LASIK vs PRK vs SMILE vs ICL

Full comparison

Procedure comparison chart

Feature	LASIK	PRK	SMILE	ICL
Cost (both eyes)	$4,000–$6,000	$3,500–$5,500	$4,500–$7,000	$8,000–$14,000
Correction range	−1.00 to −8.00 · up to −6.00 astig	−1.00 to −10.00 · up to −5.00 astig	−1.00 to −10.00 · up to −3.00 astig	−3.00 to −20.00 · up to −4.00 astig
Recovery time	1 day (most)	5–7 days vision, 1–2 weeks comfort	1–3 days	1–7 days
Corneal flap	Yes — laser-cut	No	No	No (implant)
Thin cornea candidates	Limited	Better option	Better option	Yes
Dry eye risk	Moderate (20–30%)	Lower than LASIK	Lowest of laser options	Very low
Reversible?	No	No	No	Yes — lens can be removed
Night vision halos	Possible, usually temporary	Possible, usually temporary	Lower incidence	Low
Contact sports OK?	After 4–6 weeks	After 4–6 weeks	After 4–6 weeks	After 4–6 weeks
Active military eligible?	PRK preferred by DoD	Yes — DoD approved	Some branches	Less common
Enhancement / retreatment	Possible (5–10%)	Possible (5–10%)	Limited availability	Replace lens
Technology maturity	~30 years, well-established	~35 years, oldest option	~10 years, growing	~20 years, established

"Which is right for me?" — Decision Tree

Prescription above −8.00 or below −20.00?

→ ICL is likely the only option. Laser procedures max out around −8.00 to −10.00.

Thin corneas or previous corneal issues?

→ PRK or ICL. LASIK and SMILE require more corneal tissue. Your surgeon will measure corneal thickness pre-op.

Concerned about dry eye risk?

→ SMILE or ICL. SMILE has the lowest dry eye risk of the laser options due to the smaller incision.

Active military or extreme contact sports?

→ PRK. No flap means no flap dislocation risk from impact. The Department of Defense prefers PRK.

Want the fastest recovery and proven track record?

→ LASIK. Most patients have functional vision within 24 hours. ~16 million procedures in the US since 1999.

Want a reversible option?

→ ICL only. All laser procedures permanently reshape corneal tissue and cannot be undone.

Budget is the primary concern?

→ PRK is typically the least expensive ($3,500–$5,500 both eyes nationally). Similar long-term outcomes to LASIK.

LASIK

LASIK — the most common procedure

LASIK (Laser-Assisted In-Situ Keratomileusis) has been performed more than 16 million times in the US since FDA approval in 1999. A femtosecond laser creates a thin corneal flap; an excimer laser reshapes the tissue underneath; the flap is repositioned. Most patients achieve 20/20 or better vision by the next morning.

Cost range (both eyes): $4,000–$6,000 nationally. CA/NY/WA/MA typically $4,800–$7,200.

Best for: Nearsightedness (−1.00 to −8.00), farsightedness (up to +4.00), and astigmatism. Ideal when you want the fastest recovery and widest surgeon availability.

Risk to know: The corneal flap can be disrupted by trauma — relevant for active military or combat sports athletes. Dry eye is the most common side effect (20–30% of patients experience it short-term).

PRK

PRK — lowest cost, no flap

PRK (Photorefractive Keratectomy) was the predecessor to LASIK and is still widely performed. Instead of creating a flap, the surgeon removes the corneal surface epithelium before laser reshaping. Recovery takes longer (5–7 days for functional vision, 4–6 weeks for full clarity), but long-term outcomes are equal to LASIK.

Cost range (both eyes): $3,500–$5,500 nationally — typically $300–$600 less than LASIK.

Best for: Patients with thin corneas, dry eye tendencies, or who work in high-impact environments. Military branches prefer PRK because there is no flap to disrupt.

Risk to know: The slower recovery is the main trade-off. You’ll need 2–3 days of significant rest and light sensitivity. Full clarity may take 6–8 weeks.

SMILE

SMILE — newer, minimally invasive

SMILE (Small Incision Lenticule Extraction) is the newest mainstream procedure. A femtosecond laser creates a small disc of corneal tissue (lenticule) inside the cornea; the surgeon extracts it through a 2–4mm incision — no flap, no exposed surface. The smaller incision means fewer nerves are cut, which reduces dry eye risk.

Cost range (both eyes): $4,500–$7,000 nationally. SMILE commands a premium due to the proprietary ZEISS technology and limited surgeon training.

Best for: Patients with dry eye concerns or who want a flapless procedure with fast recovery. Corrects nearsightedness and mild astigmatism.

Limitation: SMILE cannot yet correct farsightedness and is limited in astigmatism correction (up to −3.00 CYL). Enhancement options are more limited than LASIK/PRK if retreatment is needed.

ICL

ICL — implantable lens, not laser

ICL (Implantable Collamer Lens) is technically not laser surgery — it’s an additive procedure. A thin, flexible lens is implanted between the iris and natural lens without removing corneal tissue. The lens can correct extreme nearsightedness (−3.00 to −20.00) and is fully reversible — unlike any laser procedure.

Cost range (both eyes): $8,000–$14,000 nationally. The higher cost reflects the implant itself (the STAAR EVO+ lens runs $1,000–$2,000 per eye at wholesale) and the more complex surgical procedure.

Best for: High prescriptions that exceed LASIK/PRK range, thin corneas, patients who want reversibility, and those not currently candidates for laser correction.

Risk to know: Slightly elevated risk of cataract formation (addressed with the newer EVO+ design). Requires a minor surgical procedure under local anesthesia.