Laser Specs Removal Options: Pros & Cons

Medically reviewed by Dr. Rushad Shroff – Refractive and Cornea Surgeon, Shroff Eye Centre, Delhi NCR.

If you want to reduce your dependence on glasses, you may come across several laser specs removal options- including LASIK, SILK, SMILE, CLEAR, PRK, Streamlight and other procedures- and it can be quite confusing to decipher the marketing jargon from actual information . While these treatments aim to reduce dependence on glasses or contact lenses, they work in different ways and have their own advantages and limitations.

So, what are the laser specs removal pros and cons, and how do you know which procedure may be suitable for you?

In this video from Shroff Eye Centre, Dr. Rushad Shroff explains the main laser vision correction options, how they work, the technology involved, and what to consider before choosing one. The most important point is that there is no single procedure that is best for everyone. Every eye is different and the right option for you depends on your eye power, corneal measurements, eye health, lifestyle and safety criteria.

What Are the Different Options for Laser Specs Removal?

Refractive or specs-removal procedures can broadly be divided into three categories:

• Lenticule-based procedures: SILK, SMILE, SmartSight and CLEAR
• Excimer laser procedures: LASIK, PRK and Trans-epithelial PRK
• Intra-ocular surgical procedures: ICL and RLE

ICL and RLE are surgical procedures performed inside the eye and are not discussed in detail in this article. The focus here is mainly on laser-based options. You can read more about ICL Eye Surgery here.

If you want to understand the available options in more detail, see Shroff Eye Centre’s LASIK and refractive surgery guide.

How Does Laser Specs Removal Correct Eye Power?

The aim of laser vision correction is to change the shape of the cornea so that light focuses correctly on the retina which helps you see clearly without glasses.

With myopia or short-sightedness, the cornea is generally steeper than normal. Laser vision correction changes its shape to make it flatter and thus remove dependence on glasses or contact lenses.

With hypermetropia or long-sightedness, the cornea is generally flatter in the centre. Laser vision correction changes this to make the central cornea less flat.

What Are Lenticule-Based Procedures?

Lenticule-based procedures include SILK, SMILE, SmartSight and CLEAR. Although they use different laser platforms from different companies, the basic principle is similar.

A femtosecond laser creates a small piece of corneal tissue called a lenticule inside the cornea as well as a small incision on the cornea. The lenticule is removed from this incision which changes the shape of the cornea and corrects your eye power.

Dr Rushad Shroff explains that these procedures use different machines. SILK uses the ELITA femtosecond laser platform, while SMILE, CLEAR and SmartSight use VisuMax, Z8 and ATOS platforms respectively. Although the machines are different, the basic principle is to create and remove a lenticule from inside the cornea.

Pros of Lenticule-Based Procedures

One of the main advantages is that these procedures are flapless. Unlike LASIK, they do not require the creation of a corneal flap. This makes it an excellent option for vision correction for people involved in contact sports, armed forces or professions where the eyes may be exposed to impact injuries.

They also have fast visual recovery.

Another potential advantage is less disruption to the corneal surface because the incision on the corneal surface is small vs LASIK. The chance of dry eye may also be lower than with some other procedures, and visual recovery can be relatively quick.

Cons of Lenticule-Based Procedures

Lenticule-based procedures may not be suitable for everyone. Lenticule-based procedures are not the treatment of choice in those with Very high myopia or thin or irregular corneas. They are also traditionally used mainly for correcting myopia and astigmatism. Dr Rushad explains in the video that hypermetropia correction has become possible with some newer lenticule-based approaches, but suitability depends on the specific procedure and the patient’s eye measurements.

The procedure is painless and takes under 20 minutes to perform.

For more information about SILK and the ELITA platform, you can read the SILK eye surgery guide.

What is LASIK?

LASIK is one of the most established laser vision correction procedures.

During LASIK, a thin flap is created on the cornea. With Femto or Blade-Free LASIK, a femtosecond laser creates the flap. In microkeratome LASIK, a motorised blade is used.

After this corneal flap is lifted, an excimer laser reshapes the underlying corneal tissue. The flap is then placed back in its original position and it heals naturally over time without stitches.

Pros of LASIK

One of the main advantages of LASIK is faster visual recovery in the early post-surgical period. It can also correct myopia, astigmatism and hypermetropia.

Newer advancements like the Wavelight Plus and iWiss pre-treatment protocols allow 3D visualisation of the visual pathway aberrations and corrections of these using the laser allowing for better contrast sensitivity. .

The procedure is painless and takes under 20 minutes to perform.

Cons of LASIK

LASIK may not be suitable for people with high myopia or thin and irregular corneas.

Since LASIK involves creating a corneal flap, it may also not be the preferred option for people involved in combat professions, sports or activities with a high risk of eye injury.

Dry eye symptoms can also occur after LASIK. These are temporary symptoms which usually improve with time.

What is PRK and Trans-PRK?

PRK and Trans-PRK are surface-based, flapless laser procedures.

In PRK, the outer epithelial layer of the cornea is removed before the excimer laser reshapes the cornea using a chemical. In Trans-PRK, the laser is used to remove the epithelial layer.

The excimer laser then reshapes the underlying cornea.

The surface layer grows back naturally over the next few days during the healing process.

Nowadays most people do Trans PRK. This is called Streamlight when done using the Wavelight machine.

Pros of PRK and Trans-PRK

PRK is the oldest and best established technique. Since there is no corneal flap, PRK is a good option for those in contact sports, combat professionals or professions where an eye injury is a concern.

