Imagine not having to experience life from behind lenses. Imagine waking up in the morning, and starting your day without wrestling with contact lenses or hunting for your glasses. Imagine being able to wear prescription free sunglasses without having to fit them over your spectacles. These scenarios are all possible through the modern medical marvel of laser eye surgery.
The world of laser eye surgery is attractive to many patients, providing clarity, convenience, and freedom from glasses or contacts. But like any surgery, not every procedure is right for every patient. There are three main corrective surgeries: LASIK, LASEK, and PRK. All three of these procedures are designed to reshape your cornea. But all three of them vary quite a bit in terms of method. So how do you know which one is the right one for you?
Understanding Laser Corrective Eye Surgery
History of the Procedure
Refractive surgery is not a new concept. According to the Centre of Excellence for Medical Multimedia, researchers believe that corrective eye surgery dates back as far as ancient Greece. The advent of refractive surgery as we know it began back around the mid 80’s with the invention of the excimer laser. Researchers saw the potential and began exploring the possibility of using an excimer laser to perform refractive surgery.
The first laser eye procedure was performed in 1987 and was called photorefractive keratectomy, or PRK. Although there have been new procedures designed since many ophthalmologists still prefer PRK for some patients.
A Modern Perspective on Laser Eye Surgery
Medical science is always advancing, and as such, new innovative technologies and methodologies are emerging for laser eye surgery all the time. Wavefront technology, for example, takes exceptionally precise measurements of the eye; specifically the curvature of the cornea. These specific measurements allow the doctor to correct your eye with more accuracy, shaping your cornea in a way that is custom to you and your eyes, rather than simply replicating your prescription, which is not.
There are eye procedures that are completely bladeless, procedures to replace the lens of your eye, and even procedures specifically designed for those with thin corneas in mind. In a matter of 3 decades, laser eye surgery has become almost completely customizable, making it simpler than ever to get accurate, long-lasting vision correction.
Things to Consider When Choosing a Procedure
Risks & Complications
Although laser eye surgery is safe, no surgery is entirely without risk. While ophthalmologists are trained and experienced professionals, sometimes unexpected problems arise. It’s important to understand what these problems might entail before pursuing corrective eye surgery as an option. Mayo Clinic lists the following as rare, but possible risks and complications of laser eye correction.
- Undercorrection: In order to correct refractive errors such as myopia and astigmatism, ophthalmologists must remove tissue from your eye to change the shape. If the doctor removes too little, you may still require correction, and a second surgery must be performed.
- Overcorrection: In some cases, the ophthalmologist accidentally removes too much tissue from the eye; solving one refractive error, but creating a different one. This particular problem can be very difficult to fix.
- Astigmatism: If the tissue is not removed from the eye evenly, it can cause astigmatism. Astigmatism would require correction through contacts, glasses, or another surgery.
- Temporary Dry Eye: Refractive surgery can cause your eyes to stop producing tears regularly. This may affect your vision, however, you can mitigate this with artificial tears or eye drops.
- Light Halos and Glare: Patients often report an increase in glare or rings around lights after refractive surgery. This is especially true in low light conditions, for example, night driving is often heavily impacted by the glare of streetlights and oncoming cars.
- “Flap” Complications: LASIK and LASEK both involve the creation of a “flap” of the eye tissue. In some cases, the flap can have difficulty healing. For example, some corneal tissue could grow incorrectly under the flap, causing scarring. There’s also a potential for infection or an excessive tear production.
The recovery time required after laser eye correction varies based the on the patient as well as the procedure. No patient should ever drive home from their surgery (in fact, you will need to schedule a follow-up appointment with your doctor before you can safely drive again), however, in some cases, you may be able to go to work the next day.
Patients who undergo PRK usually require the most recovery time. Eyesight is usually temporarily decreased, however after a few days or weeks, the patient’s vision will begin to improve. LASIK and LASEK, on the other hand, typically heal quite quickly. Many patients find their eyesight has improved by the next day.
