PRK Eye Surgery

One of the first corrective eye surgery techniques was photorefractive keratectomy (PRK). While PRK eye surgery is grouped in the laser eye surgery category, it uses a different laser surgery technique than LASIK, and in some cases may be preferable to LASIK.

For PRK eye surgery, an excimer laser is used to reshape the cornea by ablating, or removing, very tiny bits of tissue. Reshaping the cornea changes the refraction and more precisely focuses light into the eye and retina. PRK eye surgery produces a gradual improvement in vision, rather than the very quick result seen with LASIK. In people who have near-sighted vision, a cornea that is too steep may be flattened; in those who are far-sighted, the cornea is reshaped to be more steep. An astigmatism can be corrected by smoothing the irregular shape of the cornea into a more regular shape.

LASIK Eye Surgery

LASIK is an acronym for Laser Assisted In Situ Keratomileusis. Although people use many variations of the term - lazer eye surgery, lazik eye surgery and/or lasix eye surgery - the correct term is the acronym, LASIK.

There are now different options for LASIK eye surgery.

Bladeless laser: Even highly specialized and experienced refractive laser surgery physicians have disagreements about the benefits of "bladeless" laser eye correction versus "blade" laser eye correction.

"Bladeless" laser eye correction surgery is actually surgery performed using the IntraLase (Abbott Medical Optics) to create the corneal flap for LASIK eye surgery. It is now marketed under the name iLASIK. In traditional, or "blade" LASIK eye surgery, the flap is created using a surgical instrument called a microkeratome (or "blade"). Bladeless LASIK surgery is supposed to have better outcomes, with faster recovery. The bladeless procedure also makes it possible for the surgeon to tailor the corneal flap dimensions to the individual eye, which is supposed to also contribute to better postoperative outcomes.

What the patient needs to understand that the bladeless technique only means that a surgical blade doesn't cut the corneal flap; a corneal flap is still created. The only difference is that in bladeless LASIK, the flap is created using laser instead of a surgical blade.

Wavefront Eye Surgery

Wavefront eye surgery is also sometimes referred to as custom LASIK. Wavefront is a technology that provides something of a roadmap for LASIK eye surgery procedures. It can be used with all types of laser eye surgery procedures.

Think of light as traveling in flat sheets known as wavefronts. The light waves are distorted as they pass through imperfections in the eye. With wavefront technology, the errors are displayed in a color map, or wavefront image. The tool is then used to diagnose aberrations in the eye and determine how best to correct them with laser eye surgery.

The wavefront technology as it applies to custom LASIK eye surgery brings an entirely new level to surgical eye correction. Not only does it improve visual acuity, it also has the ability to correct higher-order aberrations in vision, such as image contrast and fine details. The LASIK surgery can tailor the laser beam settings and make the resulting laser eye correction more precise, resulting in sharper, crisper, better-quality vision with fewer of the traditional side effects, such as nighttime vision problems, halos and glare.

Many women experience dry, itchy, or light-sensitive eyes due to the drop in estrogen that occurs during pregnancy. Because eyes are normally a little more sensitive and itchy after LASIK surgery, not only is this surgery potentially ineffective for pregnant and nursing women, but will be more uncomfortable.

Also, medication given to relieve complications related to LASIK can pass through the uterine wall to the unborn child or to the baby through breastfeeding. About two or three months after pregnancy and nursing, the body should return to normal and LASIK will once again be a safe option. Most women, however, choose to wait until they are finished having children before having LASIK. For further information on pregnancy and LASIK surgery, consult a doctor.

Currently, the FDA does not approve LASIK procedures for persons under the age of 18.

If you are immunocompromised and/or if you have a disease or are on medications that may affect wound healing.

If you actively participate in activities where blows to the face and/or eyes may be a normal occurrence. This includes (but is not limited to): boxing, martial arts, wrestling.

Do not have LASIK if a less-than-perfect result will jeopardize your career.

Most health insurance policies do not cover this procedure. You would not be a candidate if you are unable to pay for the procedure. (And again we reiterate - do not select a surgeon based solely on price! If price is an overriding issue for you, you should consider waiting to have the procedure until you can afford to have it done by anyone, regardless of price.)

LASIK tends to exacerbate dry eyes condition. You may want to defer having the procedure if this is a problem for you, or you should discuss with the surgeon options such as plugging the lacrimal ducts, which may alleviate the symptoms.

If you have already had refractive eye surgery, such as radial keratotomy, etc., you would not be considered a candidate for LASIK.

Probably the best reference is other people, which is what LASIK Testimonials is all about. When someone with a great experience is willing to share it and share the name of the doctor who performed the procedure, everyone has a better-informed starting place.

Don't assume too much from advertising. Anyone can buy an ad. However, don't let the fact that a doctor runs numerous ads put you off, either. If the job is done right, the LASIK procedure doesn't produce repeat business.

Nothing beats meet and greet. Most facilities will do the initial evaluation free of charge. If they don't perform a thorough evaluation, there's no reason to continue the discussion. Narrow the list down to a couple choices in your geographic area - you don't want to have to go through a complete eye exam more than a couple times. The surgeon will discuss the pros and cons and risks and complications of the procedure with you. Again, if that doesn't happen, you're in the wrong office. A surgeon with your best interests in mind will not guaranty you a result and will not tell you there are no risks and complications. There is no such thing in medicine.

Go prepared to ask questions and make sure all your questions are answered. (See "Questions to Ask")

• How long have you been performing refractive surgery procedures? (Not less than three years.)
• How many total procedures have you done? (Not less than 500.)
• How many refractive procedures of the exact type you intend to use for me, with the same equipment, and the same refractive error, have you performed? (Not less than 100.
• What percent of your refractive surgery patients receive Snellen uncorrected visual acuity (UCVA) of 20/40 or better? (The CRSQA says you should be suspicious of any number that is greater than 90%, which is the norm.
• What percentage achieved 20/20 or better? (Around 65% is the norm; ask for proof if a higher number is stated.
• Will you provide me the names and contact information of at least ten previous patients who have had the exact same surgery with similar refractive error?
• Have you ever had malpractice insurance coverage denied?
• Have you had your license to perform refractive surgery revoked, suspended or restricted?
• Have you been convicted of a felony? etc.

As you can see, the CRSQA recommends asking tough questions that some may consider difficult or even rude to ask. But remember that your precious vision depends on your surgeon's competency. You need to be confident that you have chosen the right person. If you are not happy with the answers to your questions, consult another surgeon.