LASIK vs. PRK vs SMILE: Which Is Right for You?

If you’re exploring laser eye surgery in Andover, MA, you’ve likely encountered various approaches to vision correction. At Boston Vision, we specialize in LASIK and PRK — two time-tested, FDA-approved procedures with decades of clinical research supporting their safety and effectiveness. While newer options like SMILE (small incision lenticule extraction) have entered the market, LASIK and PRK remain the gold standard for treating the widest range of prescriptions and providing predictable, customizable outcomes. This page will help you understand why LASIK and PRK continue to be the preferred choice for most patients seeking permanent vision correction. To discuss which option is right for you, contact Boston Vision at (617) 566-0062.

What Is LASIK Eye Surgery?

LASIK — short for laser-assisted in situ keratomileusis — is the most widely performed laser vision correction procedure in the world. With over 30 years of clinical use and millions of successful procedures, LASIK has an unmatched safety profile and the longest track record of any refractive surgery option available today.

LASIK involves creating a thin corneal flap using a femtosecond laser, then lifting that flap to expose the tissue underneath. An excimer laser then precisely reshapes the corneal tissue to correct refractive errors such as nearsightedness, farsightedness, and astigmatism. The flap is then repositioned, acting as a natural bandage during healing.

Most patients notice improved visual acuity within 24 hours, with rapid visual recovery that makes LASIK eye surgery an appealing option for those seeking a faster return to daily activities. LASIK remains the most extensively studied refractive surgery procedure available, with decades of peer-reviewed research demonstrating its effectiveness and safety.

What Is PRK Eye Surgery?

PRK — or photorefractive keratectomy — is the original form of laser vision correction and has been successfully performed since the 1980s. Like LASIK, PRK uses an excimer laser to reshape the cornea and correct refractive errors, including nearsightedness, farsightedness, and astigmatism.

The key difference is that PRK does not involve creating a corneal flap. Instead, the outer layer of the cornea (the epithelium) is gently removed, and the excimer laser is applied directly to the corneal surface. The epithelium naturally regenerates over several days following surgery.

PRK is particularly well-suited for patients with thin corneas, those in certain professions or with active lifestyles that involve contact sports, and patients with corneal irregularities that may make flap creation less ideal. While PRK’s initial recovery is slightly longer than LASIK, the long-term visual outcomes are equivalent, and PRK eliminates any possibility of flap-related complications.

Why LASIK and PRK Remain the Gold Standard

Broadest FDA Approval and Treatment Range

LASIK and PRK are FDA-approved to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism across a wide range of prescriptions. This makes them suitable for the vast majority of patients seeking vision correction. In contrast, SMILE is currently only FDA-approved for myopia and myopic astigmatism, meaning patients with farsightedness cannot be treated with SMILE.

Decades of Clinical Evidence

LASIK has been performed since the 1990s and PRK since the 1980s, with millions of procedures worldwide and extensive peer-reviewed research demonstrating their safety, efficacy, and long-term stability. SMILE, while promising, is a much newer procedure with a shorter track record and less long-term data available.

Advanced Customization with Wavefront Technology

At Boston Vision, we use wavefront-guided LASIK and PRK, which allows for highly personalized treatment based on the unique optical characteristics of your eye. This level of customization — often referred to as ‘custom LASIK’ — can improve visual quality beyond what standard treatments provide. SMILE does not currently offer wavefront-guided customization.

Enhancement Flexibility

In the rare cases where a patient’s vision changes over time or an enhancement is needed, LASIK and PRK offer straightforward retreatment options. With LASIK, the original flap can often be lifted again for enhancement. With PRK, the procedure can be repeated on the corneal surface. SMILE enhancements are more technically complex and may require converting to a different procedure type.

Proven Safety Profile

Both LASIK and PRK have decades of safety data and are among the most studied elective procedures in medicine. While all refractive surgeries carry some risk, the complications and side effects of LASIK and PRK are well-understood and manageable. SMILE’s safety profile continues to develop as more data becomes available.

Understanding SMILE: A Newer Alternative

SMILE — small incision lenticule extraction — is a newer laser vision correction technique that some providers offer as an alternative to LASIK. Unlike LASIK and PRK, SMILE uses only a femtosecond laser to create and remove a lens-shaped piece of corneal tissue through a small incision, without creating a corneal flap.

While SMILE has gained attention for its flapless approach and potential for reduced dry eye in some patients, it has several important limitations compared to LASIK and PRK:

Limited Treatment Range: SMILE is only FDA-approved for nearsightedness and myopic astigmatism. Patients with farsightedness cannot be treated with SMILE, whereas LASIK and PRK can correct all three major refractive errors.

