How Many Types of Laser Eye Surgery Are There? A Comprehensive Guide

Laser eye surgery has transformed the field of vision correction, helping millions worldwide break free from glasses and contact lenses. But did you know there are multiple types of laser eye surgeries, each designed for specific vision problems and eye conditions?

This guide dives deep into the 10 major types of laser treatment for eyes , explaining their technical aspects, patient suitability, benefits, and limitations. Whether you’re just curious or seriously considering surgery, this comprehensive article will help you navigate your options confidently.

What is Laser Eye Surgery?

At its core, eye laser treatment reshapes the cornea, the clear front surface of your eye, so that light entering the eye focuses properly on the retina. This correction addresses common refractive errors like:

• Myopia (nearsightedness) — difficulty seeing distant objects.
• Hyperopia (farsightedness) — difficulty seeing close objects.
• Astigmatism — blurred vision due to irregular corneal shape.
• Presbyopia — age-related difficulty in focusing on close objects.

Different surgeries use different laser technologies, like excimer lasers (which precisely ablate corneal tissue) or femtosecond lasers (which make precise cuts without heat).

1. LASIK (Laser-Assisted In Situ Keratomileusis)

LASIK is the most popular laser eye surgery globally, known for its quick recovery and excellent outcomes. Here is some technical overview of LASIK surgery: 

• A femtosecond laser creates a thin corneal flap.
• The underlying corneal tissue is reshaped using an excimer laser.
• The flap is repositioned, acting like a natural bandage.

This lasik surgery is best for mild-to-moderate myopia, hyperopia, and astigmatism. Patients often return to work within 24-48 hours, and vision improvement is almost immediate. However, LASIK is not suitable for those with thin corneas or severe dry eye.

2. PRK (Photorefractive Keratectomy)

PRK was the first FDA-approved laser surgery for eyes and remains relevant, especially for certain patient profiles. Here is some technical overview of this PRK surgery: 

• The outer corneal layer (epithelium) is gently removed.
• An excimer laser reshapes the corneal surface.
• The epithelium naturally regenerates over several days.

This PRK eye surgery is best for thin corneas, patients with active lifestyles, and those at risk of trauma (military, athletes). PRK avoids flap-related complications, but recovery is longer and more uncomfortable compared to LASIK, requiring 5-7 days for functional vision.

3. LASEK (Laser-Assisted Sub-Epithelial Keratectomy)

LASEK merges techniques from LASIK and PRK. Here is some technical overview of this LASEK surgery: 

• The epithelium is loosened with an alcohol solution and lifted.
• An excimer laser reshapes the cornea.
• The epithelial flap is replaced.

This PRK eye surgery is best for thin corneas, high refractive errors, and those unsuitable for LASIK. Although less common today, LASEK provides more corneal preservation than LASIK and faster recovery than PRK.

4. SMILE (Small Incision Lenticule Extraction)

SMILE is a minimally invasive advancement using only femtosecond lasers. Here is some technical information about this SMILE surgery: 

• A small lenticule (thin lens-shaped piece) is cut within the cornea.
• The lenticule is removed through a tiny incision, reshaping the cornea.

This PRK eye surgery is best for myopia and mild astigmatism. SMILE involves no flap, reducing dry eye risk and preserving more corneal nerves. The small incision makes it an attractive option for people in dusty or high-impact environments.

5. Epi-LASIK

Epi-LASIK is similar to LASEK but uses a mechanical separator rather than alcohol to lift the epithelial sheet. Here is some technical information about this Epi-LASIK surgery: 

• An epikeratome separates the epithelium.
• Laser reshaping is performed.
• The epithelium is repositioned.

This PRK eye surgery is best for patients sensitive to alcohol or with specific corneal characteristics. Epi-LASIK offers lower chemical exposure but has similar recovery times to PRK.

6. Contoura Vision (Topography-Guided LASIK)

Contoura Vision is the latest generation of LASIK, offering a personalised approach. Here is some technical information about this Contoura Vision surgery: 

• A detailed corneal topography map identifies micro-irregularities.
• The laser reshapes the cornea with extreme precision.

This PRK eye surgery is best for patients wanting the sharpest, most customised vision correction, including those with corneal irregularities. Many patients achieve better-than-20/20 vision (so-called “super vision”) due to the highly personalised nature of the treatment.

7. Refractive Lens Exchange (RLE)

RLE is technically not a laser corneal procedure but a lens replacement. Here is some technical information about this Refractive Lens Exchange surgery: 

• The eye’s natural lens is removed.
• An artificial intraocular lens (IOL) is implanted.

This PRK eye surgery is best for high hyperopia, presbyopia, and early cataracts. RLE can correct both distance and near vision, preventing future cataracts. However, it’s more invasive than LASIK.

8. Phakic Intraocular Lens Implants (Phakic IOLs)

Phakic IOLs add a corrective lens inside the eye without removing the natural lens. Here is some technical information about this Phakic Intraocular Lens Implant surgery:

• A synthetic lens is surgically inserted between the cornea and iris (or behind the iris).
• No corneal reshaping is done.

This PRK eye surgery is best for very high myopia and thin corneas. Phakic IOLs offer reversibility and maintain accommodation (natural focusing ability) but carry risks like cataract formation or endothelial cell loss.

9. Laser Blended Vision

This procedure customises one eye for near vision and the other for distance, using laser techniques. Here is some technical information about this Laser Blended Vision surgery: 

• Blended monovision adjusts corneal shape and depth of focus.
• Primarily used to manage presbyopia.

This PRK eye surgery is best for middle-aged adults who are not ready for multifocal IOLs. Laser blended vision offers a compromise between near and distance clarity without needing glasses, although adaptation can take weeks.

10. Conductive Keratoplasty (CK)

CK uses radiofrequency energy instead of lasers. Here is some technical information about this Conductive Keratoplasty (CK) treatment: 

• Heat applied via a probe shrinks peripheral corneal collagen.
• Central corneal curvature increases to correct mild hyperopia.

This PRK eye surgery is best for mild farsightedness and early presbyopia. CK is non-invasive and fast, but results are often temporary, requiring repeat treatments.

Comparative Table: Quick Reference

Risks and Complications in an Eye Surgery

While laser surgeries are safe and highly effective, risks include:

Dry eyes.

• Glare or halos.
• Undercorrection/overcorrection.
• Flap complications (LASIK).
• Infection or delayed healing (PRK, LASEK). 

Proper screening, an experienced surgeon, and following post-op care significantly reduce these risks.

Conclusion:

Laser eye surgery has come a long way, offering a wide range of solutions tailored to different needs. From flapless SMILE to highly personalised Contoura Vision, there’s no one-size-fits-all — the best procedure depends on your unique eyes, lifestyle, and goals.

If you’re considering vision correction, schedule a detailed consultation with a best eye specialist in Bangalore to explore your best-fit options and take the first step toward clear, independent vision.

Book Your Consultation Today!

At Swastik Eye Hospital, Bangalore’s trusted destination for advanced eye care, we combine expert surgeons, cutting-edge technology, and a patient-first approach to deliver exceptional results in cataract surgery, LASIK, and laser vision correction. Whether you’re exploring your options or ready for clearer vision, our dedicated team is here to guide you every step of the way. Schedule your personalised consultation today!