Background: Optimal vision is performance-critical in many sports, while spectacles and contact lenses may impair comfort, safety, and reliability during training and competition. Corneal refractive surgery (photorefractive keratectomy—PRK, laser in situ keratomileusis—LASIK, small-incision lenticule extraction—SMILE) is increasingly considered by athletes, but procedure selection must balance visual quality, ocular-surface stability, biomechanical safety, and sport-specific trauma risk 1,4–7,19,20. Aim: To synthesize contemporary evidence on safety, visual performance, and return-to-sport considerations after PRK, LASIK, and SMILE in athletic and athletic-like populations 1–8,19,20. Material and methods: A narrative review was conducted using PubMed as the primary database (supplemented by manual reference chasing) for English-language human studies (2018–2025) addressing refractive surgery outcomes relevant to athletes: visual acuity/quality, contrast sensitivity and low-contrast acuity, dry eye and symptoms, ectasia/biomechanics, traumatic flap events, and occupational return-to-duty in visually demanding cohorts 1–8,13–17,19,20. Results: Modern PRK, femtosecond LASIK, and SMILE provide high efficacy and safety in most appropriately selected patients 1–3. SMILE and PRK avoid a permanent flap and may be preferable in high-impact/contact sports 9–11. Visual quality (including low-contrast performance) generally recovers rapidly after LASIK/SMILE and more gradually after PRK 1,14,16,17; dry-eye metrics tend to worsen most after LASIK, with smaller or nonsignificant changes reported after PRK/SMILE in meta-analytic evidence 4,5. Ectasia remains rare but is linked to preoperative risk factors; reported ectasia after SMILE is uncommon in large cohorts 6,7. Return-to-sport timelines are primarily based on healing biology and trauma risk rather than randomized evidence 19–21. Conclusions: For athletes, procedure choice should be individualized by sport exposure, ocular-surface status, corneal tomography/biomechanical risk, and performance demands under glare/low contrast 4–8,14,16,17. Flapless approaches (PRK/SMILE) are generally favored for contact sports; structured, staged return-to-sport with protective eyewear is recommended 9–11,19–21.
Poszwa et al. (Mon,) studied this question.