Impact of refractive surgery on patients' quality of life: Comparison between LASIK, PRK, and SMILE

Abstract

Introduction: Refractive surgery, including LASIK, PRK, and SMILE, has established itself as an effective solution for the correction of refractive errors, providing patients with a significant improvement in quality of life by reducing or eliminating the need for glasses or contact lenses. Each technique has specific advantages in terms of recovery, efficacy, and incidence of complications, and it is essential to understand the differences for an informed choice of procedure. Methods: A systematic review of 28 studies comparing the impacts of LASIK, PRK, and SMILE on patients' quality of life was conducted. The search included databases such as PubMed, Scopus, and the Cochrane Library, focusing on studies published between 1999 and 2024. The inclusion criteria included studies that used validated questionnaires to assess postoperative quality of life and reported quantitative results on visual recovery and complications associated with each technique. The analysis included a qualitative synthesis of the data and, when possible, a meta-analysis to compare the outcomes between the techniques. Results: The results indicate that all refractive surgery techniques result in significant improvements in the quality of life of patients. SMILE stood out for providing a fast visual recovery and lower incidence of dry eye compared to LASIK. PRK, despite a longer recovery period, proved to be advantageous for patients with thinner corneas or those who practice contact sports, due to the absence of corneal flaps. Patient satisfaction was high in all procedures, with variations depending on the postoperative approach and the management of expectations. Conclusion: The choice between LASIK, PRK, and SMILE should be personalized, taking into account the specific needs of the patient and the anatomical characteristics of the cornea. While all techniques offer substantial benefits, SMILE emerges as an attractive option due to its combination of rapid recovery and lower incidence of complications. However, LASIK and PRK remain viable alternatives, especially in specific cases. Future studies are needed to assess the long-term effects and provide more robust guidance for clinical practice.