Laser Surgery Low-Down

Laser surgery is no longer a procedure for a brave few.

That’s right – a million-plus Americans choose it each year, and it has a 99% success rate. More and more people are opting to ditch their glasses or contacts for the promise of clear vision 24/7, but it isn’t for everyone. We got the low-down on the different procedures and things to consider from doctor Randall Fuerst, O.D., a VSP doctor in California.

Steps of the Lasik procedure...

Creation of corneal flap A laser creates a thin flap from the clear cornea which is folded back.	Laser shapes the cornea A cold beam Excimer Laser painlessly reshapes the underlying cornea through a series of computer-driven pulses based on the patients' refractive error. The laser beam is able to vaporize microscopic amounts of the cornea enabling a precision previously unattainable.	Corneal flap moved back into position Involves folding the flap back into position

Prime candidates for laser surgery are people who are nearsighted, farsighted or who have astigmatism. But certain other conditions like glaucoma and cataracts rule out
the procedure.

So what happens during the surgery? The short version: the surgeon uses a delicate FDA-approved excimer laser to improve vision. The trick is to delicately reshape the cornea, or front of the eye, so that light enters it correctly – thus fixing the vision problem.

Here’s how the various procedures are different:

LASIK (laser-assisted in-situ keratomileusis) is the most common form representing 90% of surgeries. In this procedure, the surgeon leaves a “flap” of tissue attached to the cornea, then covers the laser-corrected corneal surface with the flap. The tissue heals so quickly – within 10-12 hours – that many patients resume normal activities the same day.

Custom LASIK is just like LASIK, but with an added bonus: the surgeon uses a special instrument to get precise measurements, which helps ensure the best results.

PRK (photorefractive keratectomy) is similar to LASIK. The difference is that the surgeon uses the laser to reshape the cornea, rather than using a flap to do it.

So, what steps should you take to decide if laser surgery is right for you?

“I always recommend that patients break the process down into stages,” says Dr. Fuerst. “First, assuming the patient is at least 18 and in good eye health, he or she needs to decide just how much they’re bothered by having to wear eyeglasses or contacts.

“Start by getting a thorough eye exam, then discuss the risks and benefits of the procedure with your doctor,” he continues. “If you decide the surgery is for you, your doctor can usually recommend a good surgeon. The final step is to go and talk with other people who’ve been through the surgery.”

One other thing to consider, according to the doctor: “If you already wear bifocals that help you see up-close objects while also correcting your long-distance vision, it may not be possible to accomplish both tasks with laser surgery,” he says. “In these cases, which usually affect people over age 45, the patient may still need to use a pair of reading glasses after the laser surgery.

“In my own practice, I’ve discovered that many patients don’t mind this trade-off because they’re happy that they no longer need glasses or contacts to see well at a distance.”