About 4.9 million refractive procedures, primarily laser vision correction, were expected to be performed worldwide in 2025, down from 5.2 million in 2024 and 5.8 million in 2023 (Market Scope data cited in STAAR Surgical’s fiscal 2025 Form 10-K). The decline comes even though the U.S. alone has logged more than 20 million procedures and modern LASIK reaches better-than-20/40 uncorrected vision in 99.5% of eyes in the published literature. Satisfaction is not the problem: more than 95% of participants in the FDA’s PROWL studies were satisfied with their vision after surgery. Demand is shaped by cost, side-effect concerns and new alternatives such as lenticule extraction and implantable lenses, and by the screen-heavy habits behind rising myopia covered in our digital eye strain statistics. We aggregated data from the U.S. Food and Drug Administration, the American Academy of Ophthalmology, Market Scope (via SEC filings), Carl Zeiss Meditec, STAAR Surgical, Cochrane and peer-reviewed studies in JAMA Ophthalmology, Ophthalmology and the Journal of Cataract and Refractive Surgery.
TL;DR
- About 4.9 million refractive procedures were expected worldwide in 2025, vs 5.8 million in 2023 (Market Scope via STAAR Surgical 10-K, fiscal 2025 and 2023).
- More than 20 million LASIK procedures have been performed in the U.S. (Refractive Surgery Council).
- Carl Zeiss Meditec counts more than 3 million refractive procedures performed in fiscal 2024/25 (Carl Zeiss Meditec, Annual Report 2024/25).
- More than 95% of PROWL participants were satisfied with their vision after LASIK (FDA, LASIK Quality of Life Collaboration Project).
- Up to 46% of patients without prior visual symptoms reported at least one new symptom at three months (FDA, PROWL).
- 99.5% of 59,825 eyes reached uncorrected vision better than 20/40 (Sandoval et al., Journal of Cataract and Refractive Surgery 2016).
- Only 0.61% of eyes lost 2 or more lines of corrected vision (Sandoval et al., 2016).
- 98.7% of VISUMAX 800 lenticule extraction patients were satisfied and 93.8% no longer needed glasses or contacts (Feucht et al., Journal of Refractive Surgery 2026).
- STAAR Surgical has sold more than 4,000,000 implantable collamer lenses (ICLs) worldwide (STAAR Surgical 10-K, fiscal 2025).
- Myopia is projected to reach 4,758 million people, 49.8% of the world, by 2050 (Holden et al., Ophthalmology 2016).
- LASIK drew 14.8 times more U.S. search interest than SMILE from 2015 to 2025 (Fazio et al., Journal of Refractive Surgery 2026).
1. Global Procedure Volume: A Plateau After the Post-Pandemic Peak
The longest consistent public series on refractive volume comes from Market Scope, quoted year after year in STAAR Surgical’s annual reports. It shows worldwide refractive procedures rising from approximately 4.0 million in 2019 to 5.8 million expected in 2023, then falling to 5.2 million in 2024 and 4.9 million in 2025 (STAAR Surgical, Form 10-K fiscal 2025). The 2023 peak looks like deferred demand from the pandemic years being worked through; the two years since point to a market that is now contracting, not just normalizing.
The decline is not confined to refractive surgery. Market Scope’s latest physician survey found U.S. ophthalmic procedures overall fell 5.4% in Q2-2026 compared with the same quarter of 2025 (Market Scope, September 2026). Elective, mostly self-paid procedures such as LASIK tend to be the first to feel consumer caution, which makes the refractive figure a useful barometer for discretionary health spending.
