SMILE, PRK or ICL in Denver: Alternatives to LASIK Compared

The three alternatives at a glance

SMILE

The AAO describes SMILE (small incision lenticule extraction) as a newer type of laser refractive surgery. A laser shapes a disc of tissue inside the cornea, and the surgeon removes it through a small incision.

According to the AAO, SMILE candidates need:

• A prescription that hasn't changed in the last year
• Healthy corneas
• Generally good eye health

Keep the FDA's broader caution in mind. It says there's no long-term data for current refractive procedures and that some complications can't be avoided in a percentage of patients. That caution covers refractive surgery in general, not just LASIK.

PRK

PRK (photorefractive keratectomy) usually takes about 15 minutes, according to the AAO's PRK page, dated January 14, 2026. The surgeon removes the outer layer of the cornea, for example with a brush, and a laser then reshapes the cornea.

The trade-off is healing time. The AAO's recovery guidance says PRK heals more slowly because the outer corneal cells take a few days to grow back. As with other laser surgery, your doctor checks you the day after, follow-up visits usually run six months or more, and vision is usually stable at about six months.

Who may not be a PRK candidate

• People with corneal scars or corneal disease
• People with advanced glaucoma
• People with a cataract that affects vision
• People with uncontrolled diabetes
• Pregnant or nursing women

The AAO lists corneal scarring, corneal infection and blindness among PRK's risks. Ask the surgeon how these apply to your eyes and what follow-up looks like if healing is slow.

ICL

The American Refractive Surgery Council, an industry group, groups ICL (implantable collamer lens) with LASIK, SMILE and PRK as vision correction procedures and says it qualifies for FSA and HSA funds. That is the only ICL point we could confirm. We haven't yet verified ICL's FDA approval details, candidacy criteria, risks or recovery against official sources, so we don't describe them here.

Until we can cite primary sources, the most useful thing we can offer is a list of questions for a surgeon who suggests ICL:

• Is this lens FDA approved for my age and prescription, and can I see the approval information?
• Why do you suggest ICL over SMILE or PRK for my eyes?
• What are the main risks, short and long term, and how often do you see them?
• What does recovery look like, and how many follow-up visits are included?
• How many ICL procedures have you performed?
• What is the total price for both eyes, in writing?

Rules that apply to every option

• Stability first: the FDA counts a prescription change in the past year against refractive surgery, and the AAO lists a stable prescription for SMILE.
• No long-term data: the FDA says there's none for current refractive procedures.
• Results take time: the FDA checklist asks you to understand that final results can take months, and not to have an enhancement until your prescription stops changing.
• Close-up vision: the AAO says LASIK can't correct presbyopia. Ask whether your alternative changes that.
• Insurance: the FDA says most medical insurance won't pay for refractive surgery.

See the FDA's LASIK checklist and When is LASIK not for me? for the full wording.

Cost and paying for it

We found no verified prices for SMILE, PRK or ICL, nationally or in Denver. For reference, national LASIK estimates range from $2,000–$3,000 per eye (American Refractive Surgery Council) to about $4,400 for both eyes (GoodRx). Don't assume an alternative costs the same; ask for written quotes.

IRS Publication 502 counts eye surgery to treat defective vision, such as laser eye surgery, as a medical expense, and Publication 969 says HSA withdrawals for qualified medical expenses aren't taxed. The health FSA salary-reduction limit for 2026 is $3,400 (Mercer). Our LASIK guide has the full HSA and FSA rundown.

Questions to bring to a Denver consultation

1. Which finding makes me a poor LASIK candidate: corneal thickness, pupil size, dry eye, prescription strength or something else?
2. Which alternative do you suggest for me, and why not the others?
3. What recovery should I plan for, including time off work?
4. How many of this specific procedure have you performed?
5. What happens if I'm under- or over-corrected?
6. Does the quote cover both eyes and all follow-up visits?

Before you commit, run the license and board certification checks in our verification guide. The FDA says patient selection and the surgeon's experience and skill are still the most important considerations.