Laser Vision Correction

Laser Vision Correction (Refractive Surgery) is a term given to surgical procedures designed to correct certain vision problems such as nearsightedness, farsightedness and astigmatism with the use of the excimer laser.

The excimer laser is a computer controlled ultraviolet beam of light (a cool laser beam) that sculpts the cornea by removing microscopic layers of tissue thus reshaping the cornea so that light is focused more directly on the retina, thereby reducing or eliminating a variety of refractive errors. The cornea is made flatter to treat nearsightedness, steeper to treat farsightedness and/or more spherical to correct astigmatism.

Since the invention of the excimer laser in the early 1980’s, it has undergone numerous clinical trials to refine its use and determine its safety and effectiveness. The excimer laser is now routinely used around the world.

Each pulse of the laser disrupts the molecular bonds between the corneal cells with accuracy up to 0.25 microns (or 0.00004 of an inch) which makes it extremely accurate and precise. The more tissue removed, the more the refractive power of the cornea is altered. Often, only 50 microns of tissue, i.e., about the thickness of a human hair, are removed to achieve the proper amount of correction. Its accuracy, combined with the non-thermal characteristics, provide refractive surgeons with a tool that can deliver more consistent and predictable results.

Presently the excimer laser is widely used for two refractive procedures; LASIK (by far the most common procedure being performed) and PRK. Both procedures are done under a topical anesthetic (numbing drops).

LASIK, an acronym for Laser Assisted In-Situ Keratomileusis, treats refractive errors by removing corneal tissue beneath the surface of the cornea. It is the procedure selected by most people seeking laser vision correction today due consistency of outcomes, along with the relative lack of pain, and the rapidity with which clear vision is obtained following the procedure. Though LASIK has only been performed in this country since 1996, it has been performed internationally since the early ’90s.

LASIK involves the creation of a thin protective flap with the use of an instrument called a microkeratome and the precise application of predetermined amount of laser pulses to the underlying tissue to achieve the desired reshaping of the cornea. The cornea is made flatter to treat nearsightedness, steeper to treat farsightedness and/or more spherical to correct astigmatism. The flap is then laid back in position and naturally re-adheres.

PRK (photorefractive keratectomy) involves the direct application of the excimer laser beam to the corneal surface to reshape the cornea. The cornea is made flatter to treat nearsightedness, steeper to treat farsightedness and/or more spherical to correct astigmatism.

With PRK, there is high predictability for an excellent outcome; however, there is irritation or mild discomfort for one to two days following the procedure, until the surface has regenerated. Once this area of the eye is comfortable and the vision begins to improve. Recovery time for good visual acuity after undergoing PRK is usually 3 days to a week, but best vision may not be achieved for up to three months. Both eyes are not treated on the same day.

LASIK and PRK are both excellent procedures but deciding which is better for you is a decision that both you and your doctor need to make together. Following your comprehensive eye examination and laser vision correction consultation, your doctor will have a better idea regarding your specific visual needs and activities. From there, a recommendation can be specifically tailored to your individual case.

Laser vision correction has been approved to treat up to 15 diopters of nearsightedness (myopia), with up to 5 diopters of astigmatism and up to 4 diopters of farsightedness (hyperopia).

Yes. In most cases up to 5 diopters of astigmatism can be treated.

Amazingly, there is very little discomfort with LASIK. Anesthetic eye drops are applied, allowing patients to be awake and alert during the procedure. Most patients tell us that they don’t experience any pain whatsoever during the procedure. There is also very little discomfort afterward, mild scratchiness is what is commonly reported. Rarely, you may feel the need to take a common pain reliever afterward, but most of our patients tell us that they don’t find it necessary. After PRK, there is mild discomfort and scratchy feeling lasting one to two days.

We strongly feel that all who are candidates for laser vision correction should be able to experience a lifestyle which is more independent from contact lenses and glasses. Although we are not the most inexpensive laser vision correction provider, we offer experience and a commitment to patient care unsurpassed anywhere in the industry.

The cost of the surgery depends upon the time and the equipment required for each specific type of surgery. Therefore, LASIK, PRK, and other refractive surgery procedures that we offer all have different costs. Please check with our center for an overall summary on the different procedural costs.

At this time, most insurance companies do not cover laser vision correction since it is considered to be an elective procedure. Please check with your insurance carrier or contact our Laser Vision Correction Center Coordinator.

Patients typically find that the haziness, following the procedure, dissipates within a few hours. Visual recovery can vary with each patient, but in most cases, good visual acuity is achieved the following day after LASIK. In some instances it may take longer, especially true for people who are being corrected for higher levels of either near sightedness or far sightedness. Small fluctuations with the vision are not unusual for the first few weeks following surgery. PRK tends to provide a slower visual recovery as compared to LASIK. Following PRK, the vision will be blurred for two to four days and will slowly improve for the next one to two weeks before reaching a stable endpoint.

Most patients can return to work the following day after LASIK surgery. Others may take one day off of work following the surgery.

Depending upon the procedure you are having performed and your specific refractive error and lifestyle, both eyes can be treated on the same day. However to optimize results and outcome each patient is individually evaluated.

In order to ensure that changes in vision associated with childhood and adolescent development have been completed, refractive surgery is not performed on anyone under the age of 18. There is no upper limit on age as it relates to refractive surgery. It is not unusual for people in their sixties and even their seventies to undergo laser vision correction as long as the eye is healthy.

There are risks involved with laser vision correction as there are with any surgical procedure. They are uncommon, but need to be discussed with your surgeon. The use of an excimer laser has been approved by the US Food and Drug Administration (FDA) for use in Myopic LASIK for the correction of myopia ( up to -15 and astigmatism (up to -5 diopters) The FDA has also approved PRK for the correction of Hyperopia (up to 4 diopters).

While LASIK is relatively new, the idea of changing corneal shape in order to correct visual problems is not. LASIK is based on a procedure known as Automated Lamellar Keratoplasty (ALK), dating from the 1970’s and there is no evidence that over time changes will take place in such a way as to compromise or negate the results of the surgical procedure.

The expertise of surgeons performing LASIK in other cities may or may not be superior to the surgeons in your local area. Patients should decide which surgeon they feel most comfortable with when having LASIK. There are a few points about traveling for LASIK surgery. Although LASIK is very safe, there are risks with surgery. If a patient has traveled for LASIK, and then develops a complication (flap dislocation, striae, infection, inflammation, or other), there could be some difficulties getting the appropriate treatment. Some patients will need multiple visits with their surgeon if an uncommon but serious complication occurs. This can be very difficult if a patient has flown across the country or to other countries for the surgery. Without expert follow-up by your surgeon (the reason one would travel in the first place), there is a risk of a poor result.

In general, the ideal patient has a healthy cornea, and must not have had a significant increase in their prescription in the last year. People with certain medical conditions or pregnant women may not be good candidates. The decision to have Laser Vision Correction is an important one that ultimately, only you can make.

It is important that you have realistic expectations and that your decision is based on facts, not hopes or misconceptions. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses. Laser Vision Correction does not always create 20/20 or even 20/40 vision. It cannot correct a condition known as presbyopia, or aging of the eye, that normally occurs around age 40 and may require the use of reading glasses. In fact, people over 40 who have their nearsightedness reduced with surgery may find they need reading glasses after the procedure. We can provide you with additional information that will allow you to make an informed decision. Getting as much information as possible and finding out your refractive error (eye prescription) is the first step toward visual independence. This is accomplished by scheduling a personal comprehensive examination. This information will help you and your doctor determine which procedure is in your best interest.

Please contact us by calling 978-538-4435 and we will be glad to answer any further questions you have.