For anyone looking to correct their vision through laser eye surgery, you’ve likely boiled your options down to three procedures: LASIK, SMILE, and PRK. All three procedures are safe and effective ways to correct your vision and have successfully treated millions of patients worldwide. However, knowing which procedure will be best for you can be difficult to determine.
If you’re ready to live a life independent of eyeglasses or contact lenses, we’re here to help you understand the differences between these three treatments and their advantages.
PRK (Photorefractive Keratectomy)
A PRK procedure involves fixing refractive errors by reshaping the cornea using an excimer laser. Your surgeon will first gently remove the surface cells of the cornea (the epithelium). After which, your cornea is reshaped to correct the refractive error using a cool excimer laser. Cooling the surface of the cornea reduces thermal damage caused by the excimer laser ablation (corneal tissue removal).
The procedure takes around 10 minutes total, taking about 2 or 3 minutes per eye. Performed using eye drop anesthesia and a relaxing medication if needed, you will feel little to no pain and mild pressure.
Post-surgery it can take anywhere from 2 to 6 weeks for the corneal surface to heal, during this time visual acuity will diminish while surface cells are healing. After the cornea is healed, visual acuity will continue to improve. It can take up to 3 months for maximum vision recovery following a PRK procedure.
PRK can easily treat low to moderate severity of nearsightedness, farsightedness, and astigmatism. PRK results near identical outcomes when compared to a LASIK procedure and is a better alternative to LASIK for patients with irregularly shaped or thin corneas, those with chronic dry eye, and patients who participate in sports with the potential for direct contact with the eyes.
The majority of patients who undergo a PRK procedure achieve 20/20 vision without eyeglasses or contact lenses.
The biggest disadvantage to a PRK procedure is that vision will remain blurred during recovery and there is potential for discomfort following surgery. PRK also carries the longest recovery time of all three laser eye procedures. If patients were to elect to have both eyes treated on the same day, you will typically be unable to drive or go back to work for at least one week while surface cells grow back on the surface of the cornea.
LASIK (Laser-Assisted Stromal In-situ Keratomileusis)
Today, LASIK is the most commonly performed laser correction surgery. Like PRK, LASIK uses a two-step procedure to correct refractive error by reshaping the cornea. Using a femtosecond laser, your surgeon creates a thin flap in your corneal tissue. This flap is then carefully lifted back, exposing the concealed corneal tissue to be reshaped using a cool excimer laser. After the cornea has been reshaped and your vision restored, the corneal flap is gently put back into place where it can naturally heal.
The entire procedure takes about 3 minutes per eye and little to no pain is felt using mild eye drop anesthesia. Relaxation medication may be used if needed.
LASIK can successfully treat nearsightedness, farsightedness, and astigmatism. The procedure also has a relatively quick healing time, most patients can return to daily activities, work, and driving a vehicle one day following their surgery. Many patients report an immediate visual improvement following surgery and broader visual stability within a few days to a few weeks.
LASIK patients usually experience 20/20 vision without eyeglasses or contact lenses.
In order to create the necessary corneal flap, a LASIK candidate must have adequate corneal thickness. Some patients with thin corneas will not be able to receive LASIK surgery and might be better suited for a PRK or SMILE procedure. Additionally, patients with pre-existing dry eye may not be ideal candidates due to the low risk of LASIK induced dry eye.
SMILE (Small Incision Lenticule Extraction)
SMILE laser eye surgery is the most recent advancement in laser vision correction procedures. A SMILE procedure is a minimally invasive, one step surgery that combines the safety of traditional correction techniques but with greater comfort and precision. The SMILE procedure is sometimes known as “flapless LASIK” as it does not require the creation of a corneal flap and eliminates the risk of flap-related complications.
Instead of using the excimer laser to create a flap in the cornea, a femtosecond laser makes a tiny 3mm incision and a small piece of corneal tissue known as the “lenticule” is removed. This allows for better corneal stability after surgery and causes less of a disturbance to corneal nerves during the surgery. Like PRK and LASIK the SMILE procedure reshapes the cornea and improves visual acuity.
SMILE can correct nearsightedness and astigmatism. The SMILE procedure is much less invasive than other laser vision corrective surgeries, for comparison, the SMILE incision is only about 3mm while a corneal flap created by a LASIK procedure is around 20mm in circumference. SMILE also carries less incidence of dry eye, making it the best choice over LASIK for patients already experiencing dry eye syndrome.
A main disadvantage of the SMILE procedure is that it can only treat nearsightedness and astigmatism, not farsightedness. Additionally, recovery from a SMILE treatment requires a slightly longer time period when compared to LASIK but is still much faster than a PRK surgery.
Choosing the Right Procedure for You
When it comes down to it, choosing which procedure will be best for you can only be determined with a comprehensive eye examination and consultation by a skilled ophthalmologist. Every patient carries unique characteristics and needs. Dr. Adam Abroms and his team at ADV Vision Centers have successfully performed tens of thousands of vision correction and refractive surgeries.
To learn more about laser vision correction services and which procedure may be right for you, please call or contact us online today! With an emphasis on education, safety, and patient care, ADV Vision Centers provide state-of-the-art surgical eye care.