What is the Most Advanced Laser Eye Surgery Procedure?

It is a well-known phenomenon that we humans are suckers for the latest version – no matter what it is. When it comes to buying a car, upgrading your phone, or getting a new household appliance, we typically want the most advanced version available.

We consider the latest version to be the best – and in many cases, this is true. After all, the latest version has the advantage of the latest advances in knowledge and technology. But, does this rule apply when it comes to Laser Eye Surgery?

Well, the short answer is: Absolutely. Yet, it is important to remember that Laser Eye Surgery is, in itself, an incredible advance on earlier methods of vision correction, such as glasses and lens surgery.

With that in mind, we are taking a look at three of the main types of Laser Eye Surgery: PRK/LASEK, LASIK and ReLEx SMILE. We will explain why each procedure may be a better fit in different circumstances and how they compare with one another.


As the first generation of Laser Eye Surgery, PRK/LASEK has been around for longer than the other treatments included in this list. While this procedure revolutionised the world of vision correction, LASEK is no longer used as frequently as it once was.

However, these treatments still have an important place in Laser Eye Surgery. In fact, for some patients, PRK/LASEK may still be considered the safest option.

PRK and LASEK are two similar procedures that involve removing the outer layer of the cornea (or the epithelium). This allows access to the underlying tissue of the cornea which can then be reshaped using an excimer laser. Following treatment, a soft contact lens is placed over the cornea to promote regeneration and healing of the epithelium; this may take around a week.

When is PRK/LASEK a Good Option?

Thanks to technological advances, Laser Eye Surgery is now suitable for more patients than ever before. However, even the latest treatments aren’t suitable for everyone. PRK/LASEK may be a good option for patients who aren’t suitable for other laser treatments.

For example, it can be useful to treat patients with irregularly shaped corneas or those with chronic dry eye. It may also be a good option for those who engage in high-impact sports/activities, in which the ‘LASIK flap’ (more on this soon) may present a potential risk factor.

Nonetheless, the development of ReLEx SMILE means that PRK/LASEK is not as commonly performed as it once was.

PRK Downsides

Despite its benefits, PRK/LASEK has some drawbacks – the main one being the recovery process following treatment. PRK/LASEK has the longest recovery period out of all three treatments due to the disruption to the cornea. Typically, it takes around a week for the epithelium to grow back and blurry vision may persist for weeks afterwards.

It is generally advised that PRK/LASEK patients take a week off from work and driving. It is also recommended that screen time and alcohol consumption be significantly reduced to aid the recovery process.


When most people mention Laser Eye Surgery, chances are they’re talking about LASIK. This treatment has been the most popular form of Laser Eye Surgery since the late 1980s and, as such, has become the most commonly performed elective surgery in the world, with millions of people reaping its benefits.

The development of LASIK treatment reduced the invasiveness of Laser Eye Surgery. Rather than removing the whole surface layer of the cornea, LASIK works by creating a small circular flap which can be folded back after treatment.

As the existing cornea is kept partly intact, the recovery and healing time needed following LASIK treatment is significantly reduced when compared with PRK/LASEK.

It can safely and effectively treat a wide range of short-sightedness, long-sightedness, astigmatism, and presbyopia.

When is LASIK a Good Option?

In order for LASIK to be carried out successfully, the cornea must be thick enough to accommodate the flap. Other factors – for instance, chronic dry eye – can also make a patient unsuitable for LASIK treatment.

Patients with thin corneas or dry eyes will likely be unsuitable for LASIK but may be eligible for other methods of Laser Eye Surgery.

LASIK Downsides

While LASIK greatly reduces disruption to the cornea, the creation of a flap still involves the manipulation of the epithelium. Therefore, it is possible for complications to occur post-surgery – though this is extremely rare.

The chance of developing complications can be greatly reduced, if not avoided, by going to a high-quality clinic with a thorough post-operative follow-up protocol. This means that if a flap-related complication does occur, it can be easily managed with the help of an expert surgeon.


The third and newest Laser Eye Surgery treatment that we will be looking at is ReLEx SMILE. This is the latest innovation in Laser Eye Surgery and has allowed a significant reduction in the manipulation of the cornea surface.

In SMILE, the removal of epithelium is avoided altogether. Instead, a laser is used to create a tiny incision in the cornea, which is then separated from the underlying tissue with the use of tiny pulses delivered by the same laser. This creates a small tunnel through which the surgeon can remove underlying tissue, reshaping the corneal bed.

London Vision Clinic was the first clinic in the UK to offer this pioneering treatment. Today, the procedure is available at close to 700 clinics in over 65 countries.

When is SMILE a good option?

SMILE’s quick treatment time and rapid recovery period make it an attractive option to many patients. It is a particularly good option for those previously told they are not suitable for Laser Eye Surgery due to having thin corneas, dry eyes, or a high prescription.

The minimally-invasive nature of SMILE reduces eliminates the risk of ‘flap-related’ complications. Furthermore, it only requires the use of one laser, speeding up treatment time and reducing discomfort during the procedure. The procedure is typically completed in a matter of minutes and patients are often back to work the very next day.

SMILE Downsides

Every treatment has its downsides. And for SMILE, the main downside is that the treatment is often limited to certain prescriptions – mainly short-sightedness. In addition, SMILE is not as accessible as other treatments and is only available at certain clinics worldwide.

Laser Eye Surgery is constantly advancing. To find out more about the latest advancements in the field and how they can help you gain clear, glasses-free vision, leave us a comment below or get in touch with one of our friendly eye experts today.