| Metric | Value | Source |
|---|---|---|
| Refractive procedures worldwide, 2025 (expected) | Approximately 4.9 million | Market Scope via STAAR Surgical 10-K, fiscal 2025 |
| Refractive procedures worldwide, 2024 (expected) | Approximately 5.2 million | Market Scope via STAAR Surgical 10-K, fiscal 2024 |
| Refractive procedures worldwide, 2023 (expected) | Approximately 5.8 million | Market Scope via STAAR Surgical 10-K, fiscal 2023 |
| Refractive procedures worldwide, 2022 (expected) | Approximately 4.7 million | Market Scope via STAAR Surgical 10-K, fiscal 2022 |
| Refractive procedures worldwide, 2019 | Approximately 4.0 million | Market Scope via STAAR Surgical 10-K, fiscal 2019 |
| Cumulative LASIK procedures in the U.S. | More than 20 million | Refractive Surgery Council |
| Refractive procedures, fiscal 2024/25 (Zeiss tally) | More than 3 million | Carl Zeiss Meditec, Annual Report 2024/25 |
| U.S. ophthalmic procedure volume, Q2-2026 vs Q2-2025 | -5.4% (all ophthalmic procedures) | Market Scope physician survey, 2026 |
Context note: STAAR’s filings describe the 2022 to 2025 figures as procedures ‘expected to be performed’, so each is a Market Scope estimate published early in the following year, not a final audited count. The Refractive Surgery Council, an industry education group, gives its U.S. cumulative figure on its homepage without a date or methodology.
2. Industry Revenue: Lenses and Lenticules Gain While China Wobbles
The business side shows where the procedure mix is heading. Carl Zeiss Meditec’s Ophthalmology unit grew revenue 8.5% to 1,723.7 million euros in fiscal 2024/25, from 1,589.2 million euros, and the company names its SMILE lenticule extraction technology as a growth driver ‘not only in China, but also in Japan, the US and Europe’ (Carl Zeiss Meditec, Annual Report 2024/25). Organic growth excluding acquisitions was a more modest 2.3%, and the report says the Chinese market ‘remained stable as expected’.
Implantable lenses tell a harsher story about China. STAAR Surgical, maker of the only posterior chamber phakic lens approved by the FDA, saw net sales fall from 322.4 million dollars in fiscal 2023 to 313.9 million in 2024 and 239.4 million in 2025, with sales to China distributors dropping from 162.3 million dollars (51.7% of sales) to 77.8 million (32.5%) (STAAR Surgical, Form 10-K fiscal 2025; consolidated statements of operations). Yet cumulative ICL sales kept climbing, from more than 1,000,000 implanted eyes in the fiscal 2019 report to more than 4,000,000 lenses sold by February 2026.
| Metric | Value | Source |
|---|---|---|
| Zeiss Ophthalmology revenue, fiscal 2024/25 | 1,723.7 million euros (+8.5%; +2.3% organic) | Carl Zeiss Meditec, Annual Report 2024/25 |
| Zeiss Ophthalmology revenue, fiscal 2023/24 | 1,589.2 million euros | Carl Zeiss Meditec, Annual Report 2024/25 |
| STAAR Surgical net sales, fiscal 2023 / 2024 / 2025 | 322.4 / 313.9 / 239.4 million dollars | STAAR Surgical 10-K, fiscal 2025 |
| STAAR net sales to China distributors | 162.3 million dollars (51.7%) in 2024 to 77.8 million (32.5%) in 2025 | STAAR Surgical 10-K, fiscal 2025 |
| STAAR revenue from outside the U.S. | 91% | STAAR Surgical 10-K, fiscal 2025 |
| Cumulative ICLs | More than 1,000,000 eyes (2019 report); 2,000,000 (2022); 2,500,000 (2023); 3,000,000 (March 2024); 4,000,000 (February 2026) | STAAR Surgical 10-K filings, fiscal 2019 to 2025 |
| Countries selling STAAR ICLs | More than 75 (2023-2024 reports) to more than 85 (2025 report) | STAAR Surgical 10-K filings |
Context note: STAAR’s own filing states its belief that ‘negative publicity regarding LASIK has reduced patient interest’ in the procedure over the past decade, a claim from a competitor of laser makers that should be read as such (STAAR Surgical, Form 10-K fiscal 2024). Imaging and AI screening are becoming part of pre-surgical workups, a trend tracked in our AI medical imaging statistics.
3. Clinical Outcomes: How Accurate Modern Laser Correction Is
The efficacy question is largely settled in the literature. A review of 97 LASIK articles published between 2008 and 2015, covering 67,893 eyes, found 99.5% of eyes reached uncorrected distance vision better than 20/40 and only 0.61% lost 2 or more lines of corrected vision (Sandoval et al., Journal of Cataract and Refractive Surgery 2016). The authors concluded that aggregate outcomes were better than those in the FDA approval summaries of earlier laser systems. This is the most recent available large pooled review (2016).
The American Academy of Ophthalmology frames the same evidence for patients: about 9 out of 10 people who have LASIK end up between 20/20 and 20/40 without glasses or contacts (AAO, LASIK). Head-to-head research shows little separating the main laser approaches on vision: a 2026 meta-analysis of 17 studies and 5,686 eyes found no statistically significant efficacy or predictability difference between transepithelial PRK and LASIK or SMILE, though LASIK showed a safety advantage in some subgroups (Serfözö et al., European Journal of Ophthalmology 2026).
| Metric | Value | Source |
|---|---|---|
| LASIK articles and eyes reviewed, 2008-2015 | 97 articles, 67,893 eyes | Sandoval et al., JCRS 2016 |
| Eyes with uncorrected vision better than 20/40 | 99.5% (59,503 of 59,825) | Sandoval et al., JCRS 2016 |
| Eyes within 1.0 D / 0.5 D of target refraction | 98.6% / 90.9% | Sandoval et al., JCRS 2016 |
| Eyes losing 2+ lines of corrected vision | 0.61% (359 of 58,653) | Sandoval et al., JCRS 2016 |
| LASIK patients ending at 20/20 to 20/40 uncorrected | About 9 in 10 (90%) | American Academy of Ophthalmology |
| Topography-guided LASIK eyes at 20/20 or better, 3 months | 98% (98 of 100 eyes) | Brunson et al., Clinical Ophthalmology 2025 |
| TransPRK vs LASIK/SMILE meta-analysis | 17 studies, 5,686 eyes; no significant efficacy difference | Serfözö et al., European Journal of Ophthalmology 2026 |
| Wavefront laser surgery Cochrane review | 33 RCTs, 1,499 participants; RR 1.03 for 20/20 vision with wavefront PRK | Cochrane, Li et al. 2020 |
Context note: the Cochrane review found no evidence that wavefront-guided PRK improved the share of eyes reaching 20/20 at 12 months versus conventional treatment (risk ratio 1.03, 95% CI 0.86 to 1.24) (Li et al., Cochrane Database of Systematic Reviews 2020). Small single-center series such as Brunson et al. (50 subjects) report higher figures than pooled data and should not be read as typical.
4. Patient Satisfaction: The Strongest Numbers in Elective Surgery
Satisfaction data are consistently high across eras and technologies. In the FDA-led PROWL studies, more than 95% of participants were satisfied with their vision after LASIK, and dissatisfaction ranged from 1% to 4% for vision and 1% to 2% for the surgery itself (FDA, LASIK Quality of Life Collaboration Project; Eydelman et al., JAMA Ophthalmology 2017). PROWL matters because it was government-run, used validated questionnaires and enrolled both 262 active-duty Navy personnel and 312 civilians at five centers between 2011 and 2014.
Newer, industry-sponsored studies post similar or higher numbers. In a 300-patient multi-site LASIK study, 95% were completely or very satisfied and 98% would choose the procedure again (Lobanoff et al., Clinical Ophthalmology 2026). For lenticule extraction with the VISUMAX 800, 98.7% were satisfied, 99.1% were happy they had the procedure and 93.8% no longer needed glasses or contacts (Feucht et al., Journal of Refractive Surgery 2026). The question for the industry is no longer whether patients like the result, but why fewer of them are booking it.
| Metric | Value | Source |
|---|---|---|
| PROWL participants satisfied with vision | More than 95% | FDA, LASIK Quality of Life Collaboration Project |
| PROWL dissatisfaction rates | 1-4% (vision), 1-2% (surgery) | Eydelman et al., JAMA Ophthalmology 2017 |
| PROWL enrollment | 262 Navy personnel (PROWL-1), 312 civilians (PROWL-2) | Eydelman et al., JAMA Ophthalmology 2017 |
| Patients dissatisfied with LASIK, pooled studies | 1.2% (129 of 9,726) | Sandoval et al., JCRS 2016 |
| Completely or very satisfied, multi-site LASIK study | 95% (285 of 300) | Lobanoff et al., Clinical Ophthalmology 2026 |
| Would choose LASIK again | 98% (294 of 300) | Lobanoff et al., Clinical Ophthalmology 2026 |
| Lenticule extraction (VISUMAX 800) satisfied / would recommend | 98.7% / 98.7% | Feucht et al., Journal of Refractive Surgery 2026 |
| Lenticule extraction patients free of glasses or contacts | 93.8% | Feucht et al., Journal of Refractive Surgery 2026 |
Context note: the FDA, the National Eye Institute and the Department of Defense launched the LASIK Quality of Life Collaboration Project in October 2009. The 2025 and 2026 studies above involve device-specific cohorts and, in several cases, manufacturer support, so they are best read alongside PROWL rather than in place of it.
