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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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Objective:

The article examines the objective, findings, and clinical context described in Choosing the Right Refractive Procedure.

Approach:
  • Preoperative evaluation: Assessment may include eye biometry, corneal topography or tomography, OCT, and tear-film evaluation to examine eye dimensions, corneal structure, internal eye health, and ocular-surface condition.
  • Procedure selection: The article describes candidate considerations for PRK, SMILE, RLE, and ICL, including age, prescription stability and range, corneal suitability, eye anatomy, and visual needs.
Key Findings:
  • PRK reshapes the cornea without creating a LASIK-style flap; recovery is generally slower than with LASIK.
  • SMILE removes a laser-formed lenticule through a small opening and is described for eligible patients with nearsightedness, with or without astigmatism, within its approved correction range.
  • RLE replaces the natural lens with an artificial one and may be considered based on age, prescription, corneal suitability, or early cataract changes; the article notes that the natural lens is permanently removed.
  • ICL places a corrective lens inside the eye while leaving the natural lens in place; suitability depends in part on prescription and available space in the front of the eye.
  • The article identifies corneal structure, dry eye, age-related visual needs, surgical risks, daily activities, surgeon experience, and available technology as considerations in procedure selection.
Interpretation:

The article states that no single refractive procedure is suitable for everyone and that selection depends on preoperative testing and an individualized discussion of benefits, limitations, and recovery.

Limitations:
  • The context provides no study methods, patient data, or comparative outcome estimates.
  • It does not specify detailed eligibility thresholds or quantify procedure-specific risks.
Sources:
  • Article context provided by the user

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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