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Laser eye surgery is a safe and effective method of correcting visual problems, often removing the constant need for glasses. Our guide to laser eye surgery aims to cover all your questions, from what the procedure for laser eye surgery involves, the risks, the benefits and the different types of laser eye surgery.

There are 2 main methods of laser eye surgery:

LASIK Laser Eye Surgery

PRK Laser Eye Surgery

The major difference between the two surgeries is the way that the stroma, the middle layer of the cornea, is exposed before it is vaporized with the laser. In PRK, the top layer of the cornea, called the epithelium, is scraped away to expose the stromal layer underneath. In LASIK, a flap is cut in the stromal layer and the flap is folded back.

LASIK Laser Eye Surgery

LASIK is short for laser-assisted in situ keratomileusis and is a treatment for short-sightedness, long-sightedness, and astigmatism. This procedure makes use of a laser that is controlled by a computer in order to reshape the cornea. More often than not, the LASIK procedure will minimize the need for eye glasses or contact lenses. It is the most common type of refractive eye surgery today. The aim of refractive surgery is to change the shape of your cornea in order to bend light properly and focus the light on your retina accurately.

Why should you go through LASIK eye surgery?

LASIK can be used to treat these eye refraction errors

Myopia, nearsightedness, or short-sightedness. The front surface of your eye is flattened with the laser

Hyperopia, long-sightedness, or farsightedness. The central cornea is made steeper when the laser removes corneal tissue in this area

Astigmatism is corrected by reshaping the steepest part of the cornea and making it more spherical

How is the LASIK procedure performed?

The LASIK procedure will take around an hour to complete and can be performed on an outpatient basis. You will be awake for the entire procedure and in order to reduce discomfort and numb the pain, local anaesthetic will be applied. Your vision will be blurred throughout the procedure. Here are the steps of the LASIK process

The doctor will ask you to sit down on the reclining chair

In order to numb the area and reduce discomfort, anaesthetic drops will be applied on your eyes

Your eyes will be cleaned with an antibacterial wash

In order to keep your eyes open throughout the procedure, a special instrument will be used so that the eyelids are held in place

A suction ring will be placed on the eye so that there will be pressure on the cornea prior to cutting it

You will be asked to focus on a coloured light, this may be coloured green or red

On the surface of the cornea, a flap will be cut and folded back so that the doctor can reach the tissue underneath it. A special blade called a microkeratome will be used

The tissue that has been exposed will be dried

The laser will be put into position

The laser will be used to remove corneal tissue. A computer will be used to guide the laser in reshaping the cornea. You may notice a smell that is like burning hair during this process

When the right amount of tissue has been removed, the flap is put back into place within seconds

No stitches will be placed

You will be allowed to leave after a few minutes but you should take care of yourself and have someone drive you home

What happens after the LASIK surgery?

Right after the LASIK surgery, your eyes may feel itchy, watery, and blurry. In order to alleviate any discomfort, the doctor will prescribe certain medications or eye drops. In order to aid in the healing process, you will be required to wear eye patches while you sleep at night. You will be able to see right after the surgery although it won’t be completely clear yet. It may take a couple of months for your eye to heal and for your vision to completely stabilize. The chance of getting crystal clear vision after the surgery is also dependent on the clarity of your vision prior to the surgery. You will have to visit your doctor after forty eight hours in order to find out if your eyes are healing properly. There will be regular visits to your doctor for the next six months so that your healing is monitored and so that any complications will be spotted early on. You should avoid using make up for the first few weeks in order to prevent any foreign substances getting into your eyes. You should avoid playing any contact sports in order to prevent any trauma to the eyes. You will also be advised to refrain from water related activities like swimming and going into the sauna. You should ask your doctor when it would be best to return to your day-to-day activities.

What are the risks of the LASIK treatment?

Here are the risks that you have to take when you go through the LASIK treatment

Flap problems – complications can arise when the flap from the front of your eye is folded back during the surgery. Some of the complications may include swelling, too much tearing, and infection. Moreover, the outer tissue layer of the cornea could also grow in an abnormal way

Under correction – if not enough tissue was removed from the eye then the clarity of vision will not be as you expected. If you are nearsighted then there is a higher chance of under correction. Another refractive surgery may have to be performed on you within the year

Over correction – if too much tissue was removed from your eye then your vision may become over corrected. This is much harder to remedy than an under correction

Dry eyes – your eyes will feel dry for the first six months and your doctor may prescribe some eye drops in order to remedy the situation. For sever cases of dry eyes, you may have to go through another procedure and get special plugs placed on your tear ducts. This will keep your eyes wet and prevent the tears from excessive draining from your eyes

Astigmatism – if uneven tissue was removed from your eye then you may develop astigmatism. This is a complication that arises if your eye moves too much during the procedure. This will also need further surgery

Glares, double vision, and halos – you may experience difficulty seeing at night, see halos, glaring, and double vision after the surgery. You may be able to address this with eye drops although a second surgery may be more appropriate

You have to consult your doctor first before you go through the LASIK procedure. There are a lot of risks to take. Ask your doctor about the benefits and the risks of the procedure. Make sure that you are suitable for the procedure. Disclose all the necessary details to your doctor as much as possible. This will help both doctor and patient make sure about the suitability for the LASIK procedure or not.

