Refractive surgery in the U.S. remains dominated by corneal procedures, but lens-based alternatives have steadily gained share over the past decade. LASIK still accounts for the largest single share of refractive procedures performed annually, followed by refractive lens exchange and EVO ICL implantation. PRK and SMILE make up smaller, more specialized shares, often selected for patients who aren’t LASIK candidates due to corneal thickness or other factors.
RLE’s share has grown fastest among patients over 45, largely tracking presbyopia onset — a pattern examined in more depth in our Average Age of RLE Patients by State statistic. EVO ICL, a newer entrant, has grown from a niche option to a meaningful share of the market as reversible, non-corneal alternatives have gained awareness among both patients and referring optometrists.