Tuesday, September 21, 2010

Laser Eye Surgery


Laser procedures are commonly used to treat refractive errors (ie. near- or far-sightedness and astigmatism), with the end goal of providing the patient with clear vision without glasses or contact lenses.

There are 2 major types of Laser Refractive Surgery. While the process is a little different, they both essentially flatten the cornea (for near-sighted) or steepen it (for far-sighted):

LASIK - Laser-ASsisted In-situ Keratomileusis
  • The more recent of the 2 procedures
  • Most common due to shorter recovery period after surgery (not necessarily better results)
  • Requires the surgeon to make a thin "flap" of the surface of the cornea before using the laser
  • The flap is replaced after the the surgery - effectively producing a natural bandage for the eye

PRK - PhotoRefractive Keratecomy
  • The older of the two procedures
  • Less common of the two due to longer healing period
  • Still produces accurate results
  • Usually used for patients with thinner corneas (not enough thickness to form flap before using laser)

FAQ:
Q: Do I still need to have regular eye exams if I can see perfectly after my surgery?
A: YES YES YES!!! Patients who have had laser surgery need regular eye exams more than the average population! Firstly, they have had surgery. Next, the majority of patients that have these procedures are near-sighted and the primary cause of near-sightedness is an increased length of the eye. This causes stretching of internal structures (such as the retina) and leaves these patients with a higher risk for retinal detachments. This does not change just because they no longer have to wear glasses!

Q: Is it safe?
A: Yes. The surgeons that do these procedures, do hundreds to thousands per year. Technology is improving daily to provide more accurate results. Complications occur in less than 0.5% of patients.

Q: Is my prescription too high?
A: Most likely not. Refractive errors as high as -12.00 can be successfully treated. Tiger Woods and Roberto Luongo were about -10.00 and -11.00 respectively before having their surgeries.

Q: What are the common side effects or complications?
A: The number one post-operative complaint is dry eyes. Halos around lights, decreased night vision, sensitivity to light, and recurrence of prescription are also well documented. Most surgeries are guaranteed for 5-10 years. After which, it is possible the patient will require glasses again or a "touch up" surgery.

Q: What are the alternatives?
A: Intacs and Ortho-K are 2 possible options. Intacs are very small corneal implants that create the same effect as laser surgery of flattening the cornea. Ortho-K are contacts that you wear while you sleep. Again, these have the effect of flattening the cornea. In the morning, you take them out and don't need to wear any glasses or contacts during the day. The benefits of these 2 alternatives is that they are both fully reversible. These are limited to lower prescriptions of approximately -1.00 to -4.00.

Thank you for reading. I hope you found this information useful. Please feel free to contact me with questions and comments.

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