LASIK is the name for the most commonly performed refractive laser procedure. It involves making a very thin flap in the cornea, folding it back on its own hinge, and then an excimer laser is used to vaporize a small amount of corneal tissue. The flap is then placed back into position.
Like other technologies, LASIK and other refractive laser procedures continue to improve. There are now ways to customize the application of excimer laser removal of corneal tissue to each patient’s eyes, making visual results better and more predictable, with fewer visual side effects.
PRK, Epi-LASIK, and LASEK
Photo-refractive keratectomy (PRK), involves the use of the excimer laser on the cornea without making a LASIK flap. This technology preceded LASIK and was replaced by LASIK, for the most part, but it has now re-emerged as a more favorable choice for patients with thinner corneas or pre-existing dry eyes.
Strong Rx: Implantable Lenses
There are some patients whose myopia (nearsightedness) is so great, that laser refractive surgery cannot correct their vision without significantly thinning the cornea. For those people, a possible choice could be an artificial lens that is inserted into the front of the iris by means of a small incision. These plastic lenses have been FDA approved for the treatment of high myopia. There are risks to this surgery, including loss of vision.
Risks of Laser Eye Surgery
You must remember that elective laser vision correction is indeed surgery and should not be undertaken lightly. Both LASIK and PRK have the possibility of causing temporary or permanent damage to the eye, including double vision, streaking of vision, haloes around light, increased sensitivity to bright lights, glare, dry eyes, continued need for glasses or contact lenses, and rarely, loss of vision.
How to Choose an Eye Surgeon
When choosing an ophthalmologist to consult with regarding laser refractive surgery, do some research. This is an important decision and your choice should involve more than the factor of price alone. Personal recommendations, experience, and actual results are far more important than seeing advertisements on TV or in printed media.
What to Expect During Eye Surgery
Refractive laser surgery itself takes about 30 minutes. Pre-operative evaluation is extremely important and this will be performed prior to your surgical session. The results from the tests done before surgery will be used to make the correct intraoperative decisions. The eye(s) will be numbed with some drops and you will be lying on an operating table for the procedure. Both eyes are usually operated on the same day. You will be given instructions after the surgery and told to use certain eye drops to promote healing.
Preparing for Surgery
Pre-operatively, your ophthalmologist may want you to use eye drops to reduce dry eye or inflammation. You will also be given instructions about when to discontinue wearing contact lenses and when to stop applying facial lotions and creams.
Early Recovery From Surgery
Your ophthalmologist will want to see you 1 or 2 days after surgery. You will be given instructions as to when you may drive and what activities to avoid. After surgery, you may have mild pain or discomfort, a foreign body sensation in one or both eyes, hour-to-hour fluctuations of your vision, and some visual haze, together with tearing of the eyes.
Full Recovery Timeline
There may be fluctuations in your vision for as long as 6 months after surgery. Specifically, you may have symptoms of glare, rings around lights, light sensitivity, and difficulty with night driving. In addition, you may experience a feeling of dryness in your eyes. Your ophthalmologist will examine you during this period of time. Be sure you express your concerns and ask questions.