No Wavefront Customization: SMILE does not offer the wavefront-guided personalization available with LASIK and PRK, which can optimize visual quality for each individual patient.

More Complex Enhancements: If additional vision correction is needed after SMILE, retreatment is more complicated and may require switching to PRK or surface ablation rather than a straightforward enhancement.

Shorter Track Record: While SMILE has been performed internationally for over a decade, it is relatively new to the U.S. market and does not yet have the decades of long-term data that support LASIK and PRK.

Slower Initial Recovery for Some Patients: While SMILE is marketed as minimally invasive, some patients experience a slightly longer initial visual recovery compared to LASIK, which typically provides rapid vision improvement within 24 hours.

At Boston Vision, we have chosen to focus on LASIK and PRK because they offer the most comprehensive treatment options, the longest safety track record, and the greatest flexibility for customization and future enhancements. For the vast majority of patients, LASIK or PRK will provide superior, predictable outcomes backed by decades of clinical evidence.

Key Differences: LASIK vs. PRK

While both LASIK and PRK are excellent options, understanding their differences can help you and your surgeon determine which is best suited to your needs.

Surgical Approach

LASIK involves creating a thin corneal flap that is lifted to allow laser treatment of the underlying tissue. PRK removes the outer epithelial layer and applies the laser directly to the corneal surface, with no flap creation.

Recovery Time

LASIK typically offers rapid visual recovery, with most patients seeing clearly within 24 hours. PRK requires several days for the epithelium to heal, so visual improvement is more gradual over the first week. However, final visual outcomes are equivalent between the two procedures.

Corneal Thickness

Both procedures require adequate corneal thickness, but PRK may be preferable for patients with thinner corneas since it does not require flap creation. Your surgeon will measure your corneal thickness during your evaluation to determine candidacy.

Contact Sports and Active Lifestyles

PRK eliminates any long-term risk of flap displacement, making it a common choice for military personnel, law enforcement, firefighters, and athletes in contact sports. LASIK is also performed successfully in active patients, though the presence of a flap does carry a small risk of displacement from direct eye trauma.

Dry Eye Considerations

Both LASIK and PRK can cause temporary dry eye during the healing process. Because LASIK involves creating a flap, some corneal nerves are disrupted, which can contribute to dry eye symptoms. PRK may involve slightly less nerve disruption, though individual responses vary. Patients with significant pre-existing dry eye will be carefully evaluated before either procedure.

LASIK vs. PRK: Comparison Summary

Factor	LASIK	PRK
Surgical Approach	Corneal flap created; excimer laser reshapes tissue underneath	Epithelium removed; excimer laser applied to corneal surface
FDA Approval	Myopia, hyperopia, and astigmatism	Myopia, hyperopia, and astigmatism
Recovery Time	Rapid; most improve within 24 hours	Gradual; visual improvement over first week
Corneal Thickness	Requires adequate thickness for flap creation	May be suitable for thinner corneas
Contact Sports	Small long-term flap displacement risk with trauma	No flap; ideal for contact sports and active lifestyles
Wavefront Customization	Available (wavefront-guided LASIK)	Available (wavefront-guided PRK)
Enhancement Options	Straightforward; original flap can be lifted	Straightforward; can repeat surface treatment
Clinical Track Record	30+ years, millions of procedures	40+ years, extensive clinical evidence

How to Choose Between LASIK and PRK

Whether LASIK or PRK is the better choice for you depends on your individual anatomy, prescription, corneal health, lifestyle, and goals. There is no universal answer — which is precisely why a thorough consultation with an experienced provider matters.

Patients with thin corneas, those in professions requiring no-flap surgery (military, law enforcement), and athletes in contact sports often find PRK to be the ideal choice. Those seeking the fastest visual recovery and who have adequate corneal thickness typically prefer LASIK. Many patients are excellent candidates for both procedures, making a direct surgeon conversation essential.

At Boston Vision, Dr. Samir Melki and Dr. Jason Brenner bring extensive fellowship-trained experience in refractive surgery to every evaluation. Their approach is to match the right procedure to the right patient — not to apply a one-size-fits-all recommendation. Schedule a consultation with Boston Vision to discuss which treatment aligns with your goals. Call (617) 566-0062 or contact us online.

Why Choose Boston Vision for LASIK or PRK in Andover, MA

Boston Vision is a private academic medicine practice serving Andover, MA, and surrounding communities, including Lawrence, North Andover, and Haverhill. Dr. Samir Melki, founder and fellowship-trained cornea and refractive surgeon with a part-time Associate Professor appointment at Harvard Medical School, leads a team that includes Dr. Jason Brenner, a board-certified ophthalmologist and staff surgeon at Beth Israel Deaconess Medical Center, as well as Dr. James Gregoire and Dr. Vinny Keshav — both fellowship-trained in cornea and refractive surgery.

