4 LASIK Alternatives For Washington, DC

Brusco Vision specializes in providing a variety of LASIK alternatives to our patients in the Washington, DC, area. Many individuals interested in vision correction are not ideal candidates for LASIK for a variety of reasons, such as thin corneas or high prescriptions. At Brusco Vision, we prioritize the health and satisfaction of our patients over fitting them into a LASIK procedure that might not be best for their needs. We provide a range of LASIK alternatives such as EVO ICL, Custom Lens Replacement, ASA PRK, and SMILE, ensuring that each patient receives the best-suited treatment for their unique needs. This approach allows us to achieve optimal results for everyone.

Understanding that each patient’s eyes are unique, we are committed to offering personalized vision correction solutions beyond traditional LASIK. Our options are designed to suit different lifestyles and vision correction requirements. To discover which LASIK alternative might be right for you, schedule a consultation with us today.

4 Life-Changing LASIK Alternatives


EVO ICL (Implantable Collamer Lens) is a popular choice for individuals with moderate to severe nearsightedness, with or without astigmatism, who are not ideal candidates for LASIK surgery. This procedure involves inserting a biocompatible lens in front of the eye’s natural lens, behind the iris, providing excellent vision correction without altering the corneal structure. The lens material, Collamer, integrates well with the body and offers UV protection, reducing the risk of UV overexposure. EVO ICL is celebrated for its precision, UV-blocking capabilities, and its potential to deliver superior visual outcomes with minimal maintenance.

Candidacy: Ideal for individuals with moderate to severe nearsightedness, astigmatism, or thin corneas, EVO ICL is suitable for those who seek a removable option or are not candidates for LASIK.

Conditions Treated: Primarily corrects myopia (nearsightedness) and astigmatism, including cases where patients cannot have corneal surgery.

Cost: The cost of EVO ICL varies depending on specific patient needs but tends to be higher than LASIK due to the specialized lens and procedure involved.

Pros: Provides excellent vision correction, integrates UV protection, does not alter corneal structure, and is removable.

Cons: More expensive than some other vision correction methods.

Custom Lens Replacement (CLR)

Custom Lens Replacement, also known as Refractive Lens Exchange (RLE), is another effective alternative offered by Brusco Vision. Suitable for individuals dealing with presbyopia, this procedure replaces the eye’s natural lens with an artificial intraocular lens (IOL). This lens helps focus light directly onto the retina, similar to how contact lenses work on the eye’s surface. CLR not only corrects vision effectively but also prevents the future development of cataracts, ensuring a stable and enhanced visual experience without the need for glasses.

Candidacy: Best suited for individuals with presbyopia or early signs of cataracts who are looking for a permanent solution to refractive errors.

Conditions Treated: Presbyopia, cataracts, and significant refractive errors that cannot be effectively treated with corneal-based procedures.

Cost: Typically higher than LASIK as it involves the insertion of a premium intraocular lens.

Pros: Corrects a wide range of vision problems, prevents cataracts, and offers a permanent solution to dependence on corrective eyewear.

Cons: More expensive than some laser eye surgery procedures.


Small Incision Lenticule Extraction (SMILE) is a minimally invasive procedure designed to correct myopia and astigmatism. It is especially beneficial for those who may not be suitable for traditional LASIK. During the SMILE procedure, a small amount of corneal tissue is removed through a tiny incision, reshaping the cornea to correct the refractive error. This technique preserves the corneal surface integrity to a greater extent than LASIK, offering a quick recovery and excellent visual outcomes.

Candidacy: Recommended for patients with myopia and astigmatism, particularly those seeking a minimally invasive option with a quick recovery.

Conditions Treated: Myopia (nearsightedness) and astigmatism, particularly in patients where LASIK may pose a higher risk due to lifestyle or corneal thickness.

Cost: Generally comparable to LASIK, depending on the complexity of the individual’s refractive error.

Pros: Minimally invasive, quick recovery, maintains greater corneal structural integrity than LASIK.

Cons: Less suitable for patients with hyperopia (farsightedness) and limited adjustment capability post-procedure.


