I've high myopia (-6.25, -6.75) with low corneal thickness (492,500). Is SMILE or PRK an option for me? I don't want to get ICL because it has a lot of risks.

All surgery has inherent risks that any patient should understand before he or she decides to proceed. This is especially true in the case of relatively elective procedures like vision surgery. Unfortunately, while I have this conversation (using pictures) every day with patients, most do not appreciate risk except in terms like "What is the percentage of times it doesn't work?" or "What percentage of the time does something go wrong?" It is not really so simple as that, though.

In the case of incomplete data, or extremely rare events, we are "wired" to make judgments based on what our friends do, what we have read, and many other neural shortcuts. We tend to look for and remember information that confirms our biases. These rarely make for good decisions.

In the case of keratorefractive procedures like LASIK, PRK, and SMILE, the risks increase roughly proportionally to the degree of myopia. In ICLs, the risks of surgery are independent of the prescription. You should consider all these relative risks in careful discussion with an eye doctor who takes the time to make you both comfortable and well-informed.

_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic