Hi, in general both epi-LASIK/PRK and LASIK are suitable for the activities you mention, ie gym, soccer and basketball. The issue with LASIK is that with the flap, there is a risk that if the cornea is poked very hard at the flap edge there is a chance it might move and require urgent treatment to reposition.
Having said that, the chance of this kind of incident happening is extremely low, even when people engage in these sports professionally. There are professional footballers, basketballers, tennis players etc. who have had LASIK done (while actively playing) with no problems after surgery.
Perhaps, as a rough rule of thumb, people who practice martial arts competitively and where no eye/face protection is worn may want to consider a flapless procedure like epiLASIK/PRK or SMILE over LASIK.
Accutane use tends to make the eyes very dry, even if you are just using small amounts/short courses to deal with flare ups after the main course of Accutane is finished. The American Academy of Ophthalmology recommends stopping Accutane for at least 6 months before any laser refractive procedure, and I tend to agree with this guideline. There are sometimes patients who may need to wait even longer than this, if the eyes remain very dry.
To sum up, the choice between epiLASIK and LASIK for many moderately active people is mostly a personal one, balancing the pros of the flapless procedure versus the prolonged time to visual recovery with epiLASIK. SMILE is a consideration but the pros and cons of this should also be considered. With regard to Accutane, it is best to stop using it entirely for 6 months, and then re-evaluate the state of eye dryness before considering any laser refractive surgery.
