Vision Correction Comparison
Modern Vision Correction Methods: Comparative Summary Table
You can find a detailed summary of four modern laser vision correction procedures below.
| TransPRK (No-Touch PRK) | LASIK | ReLEx SMILE | Implantable Collamer Lens (ICL) | |
|---|---|---|---|---|
| Year Introduced | 2013 | 1994 | 2011 | 1993 |
| Procedure Time Per Eye (Under experienced eye surgeon.) | 3 to 5 mins | 10 to 15 mins | 5 to 10 mins | 15 to 20 mins |
| Corneal Thickness Criteria | Ideally, central corneal thickness should be at least 485 microns thick. More suitable for thin corneas. | Ideally, central corneal thickness should be at least 500 microns thick. | Ideally, central corneal thickness should be at least 550 microns thick. | N.A No central corneal thickness requirements (ICL is not a corneal based procedure). |
| Degree Correction Criteria (Based on average central corneal thickness of 550 microns | Myopia: Up to 1,000 deg Hyperopia: Up to 400 deg Astigmatism: Up to 500 deg | Myopia: Up to 800 deg Hyperopia: Up to 400 deg Astigmatism: Up to 500 deg | Myopia: 250 to 800 deg Hyperopia: N.A. Astigmatism: Up to 250 deg | Myopia: Up to 1,800 deg Hyperopia: N.A. Astigmatism: Up to 600 deg |
| Suction Applied | "No eyeball touch" surgery - no suction applied. | A suction ring with high pressure is applied. The cornea is flattened, resulting in a blackout of vision. | An anatomically curved contact glass with low suction pressure is applied. No vision blackout, and feels as gentle as a contact lens. | No suction applied - a small 2 -3 mm side incision is made for the insertion of the ICL. |
| Invasiveness | Minimally invasive Involves surface-based ablation of outermost cells. | Moderately invasive Involves cutting a corneal flap | Minimally invasive Involves the creation and removal of a lenticule through a micro-incision. | Moderately invasive ICL is inserted inside the eye, beyond the cornea and deep behind the pupil. |
| Dry Eyes? | Less likely TransPRK is a surface- based procedure with no nerve endings being cut, greatly reducing the risk of dry eyes. | More likely Thousands of cornea nerve endings are cut when the cornea flap is created, resulting in the risk of permanent LASIK-induced dry eyes. | Less likely A micro-incision of 2 mm is made, instead of 22 mm with LASIK, meaning a much lower risk of dry eyes. | Very Unlikely ICL surgery does not involve the cornea, thus the nerve endings are untouched. |
| Flap-Related Complications? | No 0% Risk of cornea flap or lenticule complications as no cornea flap or lenticule is cut. | Yes 1 - 2% risk of cornea flap complications. This includes: flap dislodgement, flap wrinkles, flap inflammations and flap interface problems. | No 0% Risk of cornea flap or lenticule complications as no cornea flap or lenticule is cut. 1% risk of lenticule complications (suction loss, unsuccessful extraction, lenticule tear), requiring the patient to switch to LASIK or TransPRK. | N.A. The ICL procedure is not a corneal based surgery. |
| Discomfort During Healing | Slight discomfort | Little to no discomfort | Little to no discomfort | Little to no discomfort |
| Ability To Do Crosslinking To Prevent Future Corneal Thinning Problem i.e. Keratectasia | Can be incorporated in TransPRK procedure. | Can be incorporated in LASIK procedure. | Not formally recommended by manufacturer. | Not applicable, because ICL is not a cornea based procedure. |
| Can Go Back To Work | 1 week | 2 to 3 days | 2 to 3 days | 2 to 3 days |
| Full Visual Recovery | Generally takes around 1 to 3 months | Generally takes around 1 month to 2 months | Generally takes around 1 to 2 months | Generally takes around 1 month |
| Resume Light Sports e.g. Jogging, Gym, Cycling | 1 week | 5 days | 5 days | 5 days |
| Can Do More Active Sports e.g. Swimming, Diving, Bungee Jumping, Football | 2 weeks (Important to avoid sun’s UV rays for 6 to 10 weeks) | 1 month | 2 weeks | 1 month |
| Participate In Rugged And Contact Sports | 2 weeks | It is not advisable to participate in contact sports as the cut corneal flap will never fully heal. | 2 weeks | It is not advisable to participate in contact sports as the ICL may dislodge or injure internal structures. |
| Average cost of procedure for both eyes (Singapore) | S$3,800 - S$6,000 | S$3,000 - S$5,000 | S$5,000 - S$6,000 | S$9,000 - S$15,000 |
| Summary | TransPRK was made possible with the creation of the Schwind Amaris 1050RS excimer (gas) laser in 2013, and is the much improved version of traditional PRK, which was the very first laser vision correction method. Good for anyone who prefers a safe surface-based procedure. Suitable for active people, especially those participating in contact sports. Suitable for those who are risk adverse to corneal flap complications, wish to minimise risk of dry eye, have thin cornea and high myopia, and those who are afraid of having their eyes cut. Very important to avoid the sun’s UV rays for two months post-op and to use the recovery eye drops provided for six to ten weeks depending on the eye power corrected. | Introduced in the early 1990s, this flap-based laser vision correction surgery has become the most widely known and performed procedure for correcting refractive errors. There are many surgeons who perform LASIK around the world, as it is a less demanding and less costly surgery to perform. This has allowed LASIK to be more widespread and offered by many clinics. Good for those who wish to have a fast visual recovery. However, the risk of dry eyes and corneal flap complications might be something to consider. Not suitable for those who wish to participate in contact sports, suffer from dry eye syndrome, and/or who do not wish to have their cornea cut. | ReLEx SMILE was introduced in 2011 by ZEISS, and is performed using the ZEISS VisuMax femtosecond (ultrashort pulse) laser. In 2016, it was introduced into the US after passing the US Food and Drug Administration’s (FDA) notoriously strict regulations and safety standards. Good option for those who lead an active lifestyle and are looking for a short and painless recovery, without the risks of corneal flap and dry eye complications. This is thanks to the micro-incision being 80% smaller than that of LASIK, making it a minimally invasive procedure. One thing to note is that the suitability criteria is not as wide ranging as compared to TransPRK or LASIK - hyperopia (farsightedness) is not yet treatable, and those with thinner corneas/higher myopia might not be eligible. | ICL has a long track record, and does not involve the changing of cornea shape to correct vision. This makes it a reversible refractive procedure, meaning that if there are complications, the lens can be removed, returning the eye to its original state. However, because this is an intraocular (in the eye) procedure, there is a small risk of serious intraocular eye infection (1 in 1,000), as well as a small risk of developing cataracts and glaucoma down the road. Hence, it is usually only an option for patients who are found to be unsuitable for laser vision correction procedures, e.g. patients with very thin corneas, high refractive errors (above 1,000 degrees) or cornea scarring. |
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