Advanced Surface Ablation (ASA), the modern version of Photorefractive Keratectomy (PRK), is ideal for individuals with thin corneas or those who engage in contact sports or certain professions that preclude flap creation, like in LASIK. ASA PRK involves the removal of the corneal epithelium followed by the application of an excimer laser to reshape the cornea directly. This procedure is known for its precision and effectiveness in correcting myopia, hyperopia, and astigmatism, with a slightly longer recovery period compared to LASIK but with equally impressive visual results.

Candidacy: Ideal for patients with thin corneas, those involved in contact sports, or professions that increase the risk of physical contact to the eyes.

Conditions Treated: Myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and corneal surface irregularities.

Cost: Typically the same as LASIK but can vary based on specific treatment plans and technology used.

Pros: Precise and effective for a wide range of refractive errors.

Cons: Longer recovery time compared to LASIK, postoperative discomfort, and temporary visual fluctuations during healing.

Why might I need a LASIK Alternative?

You might need a LASIK alternative for nine reasons, primarily related to specific eye conditions, general health issues, or certain anatomical factors of your eyes. Here are the main reasons why an alternative to LASIK might be necessary:

1. Thin Corneas

If your corneas are too thin, there may not be enough tissue for the LASIK procedure, which involves creating a flap and reshaping the cornea. Procedures like PRK (Photorefractive Keratectomy) or EVO ICL might be recommended instead, as these do not require creating a flap.

2. High Prescription

If you have a very high refractive error, LASIK might not be able to correct it fully. Alternatives like Phakic IOLs (intraocular lenses such as EVO ICL) can be suitable for higher levels of nearsightedness that LASIK cannot adequately address.

3. Dry Eyes

LASIK can exacerbate dry eye conditions. If you already suffer from severe dry eyes, procedures that are less likely to increase dry eye symptoms, such as PRK or implantable collamer lenses (ICL), might be more appropriate.

4. Corneal Surface Irregularities

Conditions like keratoconus or significant corneal scarring may disqualify you from having LASIK because the procedure could worsen these conditions. Alternatives such as EVO ICL or surface ablation techniques might be considered instead.

7. Occupational Hazards

If your profession or hobbies involve high risks to the eyes (e.g., boxing, martial arts), LASIK might not be suitable due to the potential for flap-related complications. PRK or ICL, which do not create a corneal flap, might be better options.

8. General Health Issues

Systemic health issues like diabetes, autoimmune diseases, or medications that affect healing can make LASIK less effective. In such cases, other alternatives might be considered

9. Lifestyle Considerations

Your lifestyle and vision goals can also influence the choice of procedure. For instance, if you prefer a removable option, ICL might be a better choice since it involves placing a lens that can be removed or replaced.

Discover Life-Changing Vision Correction Alternatives at Brusco Vision

At Brusco Vision, our commitment to exceptional eye care extends beyond traditional methods. We understand that each patient’s vision needs are unique, which is why we offer specialized alternatives like EVO ICL, Custom Lens Replacement, SMILE, and ASA PRK. These innovative procedures provide solutions tailored to individual conditions, ensuring optimal results without compromising on safety or effectiveness.

If you’re seeking a vision correction solution that aligns with your specific needs, don’t wait. Contact Brusco Vision today to schedule a comprehensive consultation. Let us guide you toward clear, dependable vision that enhances your lifestyle and frees you from the limitations of glasses and contact lenses. Your journey to better vision starts here.

Find your perfect vision correction solution

Take the Vision Procedure Self-Test

See which LASIK or LASIK alternative procedure might best match your needs.

FAQ’s About LASIK Alternatives in DC

What makes EVO ICL different from LASIK?

EVO ICL does not involve reshaping the cornea but instead inserts a biocompatible lens in front of the natural lens. This makes it an excellent option for patients with thin corneas or high myopia. Brusco Vision offers EVO ICL as a removable and advanced alternative to LASIK, providing sharp, clear vision with added UV protection.

Is Custom Lens Replacement better than LASIK for older adults?

Custom Lens Replacement (CLR), also known as refractive lens exchange or clear lens extraction, is another effective LASIK alternative that is offered by Brusco Vision. This procedure, akin to preventive cataract surgery, replaces the eye’s natural lens with an artificial intraocular lens, addressing presbyopia and other significant refractive errors. Custom Lens Replacement is often a better choice for older adults, particularly those experiencing presbyopia or early cataract signs. Unlike LASIK, CLR replaces the eye’s natural lens with an artificial one, addressing multiple vision issues simultaneously.

