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LASIK Alternatives

A Comprehensive Guide to LASIK & Other Vision Correction Methods

LASIK is a specific type of vision correction surgery that became very popular more than 20 years ago due to its ease of adoption and simplicity. It is nevertheless just one tool in the much larger toolbox of available vision correction options available to the public. Vision correction procedures could be generally divided into laser and non-laser based options.

Laser Based options include:

LASIK. Bladeless LASIK (All-Laser LASIK), Contoura LASIK (Topography-Guided LASIK), PRK, LASEK and SMILE.


LASIK, or laser in-situ keratomileusis, is a highly effective and popular procedure for correcting vision problems such as nearsightedness, farsightedness, and astigmatism. The procedure involves using a laser to reshape the cornea, the clear outer covering of the eye, in order to improve the way the eye focuses light.

To make matters a bit more complicated there are also a few different kinds of LASIK based the way the flap is created during the LASIK process (Blade vs Bladeless LASIK) and how the treatment portion of LASIK is carried out (ordinary treatment vs Topography Guided LASIK).

LASIK is a relatively quick and painless procedure that can provide patients with improved vision and a greater sense of independence. However, as with any medical procedure, LASIK also carries certain risks and complications. Furthermore, certain eye conditions or lifestyle factors may make some people unsuitable candidates for the procedure. In light of these considerations, it’s important to be aware of the alternatives to LASIK that are available. It is also important to note that LASIK cannot provide a good solution for people over 45 that are struggling with reading as well as distance vision. In order to provide freedom from both reading and distance glasses, many patients are turning towards Clear Lens Exchange.

One popular alternative to LASIK is PRK (photorefractive keratectomy):

This procedure is similar to LASIK in that it uses a laser to reshape the cornea, but the main difference is that with PRK, the outer layer of the cornea, known as the epithelium, is removed before the laser is applied. This allows the laser to directly reshape the underlying cornea. Recovery time for PRK is typically longer than for LASIK, and there may be more discomfort during the healing process, but the procedure is still highly effective and carries a low risk of complications. In the Cohen Eye Institute offices in New York City, we use PRK mainly for patients who have thin corneas or patients that are otherwise not good candidates for LASIK, or those in which Dr. Cohen finds PRK to be safer due to their particular eyes.

Another alternative to LASIK is LASEK (laser epithelial keratomileusis):

This procedure is similar to PRK in that the outer layer of the cornea is removed before the laser is applied, but with LASEK, the epithelium is not completely removed, but is rather loosened and moved to the side before the laser is applied. This allows the epithelium to be replaced after the procedure, which can speed up the healing process and reduce the risk of complications.

A third alternative to LASIK is called epi-LASIK:

This procedure is similar to LASEK, but instead of using a blade to loosen the epithelium, an instrument called an epikeratome is used. This instrument uses a laser to create a precise and uniform flap of the epithelium, which is then moved to the side before the laser is applied. Like LASEK, epi-LASIK allows the epithelium to be replaced after the procedure, which can speed up the healing process and reduce the risk of complications. This procedure has been largely abandoned by most surgeons due to its inherent risks and lack of consistency.


SMILE stands for Small Incision Lenticule Extraction. During this procedure the laser cuts a small lenticule (lens) from within the cornea which is then manually removed by the surgeon. This process corrects vision by changing the curvature of the cornea like LASIK. However, this is done through a smaller opening incision which some believe carries a lower risk. There are other risks however, that could be related to leftover tissue within the small pocket. Perhaps this is the reason that it is currently less popular than LASIK.

Non-laser based options include:

Cataract Surgery (laser or non-laser based), EVO-ICL, Clear Lens Exchange (also known as Refractive Lens Exchange).

Clear Lens Exchange (also known as Refractive Lens Exchange or RLE):

This procedure is typically used for patients with presbyopia, which is the age-related loss of near vision. During RLE, the natural lens of the eye is removed and replaced with an artificial intraocular lens (IOL) that has the desired focusing power. RLE can correct both nearsightedness and farsightedness, as well as astigmatism, and it can also correct presbyopia. Recently it has become extremely popular in New York City with people over 45 due to its lasting ability to correct presbyopia. Dr. Cohen has extensive experience with a wide range of lens implant options that could provide near, intermediate and distance vision at the same time.


During this procedure a lens is implanted into the eye to correct the vision while leaving the eye’s own lens inside the eye. This procedure can treat much higher prescription ranges than LASIK and is also reversible.

Cataract surgery: During this procedure the eye’s natural lens which has become cloudy is removed and replaced with a lens implant. Since the introduction of multifocal lens implants, older patients can regain their youthful vision. Dr. Cohen has implanted tens of thousands of multifocal lenses in the New York City area and has allowed his patients to enjoy the youthful vision and freedom from glasses available to much younger patients.

In Conclusion:

LASIK is a highly effective and popular procedure for correcting vision problems, but it’s not the only option. There are many alternatives to LASIK available, including PRK, LASEK, epi-LASIK, refractive lens exchange (RLE), EVO-ICL, small incision lenticule extraction (SMILE), Contoura LASIK and non-surgical options like glasses and contact lenses. Each alternative has its own set of benefits and risks, and it’s important to discuss the different options with a qualified and experienced surgeon. It is also important to have realistic expectations and understand that no procedure is without risks. In addition, it’s important to follow post-operative instructions carefully, maintain good hygiene around the eye, and choose an experienced and qualified surgeon who uses the most advanced technology. With this information, patients can make an informed decision about their vision correction options and find the best solution for their individual needs.

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