If you have dry eyes and spend your workday looking at a screen, the first step is to check whether the surface of your eyes is stable enough to plan surgery. SMILE, SMILE pro, and PRK can then be compared based on your corneal shape and thickness and the amount of vision correction needed. If laser vision correction that removes corneal tissue is unsuitable, the next step is to assess whether the structures inside your eyes are suitable for ICL surgery. Moderate nearsightedness and mild astigmatism alone are not enough to determine which procedure is right for you.
You may want to stop wearing glasses, yet find that your eyes feel dry every afternoon or that text on a screen becomes blurry when you wear contact lenses. In this situation, understanding the cause of your dryness and the care you will still need after surgery is just as important as looking for a procedure with a short recovery time.
Do dry eyes mean I need to postpone vision correction surgery?
Having dry eyes does not necessarily mean you need to postpone surgery. However, if damage to the eye surface or an unstable tear film causes fluctuating vision and affects examination measurements, treatment should come first, followed by repeat measurements for surgical planning. If the eye surface and measurements are stable, surgery may be considered while dry eye care continues. Preoperative assessment of the eye surface
Tears form a thin layer over the front of the cornea, keeping its surface smooth. If this tear film breaks up too quickly, it can cause stinging, dryness, and brief episodes of blurred vision. This is why the tear film also needs to be assessed when determining how much vision correction is needed.
An examination looks at tear production, how well the tear film remains stable, any damage to the corneal surface, and inflammation along the eyelid margins. The meibomian glands in the eyelids supply oils that help keep tears from evaporating too quickly, so checking how these glands function is also important when identifying the cause of dry eyes. Dry eye causes and diagnosis
Treatment depends on the cause. It may include eye drops to supplement tears, eyelid hygiene, or treatment for inflammation or meibomian gland problems. Temporary relief after using artificial tears does not, on its own, mean your eyes are ready for surgery. After treatment, the eye surface, vision, and examination measurements are assessed together.
How are SMILE, SMILE pro, PRK, and ICL compared?
After assessing dry eyes, the next step is to assess the suitability of the two approaches: laser vision correction that removes corneal tissue, and ICL surgery that places a lens inside the eye. These procedures operate on different parts of the eye, so the examinations they require and the considerations during recovery also differ.
| What to compare | SMILE and SMILE pro | PRK | ICL surgery |
|---|---|---|---|
| How vision is corrected | A small piece of tissue called a lenticule is created within the cornea and removed through a small incision. | The corneal epithelium is removed, and a laser reshapes the cornea. | A corrective lens is placed inside the eye without removing corneal tissue, while the natural lens remains in place. |
| Important factors in choosing surgery | Corneal shape, thickness, and stiffness; the tissue remaining after surgery; the degree of nearsightedness and astigmatism; allergies and eye-rubbing habits. | Corneal shape, thickness, and stiffness; the tissue remaining after surgery; the degree of nearsightedness and astigmatism; allergies and eye-rubbing habits. | Space for the lens, the anterior chamber angle, corneal endothelial cells, lens size, and any eye disease. |
| Considerations when returning to work | Everyday activities such as washing your face, applying facial makeup, and light exercise such as jogging can be resumed the day after surgery. Dryness may remain during early recovery. | The bandage contact lens is removed around day three after surgery, and vision gradually recovers at a pace that varies by person. Adjust prolonged screen use to your recovery. | Even if vision improves early, temporary blurred vision or discomfort may occur during early recovery. Adjust your workload to your symptoms, and have eye pressure and lens position checked. |
| Ongoing follow-up | Monitor the eye surface and changes in vision. | Check that the corneal epithelium is healing properly. | Continue eye surface care and long-term monitoring of eye pressure, lens position, and corneal endothelial cells. |
You can also read about how the procedures work and the examinations involved in EYEREUM's vision correction comparison and special examinations for lens implantation (in Korean).
SMILE and SMILE pro: corneal suitability and early recovery
SMILE may be considered if the eye surface is stable, enough corneal tissue will remain after correcting nearsightedness and astigmatism, and the cornea has a suitable shape and stiffness. Correction is performed through a small incision in the corneal surface. Because the procedure uses a small incision, an early return to light daily activities may be possible, depending on recovery. This can help when planning around work.
However, dryness can develop after surgery, or existing symptoms can worsen. A small incision does not make dry eye disease go away. If your eyes are already dry, both their condition before surgery and the care needed afterward should be considered. SMILE: features and considerations
PRK: corneal suitability and time for surface healing
PRK removes the corneal epithelium before a laser reshapes the cornea. Suitability is assessed using factors such as corneal thickness and shape and the amount of correction needed. A thin cornea does not automatically make PRK suitable; its structural stability also needs to be checked.
