| Choosing the Laser-assisted Refractive Surgery |
| Written by Helen White | |
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Laser-assisted refractive surgery is one of the medical miracles of the modern age, and has allowed millions of people to correct their vision without the use of prescription eyeglasses or contact lenses.
According to recent medical journals, more than a million people underwent laser-assisted refractive surgery last year, and that number is expected to grow in the future as the operation becomes more widely understood and accepted, and more insurers are driven to cover it by consumer demand. In general, laser-assisted refractive surgery corrects defects in vision such as myopia or hyperopia by using a laser to fix deformities in the curvature or shape of the cornea. The device used in the surgery is an excimer laser, a computer-guided "cool" laser that emits a beam of light that abalates undesired tissue, allowing the surgeon to sculpt the cornea without harming surrounding tissue. The benefits of this surgery are the reduction or elimination of the need for glasses or contact lenses, in most cases, and an almost immediate improvement in the patient's vision. Although there is a risk of failure in all surgeries, laser-assisted refractive surgery has a remarkable success rate, thanks to the skill of its practicioners and the accuracy of the computer-guided excimer laser. While the most well-known laser-assisted refractive surgery technique is LASIK, there are a variety of other laser-assisted surgical techniques that can be used to improve patients vision. Understanding each technique is important for patients as they consult with their doctors concerning which option they should take for improving their vision. Laser-assisted in-situ keratomileusis, as stated before, is the best known form of laser-assisted refractive surgery. Over a million people underwent the surgery in the U.S. last year, and, next to cataract surgery, it's the second most commonly performed eye surgery in the U.S. It can be used to treat nearsightedness, farsightedness and astigmatism In LASIK surgery, the surgeon cuts a flap in the surface of the cornea with a blade and then uses an excimer laser to sculpt the tissue beneath the flap. The laser sculpting takes about a minute to complete. Once that is done the flap is pulled down and replaced. Good candidates for LASIK surgery are folks 18 or older who have had stable refraction for about a year. If they're nearsighted, their myopia should be between -0.5 and - 14.0 diopters. If they have astigmatism, it should be less than or equal to 5.0 diopters. If they're farsighted, their hyperopia should be less than or equal to 6.0 diopters. LASEK surgery is a more recent innovation in laser-assisted refractive surgery. In LASEK, alcohol is used to weaken the surface cover of the cornea, known as the epithelium, which is then lifted off mechanically. The excimer laser is then used to sculpt the cornea, and the epithelium is replaced. In general, the same requirements mentioned for LASIK apply, but LASEK may be better for patients who have thin corneal tissue. Epi-LASIK is a new form of LASIK which uses a special device to peel the epithelium. The excimer laser is then used to sculpt the cornea, and then the epithelium is replaced. The benefit of Epi-LASIK is that it's gentler than LASIK and can be used for patients with thin corneal tissue. The disadvantages are that the visual recovery time is longer and there may be more post-operative complaints of discomfort. PRK, or photorefractive keratectomy, is a procedure in which the ophthalmologist uses an excimer laser without cutting a flap or lifting the epithelium. PRK was approved by the FDA in 1995 and is good for mild-to-moderate myopia. PRK has a pretty good success rate but its recovery time is significantly longer than LASIK surgery. PRK's use is beginning to decline as Epi-LASIK is becoming the surgery of choice for patients with thin corneal tissue. In general, if you have mild to moderate myopia, youre a good candidate for LASIK, Epi-LASIK, LASEK or PRK. If your myopia is sever, your choices are limited to LASIK, Epi-LASIK or LASEK. For folks with mild or moderate hyperopia, your options are LASIK, Epi-LASEK, or PRK. If you have severe hyperopia, your options are LASIK, Epi-LASIK or LASEK. For presbyopia, an age-related weakening of the eye's ability to focus, a good surgical option is conductive keratoplasty, which uses radio waves instead of a laser. Don't be afraid to ask questions of your doctor when he or she recommends a specific procedure for your eye surgery. Make sure you go over all the pros and cons of each procedure before settling on a choice, and don't be reluctant to seek a second opinion if you feel that it is necessary. Your eyes are one of your most important assets, and getting the best possible care for them is important. |
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