Which Refractive Eye Surgery Are You Actually a Candidate For?
It depends on your prescription, cornea and age. Above about −10.00 D, corneal lasers (LASIK, PRK, SMILE) hit their FDA range ceiling and EVO ICL becomes the standard option. For presbyopic patients over 45, RLE is also discussed — with a frank conversation about elevated retinal-detachment risk. The matcher above maps your case.
LASIK, PRK, SMILE, EVO ICL, or RLE. We compute eligibility from your prescription, cornea, and lifestyle using FDA-approved diopter ranges and AAO candidacy thresholds. No clinic sponsorship. Every claim cited.
Tell us about your eyes.
One screen, the same gates the surgeon uses.
The Matcher reads from FDA approval letters and the AAO Preferred Practice Pattern. SMILE's FDA-approved range is −1 to −10 D myopia with up to −3 D astigmatism (NBK549896, FDA P150040). EVO ICL covers −3 to −20 D and up to −4 D astigmatism (PMC11110473). LASIK and PRK candidacy add corneal thickness, residual stromal bed, topography, and dry-eye flags. The Matcher applies these gates to your inputs and tells you which procedures pass, which fail, and exactly why.
The output is a screening estimate, not a diagnosis. Pachymetry, topography, biometry, and a board-certified surgeon are what actually decide.
Start where your question is.
LASIK vs PRK vs SMILE
In a 750-eye study, 95 percent of LASIK, 94 percent of PRK, and 94 percent of SMILE achieved 20/20 with no statistically significant difference. Choice is driven by cornea, dry eye, and lifestyle. We unpack the head-to-head with cited numbers.
PMID 39641610 · Hagan 2024 · n=750
Read the comparison → EligibilityAm I a candidate?
The seven hard gates that determine whether you qualify for any laser procedure.
Check the gates → CostWhat it actually costs
Per-eye ranges for LASIK, PRK, SMILE, ICL, and RLE across US, UK, and medical-tourism markets.
See the table → The toolProcedure Matcher
Tell us your prescription, cornea, age, and lifestyle. We will return a screening estimate with the FDA range or AAO threshold behind each verdict.
Open the matcher → Myth busted"SMILE has no dry eye"
Refuted. SMILE has less dry eye than LASIK, not zero. The verified numbers, with sources.
Read the breakdown → TrustHow we cite, what we refuse
Every number sourced. No clinic sponsorship. No referral fees. Why that matters for what we can tell you.
About this site →"LASIK is for everyone."
Approximately 15 to 20 percent of refractive-surgery consultations result in NO laser procedure being recommended. The disqualifiers are mechanical (thin cornea, abnormal topography, prescription outside FDA range), physiological (active dry eye, autoimmune flare, pregnancy), or temporal (unstable refraction). A clinic landing page will not lead with this. Source: AAO Preferred Practice Pattern, StatPearls NBK549896.
Frequently asked questions
Which refractive surgery is best for high myopia?
Above about −10.00 D, corneal lasers (LASIK, PRK, SMILE) hit their FDA-approved range ceiling and EVO ICL becomes the standard option. For presbyopic patients above 45 with high myopia, RLE is also discussed, with a clear conversation about elevated retinal-detachment risk (1.5 to 8 percent vs ~0.1 percent unoperated, PMC7856935).
Can I have LASIK if I have thin corneas?
Not if your corneal thickness leaves a residual stromal bed below 250 µm after ablation. PRK works with thinner corneas because no flap is created. If your cornea cannot safely accept any laser, EVO ICL is the alternative because it leaves the cornea untouched.
Is SMILE actually safer than LASIK?
For visual outcomes, no. A 750-eye head-to-head (Hagan 2024, PMID 39641610) found LASIK 95 percent, PRK 94 percent, and SMILE 94 percent achieved 20/20 with no significant difference in glare or night vision. SMILE does have measurably less dry eye than LASIK and preserves corneal biomechanics better (Hedges g = 1.31, PMC6676534). For some patients that matters more than recovery speed.
How do I know if I am a candidate for any refractive surgery?
Use the Procedure Matcher above for a screening estimate. The hard gates are: age (≥ 18 for LASIK, ≥ 22 for SMILE, ≥ 45 for RLE), prescription stability (no change > 0.5 D in the last year), diopter within FDA range, corneal thickness adequate, no keratoconus on topography, and controlled dry eye. About 15 to 20 percent of consultations are not candidates for any laser procedure.
Why do you not take clinic referral fees?
Because they would compromise our recommendation. Our model lets us tell you when no procedure is right for you. That is the part a clinic landing page never says.
Sources
- Hagan W et al. Comparative outcomes of LASIK, PRK, and SMILE in US military, 2004–2019. PMID 39641610.
- StatPearls. Small Incision Lenticule Extraction (SMILE). NBK549896.
- US FDA. ZEISS VisuMax Patient Information Booklet. P150040C.
- Comprehensive review of LASIK, SMILE, and ICL outcomes. PMC11110473.
- Shen Z et al. SMILE vs FS-LASIK for high myopia (meta-analysis). PMC7870077.
- Guo H et al. Corneal biomechanics after refractive surgery (meta-analysis). PMC6676534.
- AAO Preferred Practice Pattern: Refractive Errors and Refractive Surgery (2025).
Educational content only. Not medical advice. Final candidacy requires in-person ophthalmologist exam with topography, pachymetry, and biometry. We do not accept clinic sponsorship or referral commissions.