The purpose of this page is neither to promote nor discourage LASIK/Laser Eye Surgery or Refractive Surgery. Its purpose is to educate you, the potential candidate, about the positive and negative aspects of the procedure that you may not hear elsewhere. We also provide you with some excellent websites at the bottom of this page if you would like more information.
Laser eye surgery to correct vision has been the most significant development in vision correction since soft contact lenses were developed in 1971. It is really an amazing procedure where a cold laser is used to reshape the cornea (front part of the eye) by vaporizing the tissue. The purpose of the surgery, of course, is to correct vision to 20/20, clearly and comfortably, without having to rely on glasses or contact lenses. And in most cases, this is the result. At SVC, we work with a few select ophthalmologists (Corneal Specialists, in fact) who have performed thousands of surgeries and have very high success rates with very few problems.
For patients with a strong desire and/or need to correct their vision with laser surgery, we are more than happy to co-manage your procedure. Our job is to make sure that the data going into the procedure is meticulous, and that you are well taken care of, so that we ensure your best surgical outcome.
The two predominant corrective laser procedures are: laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Both laser-assisted therapies are intended to correct near-sightedness (myopia) and astigmatism. LASIK has also been approved for correcting far-sightedness (hyperopia). Both therapies use a special laser that produces a narrow beam of invisible, ultraviolet light to remove tissue from the cornea.
With PRK, the corneal epithelium (the very front surface layer of the cornea) is anaesthetized and scraped away and the laser directly reshapes and flattens the tissue underneath. A bandage contact lens is then placed on the treated cornea and the epithelium is allowed to re-grow. The flattened, reshaped cornea allows light to focus more accurately on the back of the eye. Studies have found that PRK produces the best results when used on people with low nearsighted prescriptions. Approximately 2/3 of patients' surgeries result 20/20 vision. Repeat procedures and/or a small prescription may be needed to fully correct vision. There is usually some discomfort and/or irritation during the healing process (sometimes lasting up to 7-10 days). Vision usually stabilizes after approximately 3 months.
LASIK is similar to PRK in that it reshapes and flattens central corneal
tissue. But with LASIK, the surgeon makes an incision on the edge of the
cornea to create a flap. This flap is folded over, the exposed tissue is
treated with the laser (just as with PRK), and then the flap is replaced on the
reshaped cornea. The incision heals on its own and does not require stitches.
LASIK has been found to be the more successful procedure for higher
prescriptions and can treat up to 10-12 diopters of myopia (depending on corneal
thickness). Most people have 20/20 vision after the surgery, but repeat
treatments are still occasionally needed in people with large prescriptions. Just as with
PRK, it usually takes 3 months for vision to completely stabilize.
LASIK has both advantages and disadvantages compared with PRK. LASIK is generally less painful, leads to generally sharper vision, and can treat more severe myopia. However, because of the added step of creating a corneal flap, there are potential additional complications relating to the flap.
Starting in 1996, LASIK, has become the procedure of choice for most surgeons. The number of LASIK procedures has doubled over the past few years. In 1999, of the approximate 950,000 refractive surgeries that were performed, more than 90% of these were LASIK (the remainder were PRK). In 2000, more than 1.65 million refractive procedures were performed.
Though most surgeries have acceptable results, there are several significant risk factors that should be taken into account when considering laser eye surgery. The main risks are:
2. Abnormal healing/flap complications;
3. Lack of precision in the microkeratome (the steel blade that cuts into the cornea), laser, surgeon and/or optometrist; and,
4. Loss of best obtainable visual acuity (by as much as 3 lines, especially at night causing blur, haze, ghosting, multiple images, flare, glare and star bursting i.e. your vision resembles looking through a dirty windshield).
Through experience, careful measurements and aseptic techniques, these risks can be largely reduced, so that conditions are optimal for as perfect a result as possible. However, even with a "perfect" result, there still may be permanent long-term problems.
A recent study (July 2000) in the Toronto Star reported that the Canadian
Medical Association has added laser eye surgery to the list of risk factors for
unsafe driving, and recommends that doctors test the night vision of patients
who may be experiencing visual difficulty following surgery. The study
reports that the specific problem with night vision is a decrease in
contrast sensitivity. Contrast sensitivity is the ability to see
in low-contrast conditions, such as dim light or darkness. It was found
that as many as 30-60% of laser eye patients experienced a decrease in night
vision, opening the door for night-vision testing as a standard part of all
drivers' tests. The bottom line is that laser surgery may reduce your ability to drive a car.
Additional Risk Factors
As you are probably aware, the price of surgery has gone down significantly over the past several years, and it may drop even further still. Beware of laser centers that are promoting laser surgery at "rock-bottom prices" like they are trying to sell you a used car. Yes, cost is a factor but DO NOT BARGAIN SHOP FOR A SURGEON. Shopping for cheap surgery is like shopping for a cheap parachute. Remember that this surgeon will ultimately use a steel blade to cut your cornea and a laser to re-shape the tissue of your eyes.
This price drop may be a result of several factors, of which you may or may not be aware:
1. Competition from the large increase in number of refractive centers;
2. New centers usually mean inexperienced young doctors who need to perform as many procedures as possible to gain experience;
3. A "re-distributing" of costs so that it appears the whole procedure will cost less (e.g. if a center advertises $500 per eye, they are probably not including the costs of the initial exam, the follow-up exams, the medications, and/or supplies etc.)
More surgical centers mean more competition for patients, and they'll do anything to get you in the door. New surgeons need experience so they'll drop their prices to get you in the door. After they have you in the door, some centers will even make you sign a form saying that you promise to return to their center for all future annual eye exams.
Education is your most useful tool when considering laser eye surgery. Do your research, check out the websites below, and ask questions of a professional whom you trust, and whom you know will give you honest, helpful advise...like your friendly neighborhood Optometrists at the Super Vision Center. We tell it like it is.
It seems like every monthly Optometric Journal or magazine reports a new refractive procedure under development. These developments are either improvements to current surgical procedures, or they are new, non-surgical procedures that will serve as an alternative to surgery. Corneaplasty™ is one of these non-surgical procedures that is currently undergoing clinical trials. Click on the link to find out more about it.
If you have any questions about laser eye surgery (e.g. "Am I a good candidate for laser eye surgery?"), please feel free to contact us or stop in.
Laser Eye Surgery Links
"If you're considering LASIK, the informatoin at LasikInfoCenter will help you better understand its true risks."
This is a great article on the reality of complications with LASIK surgery. VERY informative.
This is a site created and run by people who have had complications with laser eye surgery. This has a very interesting simulator that allows you to experience the vision problems of someone who has had laser surgery.
Brent Hansen is a software engineer who has had laser surgery performed 6 times, and then eventually a corneal transplant. He is not a happy camper. Find out more about his story and what he's doing about it.
De-mystifying refractive surgery. This site has a great article on discount laser centers - what to expect and what to avoid.
This is a site created by the FDA that gives an excellent background education on LASIK. It is in layman's terms and very easy to understand.
This is a very detailed, medically oriented site that gives a thorough list of complications from LASIK.
This is a site created by a woman who has had disastrous results from LASIK surgery. She has successfully sued her Ophthalmologist and Optometrist for malpractice. Read about her experience.