shrink.

Are you interested in exploring eye refractive surgery options? Call our office to schedule an appointment with the ophthalmologist.


American Academy of Ophthalmology: Alternative Refractive Surgery Procedures, 9/27/17


All About Vision: Smile Laser Eye Surgery, 3/15/22


American Academy of Ophthalmology: LASIK: Laser Eye Surgery, 11/9/2022


All About Vision: Smile Laser Eye Surgery, 3/15/22


WebMD: What to Know About Implantable Collamer Lens (ICL) Surgery?, 7/12/2022



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