LASIK, SMILE or PRK : Which Laser Eye Surgery Is Right for You?

If you are tired of wearing glasses or contacts, you may be a candidate for laser eye surgery. Knowing the pros and cons of the different laser procedures can help inform your choice. Below we outline the three popular types of laser eye surgery: LASIK (laser in situ keratomileusis), PRK (photorefractive keratectomy), and SMILE (small incision lenticule extraction).

LASIK

LASIK is the most commonly performed laser eye surgery and costs about $2,200 per eye.¹ It can correct up to -12.00 diopters of nearsightedness, up to +6.00 diopters of farsightedness, and up to 6 diopters of astigmatism.

The procedure takes up to half an hour. Before the surgery, an eye surgeon may give you medication to relax and apply numbing drops to your eyes. They will then create a small flap of corneal tissue with a laser and lay it back in place. The surgeon will subsequently reshape the cornea with a different type of laser, to help focus light entering the eye onto the retina. You will have to look at a point of light during the procedure and may smell an odor coming from the corneal tissue removal. Right after LASIK, you may experience an itchy or burning sensation in your eyes and blurred vision. One or two days after the surgery, your doctor will check your eyes for potential complications.

LASIK Benefits:

• LASIK is highly effective, with more than 90% of patients achieving 20/20 vision and 99% with vision exceeding 20/40.²
• It has a patient satisfaction rate of 96%, the highest of any elective procedure, according to a study published in the Journal of Cataract & Refractive Surgery.³
• The surgery is quick, and so is recovery. Most patients can get back to normal within two days.
• You get results fast. Some people can see better within several hours after the procedure, while in other^4,5,6 cases vision may remain hazy for up to two weeks.

LASIK Risks:

• Potential dry eye syndrome for up to several months.
• Glare or halos.
• Irregular astigmatism, which causes distorted vision and eye strain.
• Small wrinkles that form in the cornea and may affect your vision.
• Ingrowth of epithelial cells beneath the cornea.

PRK

LASIK requires a patient to have a relatively thick cornea so that a surgeon can create a flap. For those with thinner corneas, PRK and SMILE offer better options. The same goes for patients with chronic dry eye and those who engage in contact sports with a high risk of eye injury. During the PRK procedure, which on average costs $2,300 per eye,⁴ a doctor will first put some numbing drops into your eye and then manually remove the outer layer of the cornea. The next step reshapes the cornea with a laser and finally places a special type of contact lens to protect the eye after the procedure for four to six days. Your eyes may feel watery and uncomfortable for up to three days following the surgery. Recovery after PRK takes between one and three months — which is longer than for LASIK and SMILE. If you get both eyes treated, you will also need to take a week off from both work and driving.

PRK Benefits:

• The surgery takes only about 10 minutes.
• It also has a high success rate, with about 70% of patients achieving up to 20/20 vision, and 92% with at least 20/40.⁵
• PRK is even safer than LASIK because it does not create a flap.
• Provides an option for people who don't qualify for LASIK.
• Less risk of dry eye than LASIK.
• Like LASIK, it can correct nearsightedness, farsightedness and astigmatism.

PRK Risks:

• Sensitivity to light for the first three days after surgery.
• Potential need for glasses for the first six months.
• Cloudy vision for up to four months.

SMILE

Unlike LASIK and PRK, SMILE can only correct nearsightedness of up to -10.00 diopters, and up to -3.00 diopters of myopic astigmatism — the type of astigmatism that may accompany shortsightedness. It doesn't correct farsightedness or astigmatism that is unaccompanied by myopia. It also can't treat more subtle vision errors called higher-order aberrations, which may, for example, make it difficult to see at night and can be treated with the other two methods. During the SMILE procedure, which takes between 10 and 15 minutes, a laser makes a thin, disc-shaped tissue layer right below the surface of the cornea. Then, the surgeon fishes the layer out through a small incision and reshapes the cornea. Although your vision may initially be a bit blurry, it will improve over the next few days and weeks.

SMILE costs between $2,000 and $3,000 per eye.⁶

SMILE Benefits:

• High success rate. Of all people who have the procedure, about 99% have 20/40 vision six months later, whereas 88% have 20/20 vision.⁷
• One study of 118 patients with myopic astigmatism suggested that patient satisfaction with SMILE was even higher than with LASIK, according to findings published in Clinical Ophthalmology. ⁸
• Fast recovery. You can resume daily activities in the next day or so.
• Lower risk of dry eye than LASIK.
• Provides an option for people who don't qualify for LASIK because of corneal thinness.

SMILE Risks:

• Glare or halos
• Inflammation of the eye region.
• Potential need for additional treatment with PRK.

Only an eye surgeon, also called an ophthalmologist, can help you select the right procedure. To find one, ask your primary care provider, friends, and family for a recommendation, or Google different doctors and check out their online ratings. You may want to consider only those who are board certified in ophthalmology and have performed numerous laser eye surgeries. Find a provider using the Acceptance locator on the CareCredit credit card website.

Finally, make an appointment to meet the doctor and ask any questions you have about the procedures. Note whether the doctor addresses them effectively and explains concepts clearly. It's important you feel comfortable with the physician you select to perform your procedure. It's fine to go for a second or third opinion to find the doctor who is right for you.

CareCredit for Laser Eye Surgery

Most insurance companies do not cover laser eye surgery, although some may offer discounts. You can pay for the resulting out-of-pocket cost with your CareCredit card. Use the Acceptance Locator on the CareCredit credit card website or download the CareCredit Mobile App to find a qualified vision care provider near you who accepts the CareCredit credit card. https://www.carecredit.com/app.