Two different operations
LASIK is a 15 minute laser procedure on the cornea under numbing drops, with a next-day recovery. It corrects nearsightedness, farsightedness and astigmatism by changing the cornea's curvature. Refractive Lens Exchange is intraocular surgery: the natural lens is removed and replaced with an implant, under light sedation. It corrects the same prescriptions, across a wider range, and, with a multifocal, EDOF or Light Adjustable Lens, reading vision as well.
Age decides most cases
Under 45 the natural lens still focuses, and removing it gives that up. LASIK, PRK, SMILE or the EVO ICL correct the prescription and leave the lens to do its job. Over 45 the lens is stiffening anyway, readers have arrived or are arriving, and replacing the lens solves both problems at once. Between about 45 and 50 either can be right, and the state of the lens and your goals for reading vision decide.
Prescription and cornea
LASIK treats nearsightedness and farsightedness within the range your surgeon considers safe for your cornea, which must be thick and regular enough. RLE has no corneal limit; it corrects very high prescriptions in either direction and is unaffected by corneal thickness. For younger patients with high prescriptions the EVO ICL fills the same gap without removing the lens.
Recovery and risk
LASIK recovers in a day with a few weeks of dryness. RLE recovers in a day or two per eye, with drops for a few weeks and some weeks of adaptation to the new lens, particularly a multifocal. Both are very safe. LASIK's risks are corneal: dry eye, flap issues and the need for adequate thickness. RLE's are those of intraocular surgery: infection, inflammation, retinal detachment (more relevant in highly myopic eyes) and, with multifocal lenses, night halos. Your surgeon will discuss the risks that apply to your eye.
Cost
Both are elective and quoted in writing at your consultation, with 0% financing for up to 18 months on LASIK and up to 24 months on RLE, depending on the treatment cost and credit approval. RLE costs more, reflecting the lens implant and the surgical setting, and it removes the cost of cataract surgery later.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is the right choice for you is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
