According to the American Society of Cataract and Refractive Surgery (ASCRS), there were approximately 1.8 million LASIK procedures performed in the United States in 2020. This number has been steadily increasing over the years, with the number of LASIK procedures performed in the United States increasing by around 5-10% each year. LASIK is a very popular procedure as it is a safe and effective way to correct vision and reduce the need for glasses and contacts.

The best option for vision correction varies from person to person and depends on factors such as the individual's specific visual needs, the shape and health of their corneas, and their overall eye health. LASIK is a popular and effective procedure for many people, but some people may benefit more from alternative procedures such as PRK or ICL. It's important to consult with a qualified eye doctor to determine the best option for you.

What is LASIK?

LASIK is a commonly known surgery that helps in correcting or reducing the dependence on glasses and contacts. The surgery makes use of a laser machine to create a flap on the front surface of the eye and change the shape of the eye to correct the prescription. After the flap is laid back down, it takes some time for the eye to heal and for the patient to recover their vision.

What are some alternatives to LASIK?

• PRK as a LASIK alternative - PRK is a surgical option for people who are not suitable for LASIK. It makes use of the same laser as LASIK but does not create a flap. As a result, less tissue is lost, and the end results of the vision can be the same as LASIK. However, the healing process for PRK is a bit longer, and it takes about a week for the patient to get most of their vision back to being clear.
• SMILE as a LASIK alternative - SMILE (Small Incision Lenticule Extraction) is a laser refractive surgery that is similar to LASIK, but it is a minimally invasive procedure that does not require the creation of a corneal flap. Instead, a laser is used to create a small lenticule within the cornea, which is then removed through a small incision. This procedure is best for patients with mild to moderate nearsightedness and astigmatism.
• ICL as a LASIK alternative - ICL (Implantable Collamer Lens) is another alternative option that is typically reserved for patients with high prescriptions who cannot undergo LASIK or PRK. The procedure involves implanting a small, soft, and foldable lens between the iris and the natural lens of the eye. The ICL lens is designed to correct the patient's prescription by changing the way light enters the eye. This procedure is best for patients with severe nearsightedness, farsightedness, and astigmatism.

When are SMILE or ICL recommended over LASIK?

SMILE or ICL are usually reserved for patients with high prescriptions who cannot undergo LASIK or PRK.

Some factors that may influence a doctor's recommendation include:

• Thin corneas: SMILE and ICL are typically better options for individuals with thin corneas because they do not require the removal of corneal tissue.
• High degree of nearsightedness: SMILE and ICL can be more effective for treating high levels of nearsightedness compared to LASIK.
• Dry eye: LASIK can sometimes worsen dry eye symptoms, making alternative procedures like SMILE or ICL a better option for individuals with this condition.
• Astigmatism: While LASIK can treat astigmatism, it may not be as effective as alternative procedures like ICL in some cases.

It is important to note that these are general guidelines and the best option for each individual will depend on a thorough eye examination and discussion with a qualified eye doctor.

Who is a good candidate for refractive surgeries?

A good candidate for laser refractive surgery, such as LASIK, PRK, and SMILE, is someone who:

• Is at least 18 years old
• Has had a stable eye prescription for at least one year
• Has no significant eye disease or injury
• Has realistic expectations about the outcome of the surgery
• Good overall eye health
• Absence of eye diseases (e.g. cataracts, glaucoma)
• No active eye infections
• Pupil size within normal range
• Corneal thickness within safe limits and has a healthy cornea
• Realistic expectations for the outcome
• Willingness to follow post-operative care instructions.

It's important to note that not everyone is a good candidate for these surgeries. People with certain health conditions such as diabetes, autoimmune disorders, and certain medications may not be suitable for these procedures. Also, people who have thin corneas, large pupils, or significant dry eyes may not be suitable for LASIK. In these cases, PRK or SMILE may be a better option.

Is there a non-surgical alternative to LASIK?

Ortho K is a non-surgical option that may be suitable for you if you're not a candidate for LASIK. It involves using a lens at night while you sleep. By morning, the lens gently reshapes the front surface of your eyes, correcting your vision throughout the day without needing glasses or contact lenses. Before going to bed at night, you will need to put on the lens, which will then reshape the cornea for the next day. In some cases the lenses will reshape the cornea for a few days and will only need to be worn every 3-4 days.  This option is a convenient alternative for walking around without glasses or contacts during the day while avoiding surgery. Learn more about ortho-k.