What are the laser options for vision correction in 2026?

Hi, my name is Dr. Ling. I'm a fellowship-trained, double-board-certified refractive surgeon, specializing in the full spectrum of vision correction techniques, having performed thousands of procedures to help people live a life free from glasses or contact lenses.

I want to share with anyone who is looking to learn more about vision correction what is available in 2026, so you can understand what vision correction techniques are available and how they work. My goal is to inform and educate the public so each individual can make the best decision for them, because the reality in vision correction is that there is no one-size-fits-all approach, and not every person is a good candidate.

Let's start with two broad categories of vision correction first. Currently, there are two main types of vision correction:

1. Corneal-based refractive surgery
2. Implant-based vision correction

In this article, I will discuss what's available under corneal-based refractive surgery.

So how does a laser correct the need for glasses or contact lenses on the cornea?

The idea is actually quite straightforward. Think of your cornea, which is this clear round front part of your eye that you look through, as essentially a pair of glasses that you're born with, with a certain corneal curvature that provides a certain degree of focus. This cornea, along with the internal refractive index of your eyes, determines whether you develop a need for glasses or contact lenses to see well or not.

So if you can change the curvature of your cornea, you can change the diopter of focus that your cornea provides and match that to the same degree that glasses or contact lenses could correct your vision. This is the fundamental concept underpinning corneal-based refractive surgery: to alter the shape of the cornea, resulting in a new focal point that matches your eye. There are different techniques that can be used. Nearly all corneal-based procedures are now done with lasers.

This category includes LASIK, SMILE, and PRK.

Underpinning all three procedures is that the part of the cornea amenable to resurfacing and reshaping is, in fact, not the outermost layer of the cornea, which is the epithelium. The layer of the cornea that is amenable to resurfacing is the stromal tissue, which lies just a few microns underneath the epithelium. For a laser to reshape a cornea, those few microns of tissue need to be displaced or bypassed in order to correct vision. I will explain how each procedure does that below.

PRK

So let's start with photorefractive keratectomy, also known as PRK. Approved in the mid-1990s, this procedure is done with an excimer laser that allows us to reshape the corneal stroma. In PRK, the epithelium is simply removed since it is quickly regenerative. The epithelium is one of the fastest-healing parts of the human body, able to regenerate a significant quantity of surface area over just a few days.

PRK is performed in a two-step process:

1. The epithelium is gently debrided either with a solution composed of diluted ethanol to loosen the attachment of the epithelium or with instruments that can gently lift up the epithelium to expose the stromal bed.
2. Once the stromal bed is prepped, an excimer laser treats the exposed stromal surface for a few seconds. Once done, I'll place a bandage contact lens over the cornea to allow for both comfort and controlled healing.

Vision improves gradually over the first few weeks as the epithelium regenerates underneath the bandage contact lens, with the final result at four to six weeks.

LASIK

LASIK was a groundbreaking vision correction technique that began in the late 1990s and became a household name due to its high level of safety and efficacy, and it has undergone continual improvements even to today. It's performed by two different types of lasers:

1. The cornea is prepared with a flap in the front by a femtosecond laser, an ultra-precise and gentle laser that creates hundreds of thousands of air bubbles to help separate a thin layer on the surface of the cornea. The creation of this layer allows it to be temporarily lifted up.
2. A second laser, called the excimer laser, is then able to treat underneath and treat the temporarily exposed stromal bed of the cornea to resurface the contour. This is done over just a few seconds, and then the anterior corneal flap is replaced back down in position.

This technique allows for precise prescription treatment and rapid recovery since the corneal interface heals quickly and the epithelium around the flap edge reconnects. The result is vision correction that is apparent within the first 24 hours and stabilizes over a few days.

SMILE

The most recent laser-based corneal refractive procedure to be approved is small incision lenticule extraction, also known as SMILE. This procedure, approved in the US in 2016, is unique in that it only uses the femtosecond laser to reshape the cornea. You can think of this procedure as a laparoscopic version of LASIK: laparoscopic vision correction within the cornea. There is a two-step process:

1. The femtosecond laser creates a three-dimensional, lenticular outline of the corneal stroma designed to match your prescription.
2. When this lenticule is removed from the stroma, the resulting shape will be configured to match the prescription needs.

The undisturbed epithelium allows for similar recovery as with LASIK, with the stromal interface and small incision closing quickly. Most individuals achieve notable vision correction within the first 24 hours, followed by a period of stabilization and refinement over a few days.

In future writings, I'll dive into each procedure in-depth. I will also discuss lens-based refractive surgery options, which approach vision correction from an entirely different angle.

If you are interested in vision correction, it is important to seek a surgeon who is familiar with and practices the full scope of vision correction options.