Laser Vision Correction: What Are My Options?

Laser eye surgery is an increasingly popular way of improving or correcting your eyesight permanently. Many of us have heard of LASIK eye surgery, as it’s one of the most popular and commonly carried out vision correction procedures. However, what you may not know is that LASIK is just one of several types of eye procedures that are collectively known as laser vision correction or refractive surgery.

Here, Cleveland Clinic Abu Dhabi’s Eye Institute Staff Physician, Dr. Brian K. Armstrong, answers some of the key questions around this area of eye surgery, and explains four of the refractive surgery procedures:

What is laser vision correction?

Laser vision correction, or refractive surgery, is a procedure that is performed to correct or improve vision, and to reduce the need for people to wear either glasses or contact lenses. It can be used in cases of myopia (nearsightedness), hyperopia (farsightedness), presbyopia (age-related loss of near vision) and astigmatism (abnormal curvature of the eye that leads to blurred vision).

Refractive surgery usually involves a specialist eye doctor reshaping the cornea, the transparent and protective front part of the eye, in order to improve the eye’s focal ability.

There are several different types of refractive surgery including:

1. LASIK:The most common form of vision correction, LASIK stands for laser-assisted in situ keratomileusis surgery. During the procedure, one laser creates a thin flap in the front of the cornea. A second laser is then used to reshape the tissue underneath the flap. Once the reshaping is complete, the flap is replaced – post-procedure recovery is relatively fast and painless.
2. SMILE: Small Incision Lenticule Extraction is a minimally invasive laser surgery that is used to treat near-sighted prescriptions. A single laser is used to reshape the cornea, but without creating a flap. Again, recovery is fast and painless for the majority of patients.
3. PRK: Photorefractive Keratectomy is another form of laser eye surgery. In this procedure, the front of the cornea is treated and reshaped directly. As there is no flap created, it leaves the cornea stronger, however an abrasion is created, and it may take 3-5 days before the abrasion heals. The recovery from this procedure is slow and sometimes there is pain in the first couple days, but this procedure is often recommended for patients with thin corneas.
4. ICL Procedure: In this procedure, a very thin, soft intraocular lens is implanted in the front of the eye (behind the iris and in front of the natural lens). Microscopic incisions are made in the cornea to access the inside of the eye, and the lens is then implanted into the eye to improve the vision. This procedure is often used in cases of high prescriptions and when laser corneal refractive surgery isn’t recommended.

Refractive surgeries are typically short procedures, lasting around 15-30 minutes. They are usually performed on an outpatient basis and you will return home the same day.

Is LASIK the best option?

Not necessarily. While LASIK may be one of the most popular and well-known types of refractive surgery, it shouldn’t be regarded as the go-to treatment for everyone looking to correct their vision. Refractive surgery should be assessed on an individual basis, and your eye doctor will be able to explain in detail which type of surgery is best for you and why.

Are there risks with refractive surgery?

Refractive surgery is generally considered to be safe, but as with any form of surgery there can be risks, which differ from patient to patient. Ahead of any surgery, your eye doctor will discuss with you all the possible outcomes of the procedure and address any concerns that you may have.

Following laser eye surgery, it is common to experience some of the following symptoms:

• Light sensitivity. This is most often experienced when driving at night with glare from facing headlights. This usually resolves quickly after surgery.
• Red spots in the white parts of the eye, which again usually resolves quickly after surgery.
• Discomfort in the form of gritty or dry eyes. Artificial tears are usually prescribed to help counter this.

It can take between 1-6 months before things stabilize after refractive surgery, but should you have any concerns, always consult your eye doctor.

Can laser eye surgery permanently correct vision?

This is a common question related to refractive surgery, and the answer can be both yes and no. Yes, in the sense that reshaping the cornea or implanting a new lens are permanent changes to the eye, and are designed to treat the vision problems you have or had at the time of surgery.

However, eyes like other parts of the body will continue to change and to deteriorate with age, so that means that your vision could change again over time. Presbyopia, which as mentioned previously, is age-related loss of near vision, can begin around the age of 40.

Can I go blind as a result of laser eye surgery?

This is another common question related to refractive surgery, and the answer is no. If you maintain your follow-up after surgery and follow instructions related to your surgery, you cannot go blind after refractive surgery.