5. Side Effects and Safety: What High Satisfaction Does Not Capture
High satisfaction and frequent side effects coexist. Up to 46% of PROWL participants who had no visual symptoms before surgery reported at least one new symptom three months after LASIK, with halos the most common (up to 40%) (FDA, LASIK Quality of Life Collaboration Project). Up to 28% of participants without dry eye symptoms beforehand reported them at three months. Yet less than 1% had ‘a lot of difficulty’ with, or could not do, usual activities without corrective lenses because of any one symptom.
The FDA’s patient guidance is blunter than the marketing: it warns that some patients lose lines of vision that cannot be corrected, that dry eye ‘may be permanent’, and that because the first LASIK laser was approved in 1998 ‘the long-term safety and effectiveness’ is not known (FDA, What are the risks). Dry eye is described in peer-reviewed reviews as the most common complication of LASIK, SMILE and PRK (Nair et al., Indian Journal of Ophthalmology 2023), and screening matters: 45.39% of 141 myopic patients in one Chinese cohort already had dry eye before surgery (Zhao et al., International Journal of Ophthalmology 2021). Many of those candidates are heavy screen users, the same group profiled in our blue light glasses statistics.
| Metric | Value | Source |
|---|---|---|
| New visual symptom at 3 months (no symptoms before) | Up to 46% (43% PROWL-1, 46% PROWL-2) | FDA; Eydelman et al., JAMA Ophthalmology 2017 |
| New halos at 3 months | Up to 40% | FDA, LASIK Quality of Life Collaboration Project |
| New dry eye symptoms at 3 months | Up to 28% | FDA, LASIK Quality of Life Collaboration Project |
| ’A lot of difficulty’ with usual activities due to a symptom | Less than 1% | FDA, LASIK Quality of Life Collaboration Project |
| Ectasia incidence after SMILE | 0.15% of 7,024 eyes reviewed; 0.80% in borderline corneas | Brar et al., Journal of Refractive Surgery 2021 |
| Pre-existing dry eye in refractive candidates | 45.39% (64 of 141); contact lens wear raised risk 2.934 times | Zhao et al., International Journal of Ophthalmology 2021 |
| Mean dry eye score (OSDI) after LASIK | 8.7; 71% of 300 patients asymptomatic | Lobanoff et al., Clinical Ophthalmology 2026 |
| Surgeons checking ocular surface before refractive surgery | 61.1% (2021) | ESCRS Clinical Trends Survey 2016-2021 (Kohnen et al., 2023) |
Context note: the ectasia figure comes from a single high-volume center in India (Brar et al., 2021); borderline corneas treated with SMILE plus cross-linking had 0% ectasia in that series. In the VISUMAX 800 study, 19.5% of participants still reported some night-driving difficulty.
6. Who Gets Surgery and the Demand Pipeline
The candidate pool is expanding fast even as procedure counts stall. Myopia is projected to affect 4,758 million people, 49.8% of the world population, by 2050, up from 1,406 million (22.9%) in 2000, while high myopia rises from 163 million to 938 million (Holden et al., Ophthalmology 2016). That is most recent available data from a 145-study meta-analysis, and it is the projection every refractive company cites. Childhood near work and screen exposure, tracked in our children’s screen time statistics, are part of that story.
Population surveys show who actually converts. In Korea’s national health survey, 1,621 of 21,415 adults aged 20 to 49 had refractive surgery; 73% were women and 81% were under 40, and the female-to-male odds ratio narrowed from 3.8 in 2008-2009 to 1.5 in 2013-2015 (Lee et al., PLOS ONE 2021). In Israel’s military intake data, the rate doubled from 9 per 1,000 ametropic recruits in 2005 to 18.5 per 1,000 in 2018 (Greenbaum et al., Eye 2023). U.S. interest is shifting: LASIK still drew 10.3 times more search interest than PRK, 14.8 times more than SMILE and 32.3 times more than ICL from 2015 to 2025, but SMILE and ICL interest trended up while LASIK interest declined after COVID (Fazio et al., Journal of Refractive Surgery 2026).