Can SMILE correct astigmatism as effectively as LASIK?

SMILE, groundbreaking ophthalmology alternative in laser surgery, is particularly effective for correcting myopia and astigmatism and is suited for patients with or concerned about dry eye syndrome. This minimally invasive procedure offers a quick recovery while maintaining greater corneal integrity. Brusco Vision provides SMILE as an innovative option for patients seeking an alternative to LASIK with comparable results.

What are the advantages of PRK over LASIK?

PRK is advantageous for patients who are not suitable for LASIK, such as those with thin corneas or those engaged in contact sports. PRK modifies the cornea’s surface without creating a flap, providing excellent outcomes with a slightly longer recovery. Brusco Vision recommends PRK for patients needing a robust and flap-free procedure.

How long does recovery take after EVO ICL surgery?

Recovery from EVO ICL surgery at Brusco Vision is typically quick, with many patients noticing significant vision improvement within 24 to 48 hours. Full visual stabilization might take a week or two, but most activities can be resumed shortly after the procedure.

What is the lifespan of a Custom Lens Replacement?

The intraocular lenses used in CLR at Brusco Vision are designed to last a lifetime and eliminate the need for a corrective lens. Once performed, CLR not only corrects current vision issues but also eliminates the possibility of cataracts, providing a durable and long-term solution for vision correction.

Are there any long-term side effects of SMILE surgery?

Long-term side effects of SMILE are rare. SMILE is known for its safety and effectiveness, offering a flapless alternative to LASIK with fewer complications related to corneal strength and nerve fibers. Brusco Vision closely monitors patients post-operation to ensure optimal outcomes.

Can PRK be performed on someone who has already had LASIK?

Yes, PRK can be performed on patients who have previously undergone LASIK, especially if additional vision correction is needed. This is sometimes referred to as an enhancement procedure. Brusco Vision assesses individual cases to ensure the best approach is taken for retouches or enhancements.

What are the qualifications for a good candidate for EVO ICL at Brusco Vision?

Good candidates for EVO ICL eye surgery at Brusco Vision typically include patients with moderate to severe myopia, those with thin corneas, or individuals seeking an alternative to LASIK. A comprehensive eye examination will confirm suitability for this procedure.

How does SMILE compare in cost to LASIK at Brusco Vision?

The cost of SMILE at Brusco Vision is generally comparable to LASIK, varying slightly based on specific patient needs and the complexity of the refractive error. Both procedures are investments in your vision, with differences primarily in technique and recovery experience.

Who determines which is the best type of refractive surgery for each patient at Brusco Vision?

At Brusco Vision, our skilled surgeon, Dr. Brusco, performs a comprehensive evaluation of each patient’s eyes to determine what procedure is most optimal for their vision correction needs. Dr. Brusco is adept at correcting visual impairments through precise refraction adjustments, ensuring optimal visual perception and eliminating issues like glare from eyeglass prescriptions.

Michael A. Brusco, MD, FACS, is the founder and medical director of Brusco Vision – the premier practice dedicated to changing lives through vision correction in Washington DC and the DMV. He is a board-certified and award-winning refractive surgery subspecialist who has successfully performed over 40,000 corneal-based vision correction procedures, such as high-definition all-laser LASIK and PRK. Dr. Brusco graduated with honors from Harvard College, was awarded the STAAR Top 100 International Surgeon honor multiple years, and is a member of the American Academy of Ophthalmology, the American Society of Cataract & Refractive Surgeons, the American Medical Association, and the Refractive Surgery Alliance. He is a founding member of the World College of Refractive Surgery & Visual Sciences, an organization on a global scale. Most recently, Dr. Brusco personally was performing close to 1% of all LASIK procedures in the US annually.

Scroll to Top
Schedule Your Consultation
Please provide your information below to request your 'Advanced Necessary Ocular and Vision Analysis' (ANOVA) - a 90-minute experience that gives you an in-depth, 3D look at your eye health and functionality and will leave you with a detailed understanding of your vision and whether you are a candidate for LASIK or our 5 other advanced vision correction procedures.