Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 10/31/18 10:34 AM
I was going to start out by saying this is a lot like comparing apples and oranges. Then I thought, “No one is going to read past the first sentence if I start with the tritest and oldest fruit comparison simile.” So I’ll say instead it is a lot like comparing glue and sutures.
There are two main ways to close a skin wound. One is glue (basically a sterile kind of superglue) and the other is sutures (commonly called stitches). Which one is better? It depends on the kind of cut you’re closing. For a superficial laceration that closes pretty easily without a lot of tension, glue works amazing well. And it is quick! For a bigger cut, suturing is required to make sure it heals properly. It takes a few minutes more, but is irreplaceably effective when necessary.
There isn’t anything on the medical horizon that looks like LASIK will be superseded any time soon for people with mild to moderate prescriptions. If you happen to know the number on your contacts or glasses, mild to moderate would a general range of -1.00 diopters up to -6.00 diopters. In almost every one of these cases, LASIK is unbeatable—if testing of your eye shows that you’re a candidate. Quick, super accurate, minimal recovery time.
What about the people who don’t fit in that group?
There are a lot of people with prescriptions higher than that. This is a group where ICLs win, hands down. Up until a few years ago, ICL was more like a second place prize in a contest where only the first place prize was amazing. It was like losing a free car, but getting the runner up prize of an annual bus pass. Sure it still got you where you needed to go, but boy howdy was it less enjoyable (and in some cases riskier).
That’s not the case anymore. Every day in clinic, I see post-op patients who had ICLs or who had LASIK. They are equally happy and feel like the process was easy in either case. ICL has become the same type of experience as LASIK in that the normal experience is both eyes are done the same day and vision is great the next day. It means we can now base the choice of procedure on which will provide better vision and which is safer.
Which is safer?
Interestingly enough, it correlates pretty well that the safer procedure will usually also yield better vision. For the -6.50 or higher, ICL will usually provide higher quality and higher acuity vision than LASIK. It is also usually safer because of the minimal impact of the new lens compared to changing the cornea the amount that would be required with LASIK in these cases.
So depending on your eyes, ICL may very well be better than LASIK in every category that matters from safety to quality of vision. Since there’s no generalized winner for all patients, a detailed and thoughtful exam and discussion is the only way to know what’s best for each patient. Much like the guidelines for glue vs. stitches (which is more involved than the medical adage about snitches would lead you to believe), you can’t know the solution till you know the problem.