| Metric | Value | Source |
|---|---|---|
| People with myopia, 2000 vs 2050 (projected) | 1,406 million (22.9%) vs 4,758 million (49.8%) | Holden et al., Ophthalmology 2016 |
| People with high myopia, 2000 vs 2050 (projected) | 163 million vs 938 million | Holden et al., Ophthalmology 2016 |
| Korean adults 20-49 with refractive surgery (sample) | 1,621 of 21,415; 73% female; 81% under 40 | Lee et al., PLOS ONE 2021 (KNHANES 2008-2015) |
| Female vs male odds of surgery, Korea | 3.8 (2008-2009) to 1.5 (2013-2015) | Lee et al., PLOS ONE 2021 |
| Israeli recruits with refractive surgery | 9 per 1,000 ametropes (2005) to 18.5 per 1,000 (2018); 50.5% operated at 17-18 | Greenbaum et al., Eye 2023 |
| U.S. search interest, LASIK vs alternatives, 2015-2025 | 10.3x PRK, 14.8x SMILE, 32.3x ICL | Fazio et al., Journal of Refractive Surgery 2026 |
| Recommended minimum age for LASIK | 18 or older, ideally over 21 | American Academy of Ophthalmology |
Context note: the AAO notes that almost everyone with excellent distance vision will need reading glasses after around age 40, which caps the lifetime benefit of distance-only correction. Older patients increasingly reach refractive correction through cataract surgery instead: Market Scope estimates about 33 million cataract surgeries globally in 2025, including 5.2 million in the U.S., growing to 6.1 million in the U.S. by 2030 (RxSight, Form 10-K fiscal 2025). Wearable displays may add a new reason for spectacle independence, as covered in our smart glasses statistics.
Summary: LASIK & Refractive Surgery by the Numbers
| Metric | Value | Source |
|---|---|---|
| Refractive procedures worldwide, 2025 (expected) | About 4.9 million | Market Scope via STAAR Surgical 10-K, fiscal 2025 |
| Refractive procedures worldwide, 2023 (expected) | About 5.8 million | Market Scope via STAAR Surgical 10-K, fiscal 2023 |
| Refractive procedures worldwide, 2019 | About 4.0 million | Market Scope via STAAR Surgical 10-K, fiscal 2019 |
| Cumulative U.S. LASIK procedures | More than 20 million | Refractive Surgery Council |
| Refractive procedures, Zeiss fiscal 2024/25 tally | More than 3 million | Carl Zeiss Meditec, Annual Report 2024/25 |
| Zeiss Ophthalmology revenue growth, fiscal 2024/25 | +8.5% to 1,723.7 million euros | Carl Zeiss Meditec, Annual Report 2024/25 |
| STAAR Surgical net sales, fiscal 2025 | 239.4 million dollars (313.9 million in 2024) | STAAR Surgical 10-K, fiscal 2025 |
| Cumulative ICLs sold | More than 4,000,000 | STAAR Surgical 10-K, fiscal 2025 |
| Eyes with uncorrected vision better than 20/40 | 99.5% | Sandoval et al., JCRS 2016 |
| Eyes losing 2+ lines of corrected vision | 0.61% | Sandoval et al., JCRS 2016 |
| PROWL participants satisfied with vision | More than 95% | FDA, PROWL |
| New visual symptoms at 3 months | Up to 46% | FDA, PROWL |
| New halos / new dry eye symptoms at 3 months | Up to 40% / up to 28% | FDA, PROWL |
| Would choose LASIK again | 98% | Lobanoff et al., Clinical Ophthalmology 2026 |
| Lenticule extraction patients free of glasses | 93.8% | Feucht et al., Journal of Refractive Surgery 2026 |
| Ectasia after SMILE | 0.15% | Brar et al., Journal of Refractive Surgery 2021 |
| Myopia, 2050 projection | 4,758 million people (49.8%) | Holden et al., Ophthalmology 2016 |
| U.S. search interest, LASIK vs SMILE | 14.8x | Fazio et al., Journal of Refractive Surgery 2026 |
| U.S. ophthalmic procedures, Q2-2026 | -5.4% year over year | Market Scope, 2026 |
Methodology and Sources
Every figure above was read during research for this article in a government page, an SEC filing, a company annual report or a peer-reviewed abstract. Market Scope’s paid reports were not accessed directly; its figures are cited as published in SEC filings. Statistics circulating on clinic marketing sites and SEO blogs without a primary document were excluded.