Regardless of what procedure you have, you should follow your doctor’s advice to the letter; taking any and all medication exactly as instructed. Avoid all strenuous activity and exercise for a few weeks, and protect your eyes from dirt, dust, and anything that could cause infection. Do not rub your eyes, as this could prevent healing, damage the vulnerable tissue, or cause flap complications.
For the most part, patients have 20/20 vision after their procedure. It’s not uncommon for people to require some kind of correction through glasses or contact lenses after surgery. However, in these cases, the prescription required is far less than before the surgery.
According to the American Academy of Ophthalmology, most patients will require reading glasses after the age of 40 regardless of any corrective surgery. This is due to presbyopia; an age-related condition. Unfortunately, there is no surgical procedure available at this time to correct presbyopia.
LASIK is the most commonly performed laser eye surgery in America. Unlike PRK, patients undergoing LASIK do not experience much pain or discomfort during or after the procedure.
Ophthalmologists create a small flap in the cornea, folding it back to expose underlying corneal tissue. This tissue is then reshaped using an excimer laser. Once the correct amount of corneal tissue is removed, the corneal flap is replaced. This procedure typically takes about 10 minutes per eye.
Potential Side Effects
Patients often experience dry eye symptoms after undergoing LASIK, as their eyes have temporarily stopped producing tears. This can be remedied with eye drops; however, you should consult your doctor before using anything in your eyes after surgery. Any blurry or hazy vision should clear up within 24 hours of the procedure. Although you may experience some itching, you must avoid rubbing your eyes. This could dislodge the flap, causing significant problems in healing.
Many patients experience 20/20 vision after LASIK, however, there is some variation in results. It’s not uncommon for patients to have 20/40 vision or less.
While LASIK is very effective, it’s not a good choice for people with thin corneas. LASEK was developed to give a similar result, without exposing thin corneas to the damage they might sustain during LASIK.
Rather than cutting a flap in the eye, ophthalmologists use an alcohol solution to lift the top layer of tissue away from the rest of the eye. This tissue is folded back, exposing the underlying corneal tissue to be reshaped with an excimer laser. After the appropriate amount of corneal tissue is removed, the outer layer of tissue is replaced.
Potential Side Effects
Although LASEK does not trigger dry eye the same way LASIK does, it does have its own set of side effects. The flap created for LASEK tends to heal slower than the flap created for LASIK. As a result, patients will have to wear a special contact lens that functions as a bandage until healing is complete. The healing process usually takes up to a week.
You also may experience cloudy vision lasting up to 6 months, or the sensation of having something in your eye.
Many patients experience 20/20 vision after LASEK, however, there is some variation in results. It’s not uncommon for patients to have 20/40 vision or less.
PRK fell out of popularity to some extent when LASIK was created, however, it has experienced somewhat of a resurgence in recent years. Many doctors now prefer PRK to LASIK for specific kinds of patients.
Rather than creating a flap in the surface of the eye and reshaping the corneal tissue underneath, PRK involves reshaping the cornea directly from the outside. One major disadvantage to PRK is that the patient does experience a higher level of discomfort, and will require more recovery time. PRK is another option that is preferable for patients with thin corneas. It also eliminates the risk of flap-related complications.
Potential Side Effects
As with any surgery, there is some risk of infection associated with PRK. Patients do occasionally experience temporary dry eye symptoms as a result of the surgery. There is also a chance that a patient recovering from PRK will notice sensitivity to light and increased glare; particularly in low light conditions.
Many patients experience 20/20 vision after PRK, however, there is some variation in results. It is not uncommon for patients to have 20/40 vision or less.
Before Diving Down the Google Goldmine, Speak to an Optometrist or Ophthalmologist About Your Options
Don’t Forget: The Optometrists at Dittman Eyecare Are Here for You!
We are prepared to closely evaluate your eyes and determine which corrective eye procedure is right for you. Contact us today and let us guide you through the world of laser eye surgery.