Patients at Boston Vision receive direct access to their treating surgeon, including their surgeon’s cell phone, throughout their care. The practice uses blade-free, wavefront-guided technology and follows standardized safety protocols for both LASIK and PRK procedures. With seven locations across the greater Boston area, Boston Vision combines academic-level expertise with accessible, patient-centered care.

Frequently Asked Questions: LASIK and PRK

Still weighing your options? The questions below address the most common concerns patients bring to consultations. For a personalized recommendation, call (617) 566-0062 or schedule a consultation online.

What is the difference between LASIK and PRK?

The main difference between LASIK and PRK is how each procedure accesses the cornea. LASIK creates a thin corneal flap that is lifted to allow laser treatment underneath, while PRK removes the outer epithelial layer and applies the laser directly to the corneal surface. Both procedures use an excimer laser to reshape the cornea and correct refractive errors, but they differ in recovery time, candidacy criteria, and suitability for certain lifestyles.

Which has faster recovery — LASIK or PRK?

LASIK typically provides faster initial visual recovery, with most patients seeing clearly within 24 hours. PRK requires several days for the epithelium to regenerate, so visual improvement is more gradual during the first week. However, final visual outcomes are equivalent between the two procedures, and both offer excellent long-term results.

Why don’t you offer SMILE?

At Boston Vision, we focus on LASIK and PRK because they offer the broadest treatment range, the most extensive clinical evidence, wavefront-guided customization, and straightforward enhancement options. SMILE is only FDA-approved for nearsightedness and myopic astigmatism (not farsightedness), does not offer wavefront customization, and has a shorter track record compared to LASIK and PRK. For the vast majority of patients, LASIK or PRK will provide superior outcomes backed by decades of research.

Can I get PRK if I have thin corneas?

PRK is often a suitable option for patients with thinner corneas because it does not require flap creation, preserving more corneal tissue. However, both LASIK and PRK require sufficient corneal thickness to proceed safely. A comprehensive evaluation of your corneal health will determine which procedure — if either — is appropriate for you.

Is LASIK or PRK better for contact sports?

PRK is often the preferred choice for patients who regularly play contact sports or work in professions with a high risk of eye trauma (military, law enforcement, firefighting) because it eliminates the small but long-term risk of flap displacement associated with LASIK. Both procedures are performed successfully in active patients — your surgeon will consider your specific activity level during the consultation.

Am I a candidate for LASIK or PRK?

Candidacy for LASIK and PRK depends on factors including corneal thickness, corneal health, prescription range, age, and overall eye health. Both procedures correct nearsightedness, farsightedness, and astigmatism across a wide range of prescriptions. The best way to determine candidacy is a comprehensive evaluation with an experienced refractive surgeon.

How much does LASIK or PRK cost in Andover, MA?

Pricing for both LASIK and PRK is personalized based on your prescription, the technology used, and your individual treatment plan. We do not provide one-size pricing because each patient’s needs differ. Health savings accounts may be applicable for vision correction surgery — we encourage you to contact Boston Vision at (617) 566-0062 for a personalized quote following your consultation.

What is wavefront-guided LASIK or PRK?

Wavefront-guided LASIK and PRK use advanced mapping technology to measure the unique optical characteristics of your eye, allowing for highly personalized laser treatment. This customization can improve visual quality and reduce the risk of night vision issues compared to standard treatments. At Boston Vision, we use wavefront-guided technology for both LASIK and PRK procedures.

How do I know which laser eye surgery is right for me?

The most reliable way to determine whether LASIK or PRK better suits your needs is a comprehensive consultation with a fellowship-trained refractive surgeon. Factors, including your corneal thickness, prescription, lifestyle, and eye health, all influence the recommendation. At Boston Vision, Dr. Melki and Dr. Brenner personally evaluate each patient to recommend the most appropriate path forward.

Take the Next Step Toward Clear Vision

Choosing between LASIK and PRK is a personal decision that deserves a personalized evaluation. Both procedures are time-tested, FDA-approved approaches to permanent vision correction with distinct advantages depending on your anatomy and goals. While newer options like SMILE exist, LASIK and PRK remain the gold standard for treating the widest range of prescriptions with the most extensive clinical evidence supporting their safety and effectiveness.

Patients in Andover, MA, and throughout the greater Boston area trust Boston Vision for expert, patient-centered laser vision correction. Call (617) 566-0062 or contact us online to schedule your consultation with our experienced team. We’re here to help you make a confident, informed decision about your vision.