Procedures to Correct Refractive Errors

Ready to Give Up Your Glasses or Contacts? These Refractive Procedures Can Improve Your Vision

Eyeglasses and contact lenses aren’t the only options if your vision is less than perfect. Refractive procedures can help you see clearly and offer long-term results.

Why Refraction Is Important for Good Vision

Light rays must focus precisely on your retina, the layer of light-sensing cells at the back of the eye, for clear vision. As light enters your eyes, the lens and cornea bend (refract) the rays onto the retina. The lens is a clear, disc-shaped structure behind your iris and pupil, while the cornea is a clear layer of tissue that covers the iris and pupil.

You will be diagnosed with a refractive error if light rays don’t reach the optimum spot on your retina. Refractive errors are common and can occur if your eyeball is shorter or longer than normal. Myopia (nearsightedness), hyperopia (farsightedness), astigmatism (blurred vision due to an asymmetrical cornea), and presbyopia (trouble seeing near objects as you grow older) are types of refractive errors.

These Refractive Procedures Can Enhance Your Eyesight

Eyeglasses and contact lenses correct refractive errors by changing the way light enters the eye. Of course, the moment you take off your glasses or contacts, everything looks blurry again. Refractive procedures permanently change the shape of your cornea, eliminating the need for eyeglasses or contact lenses.

Common types of refractive procedures include:

  • LASIK (Laser in-situ keratomileusis). During LASIK surgery, your ophthalmologist uses a surgical instrument or laser to create a flap in your cornea. After the flap is folded back, your eye doctor reshapes your cornea using a laser, then replaces the flap. Wavefront LASIK uses computers to map the cornea and can enhance the effectiveness of the procedure. According to the American Refractive Surgery Council, vision is better than 20/40 in 99 percent of LASIK patients after their procedures. Ninety percent of people who have LASIK have 20/20 vision or better.
  • PRK (Photorefractory Keratectomy). If you’re not a candidate for LASIK due to corneal thickness, scarring, or dry eye, PRK may be a good choice for you. PRK involves removing the top layer of the cornea, called the epithelium, and reshaping the layers underneath with a laser. Contacts that act as bandages are placed in the eye while it heals. After the procedure, the epithelium grows back.
  • LASEK (Laser Epithelial Keratomileusis). The epithelial layer is separated from the rest of the cornea, although it remains attached by a flap during LASEK. Your ophthalmologist positions the epithelial flap to the side then reshapes the cornea with a laser. After the cornea is reshaped, the epithelium is repositioned over the cornea. A bandage contact lens placed over the cornea helps the epithelium heal.
  • SMILE (Small Incision Lenticule Extraction). Used for myopia and astigmatism in people 22 and older, SMILE doesn’t require a flap. Instead, your ophthalmologist removes a small, circular piece of corneal tissue called a lenticule that is about the size of a contact lens. Removing the lenticule instantly reshapes the cornea.
  • (LTK) Laser Thermal Keratoplasty. LTK is used to improve your vision if you have presbyopia or mild hyperopia. Your ophthalmologist applies laser energy to the edges of the cornea, causing it to shrink and change shape.

Are You a Good Candidate for Refractive Surgery?

Refractive surgery may be right for you if:

  • You are 18 or older.
  • Your vision is stable and has been for the past year.
  • You’re not pregnant.
  • You don’t have certain diseases or conditions, such as corneal abrasions, glaucoma, severe dry eye, poorly controlled diabetes, Sjogren’s syndrome, AIDS, or rheumatoid arthritis.
  • Your corneas are healthy and thick enough for surgery.

In the past, thinner corneas or severe nearsightedness may have prevented you from improving your eyesight with surgery. Thanks to procedures, like SMILE or PRK, refractive procedures are now possible for many people who wouldn’t have qualified in the past.

Have you been considering a refractive procedure? Schedule an appointment with our office to discuss your options.


American Refractive Surgery Council: What Is the LASIK Success Rate?, 10/23/17

American Academy of Ophthalmology: Alternative Refractive Surgery Procedures, 9/27/17

American Refractive Surgery Council: SMILE Procedure Expands Laser Vision Correction Options, 5/25/17

American Academy of Ophthalmology: LASIK – Laser Eye Surgery, 10/21/20

University of Rochester Medical Center: Types of Eye Surgery for Refractive Errors