The corneal epithelium needs time to heal after surgery, and the bandage contact lens is usually removed around day three. Vision then gradually recovers at a pace that varies by person. If your job involves prolonged screen use, consider both your work schedule and the recovery period. If you have dry eyes, the eye surface also needs to be assessed before surgery. Recovery after surface ablation
ICL surgery: checking the structures inside the eye when corneal tissue removal is unsuitable
If laser correction of the cornea is unsuitable, ICL surgery may offer an alternative that corrects vision without removing corneal tissue. Lens implantation can be considered in a wide range of cases, including high myopia and astigmatism, eyes in which thin or structurally weak corneas make laser vision correction unsuitable, astigmatism correction in patients with keratoconus, and lens-based correction for presbyopia. However, separate suitability requirements must be met, including sufficient space for the lens and suitable corneal endothelial cells. EYEREUM's lens implantation guide (in Korean)
Because ICL surgery places a lens inside the eye, risks associated with intraocular surgery, including increased eye pressure, cataracts, and infection, also need to be weighed. Even if you can see well after surgery, regular checks of lens position, eye pressure, and corneal endothelial cells are necessary. If corneal surgery is also an option, the benefit of preserving corneal tissue should be weighed against these risks and the ongoing care required. Risks of phakic lens implantation
Dry eyes alone do not make ICL the most suitable option. Even after ICL corrects nearsightedness and astigmatism, tear film or eyelid problems still require separate treatment and care.
Does moderate nearsightedness with mild astigmatism make the choice easier?
If your nearsightedness or astigmatism has continued to change recently, the timing of surgery needs to be reconsidered. Consistent examination measurements after dry eye treatment and a stable prescription over time are different things. Both should be checked, including your recent glasses or contact lens prescriptions.
Even if less correction is needed than for high nearsightedness, it is still necessary to check whether the cornea can safely support that correction. People with the same prescription may have different surgical options because their corneal shape, thickness, and stiffness differ. Astigmatism is assessed by its axis and corneal shape as well as its degree.
If the eye surface is stable and both SMILE and PRK are suitable, you can compare early pain, visual recovery, and how each fits your work schedule. If correction using the cornea is limited, an ICL suitability examination can help determine whether this is an alternative. If an unstable tear film makes it difficult to determine the amount of correction needed, treatment and repeat examinations come before choosing a procedure.
The answer is therefore not a blanket recommendation of “SMILE because you work in an office” or “ICL because you have dry eyes.” First establish which options are suitable for your eyes, then compare recovery and long-term care.
How should all-day screen work be taken into account?
When you concentrate on a screen, you may blink less often, allowing the eye surface to dry out more easily. Surgery may allow you to read text without glasses, but it does not also resolve dryness caused by prolonged concentration. Seeing an eye chart clearly the day after surgery and working comfortably all day are different things.
At work, make a conscious effort to blink fully and take regular breaks from looking at the screen. Keep the screen slightly below eye level, and avoid air from heating or air conditioning blowing directly toward your eyes. Plan how you will continue using prescribed eye drops and artificial tears during the workday. Screen use and eye strain
During your preoperative consultation, describe your daily screen time, how long you work without a break, whether you can take breaks, and any important work commitments. With PRK, allow for discomfort during early epithelial healing. After SMILE, SMILE pro, or ICL surgery, follow-up visits and adjustments to your workload may also be needed, depending on your symptoms. For more information on returning to work and daily activities, see the SMILE and SMILE pro recovery guide.
Which examinations does EYEREUM Eye Clinic use?
When planning vision correction surgery, EYEREUM Eye Clinic assesses corneal shape and thickness along with factors that affect the quality of vision, including corneal stiffness and higher-order aberrations. Dry eye assessment includes tear breakup time and tear production tests, which examine how long the tear film remains stable and how much tear fluid is produced. Preoperative safety examinations · Dry eye care (in Korean)
If ICL surgery is being considered, additional examinations assess the space inside the eye, corneal endothelial cells, and other requirements for lens implantation. Assessing dryness on the eye surface and assessing whether a lens can be placed inside the eye examine different aspects of eye health.
If you are considering SMILE in Gangnam and often experience dryness, bring your current glasses and details of any eye drops you use, and note how long you wear contact lenses each day. Describing when symptoms occur—such as “My eyes feel drier in the afternoon” or “Text becomes clearer for a moment after I blink”—can help during the consultation. Ask your ophthalmologist to explain why particular procedures are or are not recommended based on your examination, what needs treatment first, and whether repeat examinations are needed. Contact EYEREUM Eye Clinic
