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Refractive Surgery

Refractive surgery refers to any surgical procedure that is used to treat or correct myopia, hyperopia, astigmatism, or presbyopia. These are the four basic types of refractive errors. To learn more about them, please visit our page on vision facts.

There are many kinds of refractive surgery including Laser In Situ Keratomileusis (LASIK), Photorefractive Keratectomy (PRK), and intraocular lens implant surgery. If you want to learn more about intraocular lens implant surgery, please refer to our cataract surgery page. Although it is not widely discussed, cataract surgery itself is a form of refractive surgery. And with the advent of new high-tech lens implants, many patients are able to achieve great improvement in vision, and reduced dependence on eyeglasses after cataract surgery.

When most people talk about laser vision correction, they are thinking about either LASIK or PRK. These procedures can greatly reduce a patient’s dependence on eyeglasses. Most patients who undergo these procedures will not need eyeglasses until they develop presbyopia around age 40. And then, they will only need them for reading.

LASIK and PRK, however, are not a cure-all for eye disease. While they represent the forefront of technology in ophthalmology, they are merely an alternative to eyeglasses or contact lenses. If your vision cannot be corrected to a satisfactory level with eyeglasses or contact lenses, LASIK and PRK will not be able to do so either.

LASIK

With all-laser LASIK, a femtosecond laser is used to create a thin flap in the cornea. This flap is then folded back, and an excimer laser sculpts the exposed corneal tissue to reshape it. The flap is then repositioned and allowed to heal naturally. No stitches are necessary to hold the flap in place. The main advantage of LASIK is that it is relatively painless and the results are quick. Most patients see very well immediately after the procedure.

PRK

With PRK, the surgeon removes the epithelium from the cornea using a fine brush. An excimer laser is then used to reshape the cornea. A bandage contact lens is then applied and left in place for a few days to help the epithelium heal. The main advantage of PRK is that it is a safer alternative to LASIK for certain refractive surgery candidates. The healing is typically slower, and most patients experience some discomfort during the first week following the procedure.

Because LASIK and PRK are surgical procedures, it is very important to make an informed decision when deciding whether refractive surgery is the right choice for you. Although serious complications are rare, they do occur. Some possibilities include:

  • temporary discomfort
  • blurry and fluctuating vision
  • glare and halos
  • dry eye
  • under- or over-correction
  • poor night vision
  • irregular astigmatism
  • corneal scarring
  • permanent vision loss

There is no best method for correcting refractive errors. The most appropriate correction for you depends on your eyes and your lifestyle. You should discuss your eye condition and your lifestyle with your ophthalmologist to decide which correction may be most effective for you.

At Central Vermont Eye Care, we take great pride in providing you with the TRUTH about laser vision correction and other refractive surgical procedures. LASIK and PRK can do many great things for many people. But there are many things that these procedures cannot do. We are committed to helping you make the right decision based on your eyes, your expectations, and your needs.

Adapted from the American Academy of Opthalmology

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