- U.S. Food and Drug Administration: LASIK Quality of Life Collaboration Project and What are the risks and how can I find the right doctor for me?
- Eydelman M et al., Symptoms and Satisfaction of Patients in the PROWL Studies, JAMA Ophthalmology 2017
- American Academy of Ophthalmology: LASIK patient information
- Refractive Surgery Council: homepage
- STAAR Surgical Form 10-K filings citing Market Scope: fiscal 2025 (statements of operations), fiscal 2024, fiscal 2023, fiscal 2022, fiscal 2019
- RxSight Form 10-K fiscal 2025 citing the Market Scope 2025 Premium Cataract Surgery Market Report: SEC filing
- Carl Zeiss Meditec: Annual Report 2024/25
- Market Scope: Ophthalmologists Report 5.4 Percent Decrease in Q2-2026 Procedure Volume
- Sandoval HP et al., Modern laser in situ keratomileusis outcomes, Journal of Cataract and Refractive Surgery 2016
- Li SM et al., Wavefront excimer laser refractive surgery for adults with refractive errors, Cochrane Database of Systematic Reviews 2020
- Serfözö A et al., TransPRK versus LASIK/SMILE meta-analysis, European Journal of Ophthalmology 2026
- Lobanoff MC et al., Multi-Site Study of Patient Reported Vision Quality and Dry Eye Following LASIK, Clinical Ophthalmology 2026; Brunson PB et al., topography-guided LASIK, Clinical Ophthalmology 2025
- Feucht N et al., Patient-Reported Outcomes After Keratorefractive Lenticule Extraction Using the VISUMAX 800, Journal of Refractive Surgery 2026
- Brar S et al., Incidence of Ectasia After SMILE, Journal of Refractive Surgery 2021; Nair S et al., Refractive surgery and dry eye, Indian Journal of Ophthalmology 2023; Zhao PF et al., preoperative dry eye, International Journal of Ophthalmology 2021
- Kohnen T et al., ESCRS Clinical Trends Survey 2016-2021, Journal of Cataract and Refractive Surgery 2023
- Holden BA et al., Global Prevalence of Myopia and High Myopia 2000-2050, Ophthalmology 2016
- Lee Y et al., refractive surgery trends in KNHANES 2008-2015, PLOS ONE 2021; Greenbaum E et al., refractive surgery among Israel Defense Forces recruits, Eye 2023; Fazio NF et al., U.S. Google Trends analysis 2015-2025, Journal of Refractive Surgery 2026
- Data watch: There is no free, audited annual count of LASIK procedures; the global series here is Market Scope’s, read only as quoted in STAAR Surgical’s filings, and each 2022 to 2025 value is described as ‘expected’, so the jump from 4.7 million (2022) to 5.8 million (2023) and the later decline may partly reflect revised estimates. Carl Zeiss Meditec’s ‘more than 3 million refractive procedures’ appears in its annual report as an illustration of the reach of its products, does not define its scope and covers a fiscal year ending September 2025, so it is not comparable with Market Scope’s calendar-year total. STAAR, a lens maker, has a commercial interest in describing weak LASIK demand. Market size estimates from commercial research firms were not used: the pages we tried were blocked (403) or returned unrelated content, so no market-size dollar figure could be cross-checked against two firms. The Sandoval review (2016), Holden projections (2016), PROWL data (collected 2011 to 2014) and Korean survey data (2008 to 2015) are older than three years and are the most recent available of their kind. Several 2025 and 2026 patient-reported outcome studies are single-device or small cohorts. Market Scope’s Q2-2026 decline covers all ophthalmic procedures, not refractive surgery alone. PubMed pages were unreadable (cookie wall), so abstracts were read via Europe PMC and NCBI E-utilities.
Last updated: October 3, 2026. We update this roundup quarterly, and the next refresh is expected when STAAR Surgical files its fiscal 2026 Form 10-K with Market Scope’s 2026 refractive procedure estimate and Carl Zeiss Meditec publishes its Annual Report 2025/26.