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Guide to Corrective and Laser Eye Surgery Procedure Options

Jen Jones

Improving eyesight has been sought after for nearly one thousand years. From the introduction to the spectacles in the 13th century to the concave lens improving nearsightedness in the 16th century; from Franklin’s bifocal lens in the 18th century to the contact lenses in the 19th and 20th centuries, new methods to improve eyesight have been constantly being created. Thanks to modern day technology, one can have perfect eyesight—without glasses or contacts—through corrective eye surgery. Although there are many types of corrective eye surgery for you to choose from with your ophthalmologist, it is important to research the types of and risks of eye surgery before agreeing to this procedure.

Corrective Eye Surgery

Corrective eye surgery uses procedures based in laser reshaping of the eye or uses procedures based in surgical insertion of artificial lenses in order to correct eyesight. The result of these procedures leaves the patient with the ability to have perfect vision without the aid of contact lenses or glasses.

When deciding with your ophthalmologist on the best eye surgery for you, your lifestyle and the resulting necessary eyesight comes into play, including near vision and depth perception. Typically most eye surgery patients are between the ages of 20 and 40 and have either mild to moderate nearsightedness, farsightedness, or astigmatism.

Laser Eye Surgery Procedures

Photorefractive Keratectomy, or PRK, is a laser vision correction procedure. Approved in 1995 by the FDA, PRK removes tissue from the eye’s surface to alter the cornea’s curvature. Many ophthalmologists recommend PRK instead of LASIK eye surgery if the patient has diabetes, has a disease that would affect the healing process, or thin corneas.

Similar to PRK, Laser-Assisted in situ Keratomileusis, commonly known as LASIK, is a type of laser eye surgery. LASIK eye surgery creates a thin, hinged flap in the eye’s surface. Underneath this flap the laser energy reshapes the eye; the replaced flap after the procedure acts as a bandage. There are four different forms of LASIK eye surgery depending on how the flap is created:

  • Epi-LASIK,
  • All-Laser LASIK
  • Wavefront LASIK

LASEK creates an ultra thin hinged flap and floats the flap away from the eye’s surface with alcohol while the laser reshaping of the eye occurs. Epi-LASIK involves a procedure similar to LASEK, but uses a special cutting tool to lift the flap, reducing the risk of a reaction to the alcohol on the eye’s surface. All-laser LASIK uses two lasers: one laser to create the flap and another laser to reshape the eye underneath. Wavefront LASIK uses a wavefront to measure how light travels through the eye, allowing lasers with wavefront analysis to detect and adjust for vision errors when the laser reshapes the cornea.

Corrective Eye Surgery Procedures

If the patient suffers from either nearsightedness or farsightedness, the patient can opt for either implantable lenses or conductive keratoplasty. Implantable lenses are similar to contact lenses, but are surgically implanted with the patient’s natural lens left in place. This procedure is typically used with those with high levels of nearsightedness. Conductive keratoplasty applies spots around the periphery of the eye using a tiny probe and heat radio waves. This steepens the cornea and provides near vision for those who have farsightedness.

Cataract surgery uses multifocal IOLs to partially restore the patient’s near vision and correct nearsightedness and farsightedness. This type of eye surgery removes the eye’s natural lens in the event that the lens has a cataract formation and has grown cloudy. Similar to cataract surgery, Refractive Lens Exchange (RLE) removes a clear lens from the eye and replaces it with an artificial lens. This procedure reduces high degrees of farsightedness. Since RLE has a high risk of complications compared to other corrective and laser eye surgeries, RLE is typically only used if a severe vision correction is needed.

Risks of Corrective Eye Surgery

There are numerous risks involved with corrective eye surgery depending on the type of eye surgery. Laser eye surgery risks generally involve either overcorrection or under correction where quality vision has not been achieved. Another risk to laser eye surgery is the loss of best corrected vision, which forces the patient to rely on contacts or glasses after surgery. Risks for corrective eye surgery typically results in infections inside the eye or retinal detachment.

By discussing all eye surgery options, risks, and side effects with your ophthalmologist, you can make the best decision for the eye surgery procedure needed to improve your vision. Although corrective surgery is a modern and an ideal way to achieve perfect eyesight without the assistance of glasses or contact lenses, there are side effects ranging from mild to severe for each type of eye surgery, and a potential side effect should not keep you from selecting the best option for you. Be sure to carefully research each option so you can understand the procedure you are selecting for your vision improvement.

[page updated December 2008]
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