Laser Vision Correction (LASIK and PRK)
Am I a candidate? | PRK vs LASIK | LASIK consent form | Hidden Danger!
The term Laser Vision Correction usually
refers to the surgical correction of refractive errors using ultraviolet
or "Excimer" lasers. Basically your prescription is permanently etched
onto your eye. PRK (Photorefractive Keratectomy) is an FDA approved procedure
for correcting nearsightedness, astigmatism, and farsightedness that uses
an excimer laser to remove a thin layer of the surface of the cornea.
LASIK (laser assisted keratomileusis) is a similar FDA approved procedure
that uses an excimer laser to remove a thin layer of tissue from inside
cornea. LASIK starts with a specialized instrument (keratome)
lifts a flap off the top of the cornea. After the flap is lifted, the excimer
laser is used to correct your vision, then the flap is smoothed back into
The Lasik Procedure. Note the lifted corneal flap to the left.
The goal of laser vision correction, and every other type of refractive surgery, is to make you less dependent on glasses and contacts. OK, usually this means far less dependent, but you need to keep in mind that some people still wear glasses at times to view distant objects, especially under conditions of dim light. Additionally, many if not most people eventually need glasses in order to read. Anyone who tells you otherwise either doesn't know what they're talking about, or is purposely misleading, and they might even be violating truth in advertising laws.
Am I a candidate for Laser Vision Correction?
The best way for me to answer that question is for you to come in to the office for a FREE CONSULTATION. Be certain to bring in your glasses, or your contact lens prescription. Before surgery, all candidates must also have a complete eye exam including a cycloplegic refraction, and they must have realistic goals. Only a qualified ophthalmologist who performs these procedures can determine whether or not you are a good candidate. However, there are several selection criteria that are listed below:
Age: You must be at least 18 years of age. There is no upper age limit, however, the average age of people having cataract surgery is about 75. If you have cataracts, or if you are in your "golden years", you would probably be better off just having "Clear lens extraction," which is just a fancy term for cataract surgery. (P.S. EVERYONE gets cataracts, there are no exceptions). In fact, in general I DO NOT RECOMMEND laser vision correction to anyone over the age of 70, and you probably should not have the procedure done if you are over 65. There is one very important HIDDEN DANGER OF LASER VISION CORRECTION that you need to consider: basically, it is very difficult to accurately determine what implant you need after cataract surgery when you have had any type of corneal refractive surgery (i.e. RK, PRK, and LASIK).
General Health: Pregnant women and patients with autoimmune, immunodeficiency, and certain collagen vascular diseases should not have this surgery. Patients taking Accutane (isotretinoin) or Cordarone (amiodarone) should not have this surgery, and they should really wait for several months after stopping these medications before having the procedure. CAUTION: DO NOT STOP TAKING YOUR MEDICATION UNLESS INSTRUCTED TO DO SO BY YOUR PHYSICIAN.
Ocular Health: In general, your eyes must be free from diseases, although there are certain exceptions.
Stable Refraction: You must not have had any significant changes in your glasses or contact lens prescription in the past 18 months.
Range of Refraction: Laser Vision Correction should only be used for low to moderate amounts of near-sightedness (myopia), far-sightedness (hyperopia) and astigmatism. People with very high refractive errors (greater than 5 diopters of hyperopia or greater than 10 diopters of myopia or greater than 4 diopters of astigmatism) may want to consider Clear Lens Extraction, but should probably wait for different technologies, like implantable contacts.
Which is better PRK, or LASIK?
Long term, both PRK and LASIK appear to be equivalent.
The principle advantage of LASIK is convenience: recovery is much faster than with PRK, and both eyes can be corrected on the same day.
The principle disadvantage to LASIK is that there is a higher rate of complication during the procedure (intraoperative). The keratome instrument used to create the LASIK flap is associated with certain complications that cannot occur during PRK, where we don't use a keratome...
In general I now recommend LASIK for:
most people with up ten diopters of myopia, or myopia plus astigmatism, and for most people with up 5 diopters of far-sightedness, or far-sightedness with astigmatism.
In general I now recommend PRK for:
LASIK is by far the most common refractive procedure these days because it has a very fast recovery time, and is much more convenient. We tend to place a high value on convenience, but if you have a very low refractive error of if you are a professional kick boxer, you may want to consider for PRK instead of LASIK.
Well, if you were paying close attention, you probably noticed that I recommended both PRK and LASIK for low myopic corrections, I recommended PRK or NO refractive surgery at all for very high myopic corrections, and LASIK for most people with moderate amounts of myopia, hyperopia, or astigmatism.
OK, now give me
ALL the gory details about LASIK......
(This link takes you to a copy of my consent form for LASIK), and
Guess what, there really is a hidden
danger of LASIK!!!
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