Eye Surgery
Is "laser eye surgery" the same as "refractive eye surgery"?
There are different terms used to describe vision correction surgery. The medical term for vision correction surgery is refractive surgery. The reason for that term is; refraction is measuring your eye for glasses or contacts. So, refractive surgery is correcting your refraction to so you don't have to wear glasses or contacts. A lot of people use laser eye surgery as a synonym for refractive suergey. It is pretty much the same thing. The difference is there are other ways to correct your vision other than lasers. For example, nowadays we have lens implants that can give spectacular corrections to nearsighted people. The lens implants are a form of refractive surgery but they are not laser surgery or laser eye surgery.
What are my options for laser eye surgery?
Robert K. Maloney: The most common surgery to correct vision is LASIK surgery, or laser eye surgery. The way that works is that it reshapes the front surface of your cornea, almost like sculpting a contact lens directly onto your eye. That corrects your vision like you're wearing a contact lens, without having the discomfort and inconvenience of putting a lens in and out. There are different ways to do laser eye surgery. LASIK, the most common, involves peeling back the outer layer of your eye, reshaping the eye with a laser, and then putting that layer back down. Another alternative, which goes by different names, but it's most commonly called PRK or surface ablation or flapless LASIK, involves lasering directly on the surface of your eye without a flap. The advantage of that is it's a very simple operation, but the disadvantage of that is it takes about four days for your eye to heal.
What is meant by the term "IntraLase"?
In Lasik surgery, we make a flap before we reshape the eye. There's two different ways, in general terms, to make the flap. The traditional way uses a machine. It is a miniaturized cutting instrument that cuts the outer layer off the surface of your eye. It works very well. It's been used for a long time. Recently, in the last several years, a new alternative way of making a flap has been developed called the IntraLase. That's basically a laser that puts thousands of tiny bubbles in the surface of your eye just beneath the surface. The laser uses these bubbles to separate that layer. In that way, it makes the flap without having to cut your eye with a traditional machine. That has some advantages in terms of safety. Both are very safe, the IntraLase gives a slight advantage in terms of safety and some people think slightly better results.
Can I get refractive eye surgery without using a laser?
Some people are too nearsighted for LASIK surgery. LASIK just isn't powerful enough to correct them safely. For them, we recommend what we call "implantable contact lenses". These go by different terms, but basically it's a small contact lense that's inserted into the eye through an incision and then it sits in the front part of the eye forever. It's never removed, it never needs to be cleaned or taken out, you don't feel it, it's completely comfortable, and it corrects your vision forever. It's a very nice way of correcting very high levels of nearsightedness. The implantable contact lense goes by a number of different terms. It's also called the ICL, the collamer lens, the Verisyse lens, Phakic IOLs. These are all basically variations on the same theme of a contact lense that goes in your eye permanently to correct vision.
What are the risks of laser eye surgery?
Like all surgeries LASIK (laser eye surgery) is not risk free. What people worry most about is, "Will I lose my vision?" The good news is losing vision is extraordinarily rare. In fact, there is good evidence from large studies that you are less likely to lose your vision with LASIK surgery then by wearing contact lenses. So the risk of something terrible happening is just incredibly low. The common risk for LASIK though and really what people need to think carefully about are the following. First, your vision may be very good but not perfect. Now that's not a terrible risk because at least your vision will be very good but we never know whether we are going to get you all the way to 2/2 vision. The second common risk is, it is common to have glare around lights at night or halos. What that means is when you look at a headlight or a streetlight at night in a dark environment, you will see a little low of light around it. We call that a halo or sometimes little spikes coming out which we call glare. That can be annoying. It can make it harder to drive at night. Now contact lenses cause that as well and so for most contact lens wearers that's not an issue. They are already used to it. Finally, LASIK tends to make the eyes somewhat drier. So your eyes will just feel drier after LASIK than they did before. That may lead you to use lubricating eye drops occasionally or some other treatment may be indicated. The good news is LASIK dries the eyes out less than contact lenses. So again if you are a contact lens wearer, we can usually make you more comfortable with the LASIK surgery.
What can I expect after my eye surgery?
After eye surgery, after you've healed from your laser eye surgery, your vision should be very good. In fact, statistically nowadays, about 95 percent of people get 20/20 vision. So 20/20 has actually become the usual result, amazing as that is. Now, laser surgery doesn't correct the loss of reading vision with age, so even if you have perfect vision after your laser surgery at age 30, when you get to 45 or 50, you'll get reading glasses. Now, it turns out there are some things we can do to help reading vision as you get older. If we make one eye nearsighted after our laser surgery, we can allow you to read without glasses. That's a condition called monovision: one eye more for distance, one eye more for reading. We do that with contact lenses as well. So we can help you with the aging process.The eyes are normally a little bit drier after laser surgery. That usually goes away in six months in most people, but it can persist. And then you should also expect to just have the comfort and freedom of not dealing with glasses or contacts anymore. I mean, it's fun for somebody who's wearing glasses or contacts their whole life to go to an optical store and buy non-prescription sunglasses, or to hop in a pool and open your eyes underwater without worrying about your contacts falling out.
