Laser Vision Correction 101

The cornea is the window at the front of the eye which helps focus light to provide a clear visual image. The idea of correcting spectacle prescription through reshaping of the cornea was first proposed in 1949. Early efforts to manually reshape the cornea were attempted around that time, but yielded inconsistent results. Excimer lasers later revolutionized the field of ophthalmology due to their ability to precisely remove corneal tissue and the era of laser vision correction was born.

Photorefractive keratectomy (PRK) was the first widely-adopted form of laser vision correction. The first PRK procedure was performed in 1988. In this procedure, the corneal surface is reshaped using an excimer laser. The results and safety are excellent, but postoperative pain and a relatively slow recovery are common since the resulting abrasion on the corneal surface must heal. 

Laser in-situ keratomileusis (LASIK) is now the most common form of laser vision correction due to the excellent outcomes, safety, and rapid recovery. The first LASIK procedure was performed in 1990. In this procedure, a thin flap of corneal tissue is created using a cutting laser and this flap is lifted to allow reshaping of the inner cornea with an excimer laser. The flap is then placed back into position, which results in a shorter duration of discomfort and faster recovery compared to PRK. Utilizing modern lasers, over 90% of treatments result in vision that is 20/20 or better. 

LASIK may be used to correct nearsightedness, farsightedness, and astigmatism. The age-related need for reading glasses cannot be directly corrected with a laser. However, monovision may be utilized to reduce dependency on reading glasses. With monovision, the dominant eye is targeted for distance vision and the non-dominant eye is placed in focus at near. Using both eyes together, the individual experiences a blend of distance and near vision. 

As techniques and lasers have advanced, the safety of LASIK has improved significantly. In fact, it has been suggested that the risk of significant vision loss following LASIK is approximately 10 times lower than contact lens wear1. While most individuals can safely undergo laser vision correction, some may be at a higher risk for problems. Preoperative screening evaluations are important to identify these higher risk individuals prior to surgery. 

Studies have repeatedly demonstrated very high patient satisfaction with LASIK. For instance, an FDA-sponsored study found that 98% of patients were satisfied with their outcomes three months after surgery2

What should you do if you are interested in laser vision correction? 

A personalized LASIK evaluation is required to assess if you are a candidate for LASIK. To schedule your personalized LASIK evaluation, please call 888.466.2020. You will be advised to refrain from wearing contact lenses prior to your evaluation. Treating preexisting dry eye is also recommended to assure that your preoperative measurements are accurate. 

References 

  • Mathers WD, Fraunfelder FW, Rich LF. Risk of Lasik Surgery vs Contact Lenses. Arch Ophthalmol. 2006;124(10):1510–1511.
  • 2 Eydelman M, Hilmantel G, Tarver ME, et al. Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies. JAMA Ophthalmol. 2017;135(1):13–22. 

About the author

Image of Jesse M. Vislisel, M.D.

Jesse M. Vislisel, M.D.

Comprehensive Opthalmology, Cataract & Refractive Surgery, Corneal & External Disease,

Dr. Vislisel is a board-certified ophthalmologist specializing in cornea, external disease, and refractive surgery. He received
his medical degree from the University of Iowa in 2007 and graduated with Research Distinction. He then completed his medical internship in Tucson, Arizona and returned to the highly-ranked University of Iowa for his ophthalmology residency and fellowship training in cornea and external eye disease where he received the Fellow Teaching Award and the P.J. Lei...

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