LASIK has become a household name in vision correction, and for good reason—it’s quick, effective, and can dramatically reduce or eliminate the need for glasses or contacts. It’s one of the most widely studied, safe and effective procedures for treating most nearsighted, farsighted and astigmatic prescriptions. But LASIK isn’t right for everyone. Whether due to thin corneas, dry eye, age, or a significantly high prescription, some patients don’t qualify for the procedure—or prefer a different route.

If LASIK isn’t an option for you, don’t worry. There are several safe and effective alternatives that can help you achieve clearer vision. Here’s a look at some of the most popular choices and the pros and cons of each.

1. PRK (Photorefractive Keratectomy)

Patients with thinner corneas or those at higher risk of eye trauma (i.e. military, police, professional athletes) are often recommended to have PRK instead of LASIK following a thorough evaluation. PRK was actually the first type of laser vision correction and is still widely performed today. Unlike LASIK, PRK doesn’t involve creating a corneal flap. Instead, the outer layer of the cornea is removed, and a laser reshapes the surface beneath. It is essentially the LASIK procedure without the corneal flap. Visual outcomes are expected to be the same as LASIK but recovery takes a bit longer and is a little more uncomfortable for the first few days.

Pros:

• No corneal flap
• Great for active lifestyles or contact sports
• Same end result/visual outcome as LASIK

Cons:

• Longer healing time than LASIK
• Temporary discomfort for a few days after surgery

Talley Eye Institute LASIK surgeon, Dr. Joey Carr had PRK in 2019. “I chose to have laser vision correction on my own eyes in 2019 after growing tired of glasses and contacts. The best option for me was PRK—though it requires a longer healing period and greater commitment, it offers the same excellent visual outcomes as LASIK. PRK is often a great option for patients whose corneas are too thin for LASIK.”

2. SMILE (Small Incision Lenticule Extraction)

SMILE is a minimally invasive laser procedure where a small disc of corneal tissue is removed through a tiny incision. It preserves more of the cornea’s natural structure and may cause less dry eye afterward. This procedure still leaves a lot to be desired in terms of being a truly compatible alternative to LASIK.

Pros:

• Smaller incision than LASIK, without corneal flap
• Lower risk of dry eye
• Quick recovery

Cons:

• Currently only approved for certain prescriptions; limits eligibility for those with higher prescriptions of hyperopia
• Not as widely available as LASIK or PRK
• Less accurate in treating higher levels of astigmatism
• Because there is no corneal flap, an enhancement (or touchup) is more complicated and involves having PRK

3. Refractive Lens Exchange (RLE)

Refractive Lens Exchange is a great option for those patients over 40 who don’t yet have cataracts but are experiencing presbyopia (age-related loss of near vision) and are frustrated with needing glasses or contacts. RLE involves replacing the eye’s natural lens with an artificial intraocular lens (IOL), similar to cataract surgery. Learn more about what's involved with an RLE in this blog post.

Pros:

• Can correct both near, intermediate, and distance vision
• Prevents cataracts later in life

Cons:

• More invasive than LASIK
• Higher cost
• Longer recovery time than LASIK

4. Implantable Collamer Lenses (ICLs)

Think of ICLs as permanent contact lenses implanted in your eye, behind the iris and in front of your natural lens. No corneal tissue is removed, making it a good option for younger patients who have thinner corneas and larger prescriptions.

Pros:

• Reversible
• Good for very high prescriptions
• Lower risk of dry eye

Cons:

• Requires minor surgery
• More expensive than LASIK
• Not suitable for all eye shapes
• Longer recovery than LASIK

If you’ve been told you’re not a candidate for LASIK, it doesn’t mean you’re without options. Today’s vision correction options are more diverse and personalized than ever. It’s best to have a detailed discussion about the risks, benefits and costs associated with the procedures recommended to you by a qualified and experienced surgeon. Our surgeons at Talley Eye Institute ensure you have a thorough diagnostic workup to not only rule out potential risks or contraindications, but to make a personalized recommendation for your best visual outcome. Schedule your FREE consultation today!