Laser Eye Surgery Comes of Age

Many people go through life wearing glasses or contact lenses for common eye disorders such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (distorted vision). Yet laser refractive eye surgery has made it possible for countless numbers of people to do away with the need for corrective lenses altogether. How do you know if it's right for you?

"For many people, laser eye surgery provides excellent vision improvements, yet a small portion of patients who try it may end up with worse eyesight than before they went in," says optometrist Elise Brisco of Los Angeles. "People who are slow healers or who have certain chronic medical conditions such as glaucoma or diabetes are not good candidates for laser eye surgery," says Brisco.

Others who may be poor candidates include:

  • those with uncontrolled vascular disease,
  • those with autoimmune disease
  • certain eye diseases affecting the cornea or the retina
  • pregnant women

Pregnant women should never have refractive surgery, as the refraction of the eye may change during pregnancy.

The two most common types of laser eye surgery are PRK and LASIK. PRK is an outpatient surgical procedure which gently reshapes the cornea by removing microscopic amounts of tissue from its outer surface. The procedure takes only a few minutes, and patients typically return to daily routines in one to three days.

Before the procedure, the patient's eye is measured to determine the degree of the visual problem, and a computer is used to draw a map of the eye's surface. This map helps the ophthalmologist decide whether a patient's vision may benefit from the procedure.According to the FDA's Center for Device and Radiological Health, about 5 percent of patients in clinical studies continued to need glasses for distance vision following PRK, and up to 15 percent needed glasses occasionally, such as when driving. For almost 5 percent of patients, vision without corrective lenses was slightly worse after surgery than before.LASIK is performed for all degrees of nearsightedness and involves cutting a flap of corneal tissue, removing targeted tissue from beneath it with the laser, and then replacing the flap. With LASIK, the skill of the surgeon is more important, because he or she will be making an incision, and not relying on a computer to map the eye as in PRK.You can find an ophthalmologist in your area who performs laser eye surgery through the American Academy of Ophthalmology's free nationwide directory.
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