Photorefractive Keratectomy - PRK laser eye surgery

Photorefractive Keratectomy can be abbreviated as PRK. This was the first method of laser eye surgery which was used to treat low refractive errors. It is a suitable surgery for those with thin corneas. PRK and LASIK are both classified as a laser eye surgery although each has its own advantages and disadvantages.

What are the advantages and disadvantages of PRK compared to LASIK?

LASIK patients experience lesser discomfort and they also get better vision faster than PRK. The improvement in PRK is slower and gradual. Surgeons usually choose PRK for patients who have larger pupils and thinner corneas. An excimer laser is used in the PRK process. Cool ultraviolet light is used to ablate small bits of tissue from the surface of the cornea in order to shape it properly. When the cornea is shaped properly, it will focus light on the eye and on to the retina properly as well, thus resulting in clear vision. PRK can be a great way to address problems of nearsightedness and farsightedness. For nearsighted people, the objective is to flatten a cornea that is too steep while for the farsighted people, the objective is to steepen a cornea that is too flat. PRK can also correct astigmatism by fixing an irregular cornea and making its contours smoother.

What happens before the PRK procedure?

First, your doctor will give a thorough examination of your eyes and find out the best way to correct your vision. Your doctor may recommend laser ablation or not depending on the findings. Corneal topographers will be used to take photographs of your eye and completely map your cornea. No one has a cornea that is perfectly round and this topographer will identify the irregularities including the flatness or steepness that must be revised in order to have clear vision. Before the actual procedure, you will also have to tell your doctor about any conditions that you may have that might interfere or affect the outcome of the surgery. There are some conditions that will disqualify you as a candidate for PRK surgery while there are some conditions that will make you postpone the procedure to a later date. You can ask your doctor about the details regarding this.

How is the PRK procedure performed?

PRK is usually performed as an outpatient procedure. The PRK procedure is very quick. It can take less than a minute. You will be awake for the rest of the procedure and not feel anything. Some oral sedatives will be given to you in order to minimize any discomfort. In general, people will not feel any pain when they go through the PRK procedure. Anaesthetic drops will be put on your eyes in order to minimize discomfort. You will have to lie down as the doctor puts the laser into its proper place. Eyes are operated on one at a time and a retainer is placed on the eyes in order to keep them open. With the anaesthetic drops, this will not be uncomfortable. There is a suction ring that will keep your eye pressurized and immobile throughout the procedure. There will be a laser machine that makes a steady clicking sound during the procedure. This sound is from the laser pulses that are being emitted. You may smell a faintly acid odour when tissues from your eye are being removed. The surgeon will have complete control over this laser during the procedure. It can be shut down any time just in case something wrong happens. When the procedure is finished, you will be asked to rest for awhile. If both of your eyes are getting operated on the same day then there may be a little time interval between eyes. There are even some people who have the next eye operated on the next week.

What happens after the PRK surgery?

You should always keep in mind the doctor’s advice after every surgery. You should rest amply, take your prescription medications diligently, and contact your doctor if you encounter any problems. Your eyes are just as vulnerable after the surgery compared to the surgery itself so you should take care after the procedure. Right after the PRK procedure, you will be required to rest at home. You should have someone drive you home after the procedure in order to be safe. You can go to work the following day although this is not advisable. It is best to take a week off and rest your eyes. You should avoid any strenuous exercise for a week because this could put stress on your eyes, cause trauma, and delay the healing. You should not rub your eyes. The doctor will examine your eyes as often as possible in order to monitor its healing progress. You may even be examined every day. You may have to wear a special bandage contact lens, apply antibiotic drops, and apply anti-inflammatory drops for a couple of weeks after the procedure. People usually achieve a twenty-twenty vision with PRK or even better although it is unavoidable to have cases where people get twenty forties and such. Come to think of it, twenty forty is already a decent vision range. You may need to wear contact lenses or eye glasses after the laser vision correction although your prescription levels will be much better than they were before you went through the procedure. Some postoperative complications that can arise include infections and night glares. When you are driving at night, you may notice halos or starbursts when you look at lights. Despite a successful surgery, people may still need to wear reading glasses or bifocal lenses when they hit their forties. Your eyes will become stiff as you age. This condition is referred to as presbyopia and it is inevitable. You will have trouble looking at objects up close. Looking at objects at a distance would still be okay for a time.