What are the types of refractive laser surgery?

While LASIK is the most common surgery for refractive errors, there are other procedures that have similar procedures or goals. Refractive laser surgery options include:

• LASIK. The surgeon uses a laser or blade to create a flap in the outer layers of the cornea. A laser is then used to reshape the part of the cornea that is exposed. The flap is then closed. Discomfort after surgery is minimal, and vision recovery usually takes place in 1 to 2 days.
• Photorefractive keratectomy, also called PRK. With PRK, the very thin top layer of the cornea is removed. Then the cornea is reshaped with a laser. A contact lens is used to protect the eye while it's healing. Pain usually lasts 2 to 3 days. Vision recovery can take several days and vision gradually improves.
• Small-incision lenticule extraction, also called SMILE. With SMILE, the surgeon uses a laser to create a thin disc, called a lenticule, in the cornea below the surface of the eye. Then the surgeon removes the lenticule through a small incision. With the lenticule removed, the shape of the remaining cornea corrects the refractive error. Healing time is similar to that of LASIK, but vision recovery is a bit longer. SMILE is used to correct only nearsightedness and astigmatism.

If you play contact sports or work in a job that has a risk of trauma to the eyes or face, LASIK surgery may not be a good choice for you. These jobs may include police officer, firefighter and positions in the military. PRK and SMILE may be better options.

Intraocular lenses

A less common alternative to refractive laser surgery is the use of artificial lenses placed inside the eyes. These are called intraocular lenses.

Intraocular lenses can treat different types of refractive errors depending on the specific procedure and lens used. They may correct more-severe refractive errors than laser surgeries of the cornea can correct. The recovery of vision after intraocular lens placement is generally shorter than with laser surgeries.

There are three general methods:

• The artificial lens is placed in front of the iris to correct the refractive error.
• The lens is placed behind the iris. This type of lens, called an implantable collamer lens, is a combination of plastic and biological material that allows it to work more like a natural lens.
• An artificial lens also may be used to replace the natural lens. This is called a refractive lens exchange or clear lens extraction. This is essentially the same procedure as that used to treat a cloudy lens, a condition called a cataract.