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The Ophthalmologist / Issues / 2026 / November / Choosing the Right Refractive Procedure
Anterior Segment Refractive Insights

Choosing the Right Refractive Procedure

How preoperative screening guides the choice between PRK, SMILE, ICL and RLE

By Azhar I. Salahuddin 11/5/2026 2 min read

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5 Key Takeaways
  • 1

    Preoperative evaluation includes biometry, corneal topography or tomography, OCT, and tear film assessment to guide procedure selection and identify risks.

  • 2

    PRK reshapes the cornea without creating a flap and may suit some patients with relatively thin corneas or flap-related concerns, but recovery is slower than with LASIK.

  • 3

    SMILE treats eligible patients with nearsightedness, with or without astigmatism, when prescription and corneal measurements fall within the procedure's approved range.

  • 4

    ICL places a corrective lens inside the eye while preserving the natural lens and may suit some patients with moderate to high myopia who meet anatomical requirements.

  • 5

    RLE replaces the natural lens and may be considered for some adults over 40, but its permanent removal requires careful assessment, particularly in younger patients.

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.

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