It may also be considered in some patients with thinner and irregular corneas where LASIK or lenticule-based procedures may not be appropriate for vision correction.

The risk of dry eye may also be lower compared with LASIK.

Newer advancements allow 3D mapping and treatment of some visual aberrations using the Wavelight Plus diagnostic protocol.

The procedure itself is painless and takes under 20 minutes to perform.

Cons of PRK and Trans-PRK

The main disadvantage is slower visual recovery compared to Lenticule-based procedures and LASIK.

The corneal surface takes 5-7 days to heal and during this time patients experience some discomfort.

Over-the counter painkillers usually help manage discomfort during the healing period.

Some patients may also experience some halos and glare during the recovery period which usually settles over some time.

Is Laser Specs Removal Painful?

Laser vision correction procedures are performed using numbing eye drops, so patients generally do not feel any pain during the procedure. Some patients report feeling a little pressure on the eye.

The treatment itself is also relatively quick, taking around 20 minutes or less. Patients can usually go home after the procedure.

The recovery experience, however, differs between procedures. For example, recovery after LASIK and SILK; other lenticule-based procedures is painless- but PRK can cause some discomfort while the surface of the cornea heals.

What Are the Risks of Laser Specs Removal?

Like any surgical procedure, laser vision correction has potential risks. Infection is one possible risk, although Dr Rushad Shroff describes the risk as very low if all precautions are observed.

Some patients may also experience temporary symptoms such as dryness or changes in vision during the healing period.

There is also a small possibility that some eye power may return over time and which may be corrected using enhancement or touch-up procedure. As you age, you will develop presbyopia, cataract and other age-related problems as you would have even if you had not got any laser vision corrections.

In those with high eye powers, the risks associated with high eye power remain- such as risk of retinal detachment, or risk of glaucoma etc and need to be monitored as you would if you had not got laser vision correction.

What Are Contoura and InnovEyes?

Contoura is the name used by patients for topography-guided laser treatment. Dr Shroff explains in the video that technologies such as Topolyzer can map the cornea and measure its optical characteristics. This information is then transferred to the treatment laser to help create a customised treatment- called Contoura LASIK which is performed by the Wavelight machine.

InnovEyes is another diagnostic protocol and old name for Sightmap with the Wavelight Plus treatment protocol. It helps create a 3-D model of the eye which maps the whole visual pathway and helps correct more visual aberrations.

The treatment in both is LASIK- only the pre-LASIK diagnostics are different.

Which Laser Specs Removal Procedure Is Best?

There is no single laser specs removal procedure that is best for everyone.

The suitable option depends on factors such as:

• Your eye power
• Corneal thickness
• Corneal shape
• Overall eye health
• Eye surface and tear film
• Lifestyle and occupation
• Participation in contact or combat sports
• Whether the procedure meets the required safety criteria

A detailed eye examination is therefore an important part of choosing a laser vision correction procedure.

Rather than choosing a procedure simply because it is newer or because of its marketing, discuss your lifestyle needs and available options with a qualified refractive surgeon.

To understand more you can also explore Shroff Eye Centre’s vision correction options

Final Thoughts

Understanding the laser specs removal pros and cons can help you have a more informed conversation with your eye specialist.

Lenticule-based procedures such as SILK offer a flapless approach and can provide relatively quick visual recovery in suitable patients. LASIK offers fast visual recovery and can correct myopia and hypermetropia. PRK and Trans-PRK are also flapless options that may be considered for certain corneal profiles, although their visual recovery is generally slower.

The key takeaway is simple: there is no single best procedure for every eye. The right laser specs removal option is the one that meets the safety requirements of your individual eyes and is appropriate for your vision needs and lifestyle.

Which vision correction procedures are available at Shroff Eye Centre?

At Shroff Eye Centre, we have LASIK (Contoura and Wavelight plus sightmap), SILK, Streamlight, PRK and ICL surgeries. To know more read REFRACTIVE SURGERY or call us on 9910956780.

Frequently Asked Questions

Q: Is laser specs removal safe?

Laser vision correction is safe for suitable patients who meet the required criteria. As with any surgery, it has some risks and nobody can guarantee 100% safety- that would be irresponsible if someone promises you that. A detailed eye evaluation is thus important before surgery to establish if you meet safety criteria.

Q: How do LASIK, PRK and SILK differ?

LASIK, PRK and SILK use different techniques to reshape the cornea. The most suitable option depends on factors such as eye power, corneal characteristics, eye health and lifestyle. See our detailed LASIK vs PRK vs SILK comparison to understand the differences.

Q: How long does laser specs removal take?

Laser specs removal surgery itself usually takes around 20 minutes or less, depending on the procedure. After the surgery, you can generally go home soon after. Recovery time varies by procedure, with some options offering faster visual recovery than others

Q: Is PRK more painful than LASIK?

PRK can be more uncomfortable than LASIK and SILK during recovery, especially during the first 5-7 days while the cornea heals. Pain-relieving medicines may be prescribed to manage the discomfort. However, neither is painful during the procedure itself.

Q: Is glass removal permanent after laser specs removal??

Yes in most patients specs removal is permanent till they hit their 40s.

Some eye power can return after surgery in a few patients but usually not to the same degree- it can usually be treated by an enhancement treatmentAs you age, you may develop presbyopia or cataract or other eye changes/ trauma which may require you to wear specs or glasses again.