· LASIK (Laser In-Situ Keratomileusis) corrects nearsightedness (myopia), small amounts of farsightedness (hyperopia), and astigmatism. With the LASIK procedure, a thin layer of the cornea is lifted to create a “flap” that stays connected on one side. Next, the excimer laser sculpts the cornea with ultraviolet, laser light. Finally, the “flap” is returned to its original position and heals in place without the need for stitches. Visual recovery is typically rapid.
· PRK (Photorefractive Keratectomy) is done without creating a “flap” on the eye. Instead, the surgeon first removes the outer layer of the corneas, called the epithelium. Then, the same excimer laser used in LASIK sculpts the cornea with a cool, ultraviolet light. A soft contact lens is placed over the eye and then worn the first 72 hours following surgery to help the outer layer to grow back. There is a longer healing time, a longer visual recovery period, and more discomfort associated with PRK than with LASIK. Because no corneal flap is created and manipulated during PRK, it is technically easier for a surgeon to perform PRK than LASIK.
· LASEK (Laser Epithelial Keratomileusis) is a modified form of photorefractive keratectomy (PRK). However, unlike PRK, the epithelium is not removed in LASEK. The surgeon instead folds back the loosened epithelium so that the laser can reshape the exposed cornea. After laser application, the surgeon replaces the "epithelial flap" over the corneal bed and placed a bandage soft contact lens on top. Visual recovery after LASEK is generally faster than in PRK but slower than in LASIK.
Custom or Wavescan refractive surgery is a fairly new technology that gives a customized laser treatment to correct aberrations of the eye that conventional refractive procedures do not. Wavescan or Custom surgery involves a link from your eye to the excimer laser. This link provides a “fingerprint” image of your eye, allowing the laser to treat in a more precise manner.
Currently, the procedure costs $1500-2100 per eye. Generally it is not covered by insurance, but you should check with your insurance provider. Payment plans are available.
For many patients, LASIK is indeed painless. However some patients experience significant discomfort during and/or after the procedure. Discomfort during the procedure, if any, usually happens when the suction ring of the microkeratome (the flap maker) is seated on the eye. The suction can give the eye a modest to strong pressure sensation.
Nobody knows if there are significant long-term (beyond 15-16 years) adverse effects from LASIK. However, the scientific community does not foresee any significant long-term adverse effects.
Most people return to work within 2-3 days.
Refractive surgery is highly technology driven. Just like in the computer industry, there are constant advancements. The important question is whether the technological advances translate into proportionate increases in patient satisfaction. Because the level of patient satisfaction with modern refractive surgery is already so high, there probably will not be dramatic advances in satisfaction for most patients.
