Over one million Americans undergo laser eye surgery every year. The procedure was approved in the U.S. in 1996 after another surgery, radial keratotomy (RK) paved the way a decade earlier.
RK uses actual blades instead of laser to correct nearsightedness (difficulty seeing faraway objects). Most laser surgeries still use a blade during the first half of the procedure -- creating a corneal flap -- but utilize lasers to make the incisions that correct vision.
What is Laser Eye Surgery and How Does It Work?
Laser eye surgery reshapes the cornea to correct myopia (nearsightedness), hyperopia (farsightedness, or trouble seeing close up) and astigmatism (a faulty curvature of the cornea that makes vision blurry). Patients' eyes are numbed but they are awake during the procedure.
There are several kinds of laser eye surgery, but the most common is called lasik, which stands for laser in situ keratomileusis. Lasik follows most of the same steps as other laser eye surgeries:
- The procedure begins with a fine, steel blade called a microkeratome to cut a small flap from the cornea.
- Next, he or she uses a laser to reshape the collagen beneath the cornea.
- Incisions are made using measurements of the patient’s eyes made prior to surgery.
- The flap goes back into place.
Lasik and other laser techniques typically take 10 to 15 minutes per eye and physical recovery is as little as one day. Many people notice a marked, immediate improvement but it may be three to six months before vision reaches its optimal level: 20/20 (considered perfect) to 20/40 for 95% of patients. A few achieve better than 20/20 vision and some will still need corrective lenses especially for certain tasks.
Laser Eye Surgery Not for Everyone
Many people are not eligible for laser eye surgery including:
- Those under 18
- Pregnant and breastfeeding women (both conditions temporarily alter your prescription)
- Anyone whose prescription has changed in the past year
- People with chronic autoimmune disease or conditions that impede healing
- Patients on medications impacting healing or vision
- Anyone who's had a serious eye inflammation, or herpes eye infection
- Those with glaucoma
- People with exceptionally thin or damaged corneas, extremely large pupils or very dry eyes
- Athletes or others who regularly risk blows to the eye
- Anyone whose career prohibits lasik, such as some aviation employers
Alternatives to Lasik Eye Surgery
There are alternatives for people who aren't good candidates for lasik or those who want to make a different choice.
- Custom wavefront lasik: This technique differs from regular lasik in that doctors use computer automated readings to take much more precise measurements of the eye, usually resulting in better outcomes.
- Bladeless lasik: Sometimes called intralasic, this more expensive method is just like lasik except it uses a laser, not a blade, to create the corneal flap.
- Lasek: This procedure is similar to lasik but it involves making a much thinner corneal flap, so it's better for people who have thinner or flat corneas.
- Photo-refractive keratectomy (PRK): Using this method, the cornea is not cut. Instead, the surgeon removes the entire outer layer of corneal cells, which is better for those with thin or flat corneas or large pupils. Only one eye undergoes PRK at a time.
Risks and Complications of Laser Eye Surgery
Good vision involves much more than seeing clearly. Temporary and even long-term complications can arise from any laser surgery. These usually go away in time, and may include:
- Loss of crisp vision: Many patients describe a sharpness that's lacking even when their post-surgery vision tests well.
- Dry eyes
- Poor night vision due to halos, glare and starbursts, which usually disappear after six weeks, but not in all cases.
- Overcorrection/undercorrection: Nearsighted people may become farsighted, for example.
- Diffuse lamellar keratitis (DLK): A rarely occurring inflammation that must be treated immediately to avoid eye damage.
Choosing a Laser Eye Surgeon
Don't select a surgeon based on their frequent advertising. Instead, look for someone who's affiliated with a teaching hospital or a facility known for advanced technology.
Referrals can also come from a trusted medical professional or someone who's had a successful surgery. Names of doctors are also available on the American Academy of Ophthalmology website.
It's helpful to prepare a list of questions for doctors under consideration to find out how many such surgeries he or she has done and what percentage have been successful.
Cost of Laser Eye Surgery
Laser eye surgery is considered a cosmetic procedure and is not covered by insurance. The cost depends on location, but the fees can run from $499 to $2,500 per eye for lasik. Bladeless lasik will add about $500 or more to the cost for each eye.
Fees that run much lower can indicate false advertising or be a sign that the equipment may not be up to date.
Related Laser Eye Surgery Sources
About.com Laser Eye Surgery Cost [1] About.com History of Laser Eye Surgery [2] About.com Intralasik [3] About.com Lasik Expectations [4] About.com Lasik Not Right for Everyone [5] About.com Lasik Surgery [6] About.com Lasik Explained [7] About.com Vision Correction Surgeries [8] All About Vision Choosing a Surgeon [9] All About Vision Lasik [10] All About Vision Photorefractive Keratectomy [11] American Academy of Ophthalmology Finding a Surgeon [12] Docshop.com Lasik Cost, Complications [13] Eye Surgery Education Council Complications [14] Eye Surgery Education Council Costs [15] Eye Surgery Education Council Doctor Questions [16] Eye Surgery Education Council Surgery Diagrams: [17] FDA: Lasik Surgery [18] ImproveYourVision.com Blade-Free Lasik [19] LaserEyeSurgery.net Laser Surgery [20] LaserEyeSurgery.net Surgery Types [21] LaserEyeSurgeryReview.com Laser Surgery [22] LaserEyeSurgeryReview.com Custom Wavelength Lasik [23] Lasik Surgery News What’s New In Lasik? [24] LocateADoc.com Finding a Doctor [25] Medicinenet Lasik [26] National Institutes of Health Laser Eye Surgery [27] WebMD Lasik [28] WebMD Radial Keratotomy [29]