LASER SURGERY ADVOCACY
LASER SURGERY ADVOCACY
Essentially there are three classes of laser eye surgery types:
1. LASIK (Laser-assisted In Situ Keratomileusis) – in this procedure, a corneal flap is created and then laser is used to reshape the underlying stromal tissue with an excimer laser. Recovery is fast, often within 24 hours. Due to cutting through the cornea, nerves are damaged and can take up to a year to repair so patients typically will have more dry eyes during this time. Complications are related to the flap creation.
2. PRK (Photorefractive Keratectomy) – this procedure removes the superficial layer of the cornea and then uses laser to reshape. It is generally reserved for patients with thin corneas, irregular corneas or those in contact sports as there is no complication from creating a flap. Recovery however is slower taking up to two weeks and is more uncomfortable post surgery. Pain medications are typically prescribed.
3. Small Incision Lenticular Extraction – this procedure is minimally invasive. The laser creates a small lenticule that is removed through a tiny incision of the cornea. It is suitable for those who play contact sports or are active individuals, as there is no flap complication. Recovery is gradual.
Image source: Zhang et al., 2025. Bioengineering, 12(4), 380. Available under CC BY 4.0.
Non-laser refractive options:
- ICL (Implantable Collamer Lens) – this is a lens implant inside the eye, behind the cornea. It is a good option for those who do not have cataracts, are young (pre presbyope) and have high myopia (who are not candidates for laser refractive surgery).
- RLE (Refractive Lens Exchange) – this procedure is suitable for patients who have presbyopia or high refractive degrees. The natural lens is removed and replaced with an artificial intraocular lens.
- Refractive error degree – mild cases with healthy eyes are generally suited for LASIK.
- Corneal thickness and shape – if corneal thickness is thin or shape less regular, PRK is generally considered.
- Age and presbyopia – lens replacement is generally best.
- Lifestyle – active patients, or patients involved in contact sports or high-risk activities are generally better suited to PRK or lenticular extraction surgery.
- Eye health – depending on the condition, surgery options may be limited.