Ortho-K vs. LASIK Eye Surgery: Benefits, Risks & How to Decide

Ortho-K stands for orthokeratology, a unique approach for fitting special contact lenses to alter the shape of the cornea. The breathable lenses are worn only overnight, freeing the wearer from relying on corrective eyewear during the day.

Ortho-K is sometimes called CRT, which stands for corneal refractive contact lenses. It is intended to help people who have mild to moderate myopia. 

What Is Ortho-K?

According to the American Academy of Ophthalmology, myopia affects 25 percent of people in the U.S. Ortho-K temporarily corrects daytime eyesight by using special contacts that are worn overnight. 

Ortho-K may be used to treat children for myopia. It is considered an effective way to slow down progressive myopia. The nighttime reshaping of the cornea enables the wearer to see clearly for daily activities. 

Ortho-K is a popular choice for young children with mild to moderate myopia. It is also popular with athletes, as it enables people to play sports without depending on prescriptive eyewear. If people are worried about potential risks of surgery, ortho-K may be a good option.

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What Is LASIK? 

LASIK is a vision correction procedure to address refractive errors. The goal is to achieve clear, crisp vision with reduced dependence on contacts or glasses. 

To be eligible for this procedure, you should have a stable eye prescription that has not changed significantly in a year and enough corneal thickness for the surgery. In addition, candidates should have realistic expectations about the surgery risks and benefits. 

Advantages of Ortho-K Over LASIK

While patients may achieve clear vision with both ortho-K and LASIK, there are some advantages to choosing ortho-K.

Nonsurgical

One of the biggest advantages of ortho-k over LASIK is that it is a nonsurgical approach. Many people feel uncomfortable with the idea of eye surgery. If you want clear vision without surgery, wearing overnight lenses may be an appealing alternative. 

Daytime Freedom

Ortho-K lenses reshape the cornea overnight. You don’t need to wear them during the day. You can see clearly without relying on contacts or glasses during your daily activities as a result.

Reversible

Ortho-K is reversible, while LASIK is not. If you ever choose to stop the treatment, your eyes will slowly return to their original shape. 

If the results from ortho-K are not satisfactory, the patient simply stops wearing the lenses. The results from LASIK are not reversible, though they can often be improved with an additional LASIK procedure, known as an enhancement. 

Option for Children

LASIK is not FDA approved for anyone under 18, but most surgeons recommend you wait until you are 21 or even 25 for LASIK. At that point, your vision has generally stabilized. Since children’s eyes continue to change, they aren’t good candidates for LASIK.

Ortho-K is an option for children since the results are not permanent.

Cost-Effective

Ortho-K lenses tend to be less expensive than LASIK. While you’ll incur replacement costs over time and the results from LASIK are long term, you’ll end up saving money in the short term.

Disadvantages of Ortho-K Compared to LASIK 

LASIK offers a permanent solution, which lasts a lifetime for many people. This means that after a successful LASIK surgery, you may enjoy clear vision without reliance on prescription glasses or contacts for decades. 

With ortho-K, you’ll need to wear the breathable contacts every night. If you want to maintain the vision correction, you’ll have to keep up with your routine.

Over time, the cost of ortho-K may outweigh LASIK. This depends on how long you enjoy the results of LASIK. 

Is Ortho-K Safer Than LASIK?

Both ortho-K and LASIK are considered very safe. Since ortho-K does not involve surgery and the inherent risks there, it may be considered safer than LASIK.

According to the American Academy of Ophthalmology, ortho-k does come with a higher risk of infection, called microbial/bacterial keratitis. The risk is of particular concern because this treatment approach is often used for children and young adults. This population may find it more challenging to maintain good eye hygiene practices that reduce the risk of infection.

Overall, ortho-k is considered a safe way to correct vision that can be used without a time limit. As long as your eyes are healthy and you are comfortable with the approach, you can keep using these lenses to correct your daytime vision. 

Who Is a Candidate for Ortho-K?

Good candidates for ortho-K include the following:

• Children between 8 and 12 years old who have progressive myopia
• Adolescents and young adults with mild to moderate myopia
• Adults who don’t want LASIK
• People who are involved in sports activities
• Those who work in dusty or smoky environments
• People who are not a candidate for LASIK surgery

This treatment is not a recommended option if you suffer from severe myopia or have dry eye syndrome.

How to Determine Which Is Better for You?

According to the American Academy of Ophthalmology, both LASIK and ortho-K are considered effective and safe. To determine which one is better for you, a doctor will assess your age, lifestyle, refractive error, and vision goals.

Since ortho-K is a reversible treatment, you may be able to get LASIK if you find ortho-K doesn’t work as you envisioned. Talk to your doctor about all your options to determine the best path forward.

Ortho-K vs. LASIK FAQs

Is ortho-K better than LASIK?

Ortho-K offers some advantages that LASIK does not. There is a lower risk of complications, and it is a reversible treatment. It does not involve surgery, which is a major benefit for many.

Can children get ortho-K treatment?

Ortho-K has been shown in clinical studies to significantly slow the progression of nearsightedness in children. LASIK is not an option for children.

Is ortho-K bad for your eyes? 

No, ortho-K is not bad for your eyes when used appropriately. It does come with some risk of infection, but it is widely considered a safe treatment to correct daytime vision. 

Does ortho-K give permanent results?

No, you must continue wearing the ortho-K lenses nightly in order to continue to achieve clear daytime vision.

References

1. What Is Orthokeratology? (September 2018). American Academy of Ophthalmology.

2. Nearsightedness: What Is Myopia? (December 2021). American Academy of Ophthalmology.

3. Myopia. Johns Hopkins Medicine.

4. LASIK – Laser Eye Surgery. (October 2020). American Academy of Ophthalmology.

5. 7 Things You Didn’t Know About Ortho-K. (September 2018). Primary Care Optometry News.

6. Orthokeratology (Ortho K) Cost and Financing. CareCredit.

7. How Much Does LASIK Eye Surgery Cost? VSP.

8. Interventions to Slow Progression of Myopia in Children. (January 2020). Cochrane Database of Systematic Reviews.

9. The Safety of Orthokeratology—A Systematic Review. (January 2016). Eye & Contact Lens.

10. Orthokeratology: Clinical Utility and Patient Perspectives. (February 2017). Clinical Ophthalmology.

11. Effect of Orthokeratology on Myopia Progression: Twelve-Year Results of a Retrospective Cohort Study. (December 2017). BMC Ophthalmology.

12. Efficacy, Predictability and Safety of Long-Term Orthokeratology: An 18-Year Follow-Up Study. (February 2022). Contact Lens and Anterior Eye.

13. Consider Ortho-K For Myopia Control. (July 2012). Review of Optometry.