LASIK for Nearsightedness, Farsightedness, Astigmatism

LASIK, or Laser in-Situ Keratomileusis differs from PRK in that it corrects vision by reshaping corneal tissue under the surface of the cornea, rather than on the surface. LASIK combines the use of an Excimer laser with an instrument called a microkeratome. After the eye has been numbed using eye drop anesthesia, an eyelid holder is placed between the lids to prevent blinking. The surgeon uses a  microkeratome to make a flap of tissue on the cornea. This flap is one sixth to one eighth of a human hair in depth and works as the eyes own natural bandage, promoting quicker visual recovery and comfort. The flap is folded back in place after the laser is used to reshape the cornea. The laser treatment itself lasts an average of a minute or less.

Because LASIK is performed under the protective layer, or flap, there is less surface area to heal, less risk of corneal haze, less postoperative discomfort, and less need for postoperative medication. While your Doctor will encourage you to protect your eyes from bumping or rubbing by sleeping in protective shields for one week, the flap is sealed into place after approximately two minutes under the laser. If the flap is in good position after 24 hours flap complications are rare.

 LASIK can also treat a higher range of nearsightedness, farsightedness and astigmatism than PRK. However, because of the use of the microkeratome, LASIK carries additional surgical risks as compared to PRK.

Realistic Expectations

The goal of any vision correction procedure is to reduce your dependence on corrective lenses, such as glasses or contact lenses. Laser vision correction does not always result in 20/20 or even 20/40 vision. Some patients might even lose a line of best correction vision, or a line on the vision chart that might otherwise be seen with glasses or contacts. Also, laser correction cannot correct or prevent a condition known as presbyopia, or aging of the eye, that normally occurs around age 40 to 50 and requires the use of reading glasses. [One of the ways to address the condition of presbyopia is to use a technique referred to as monovision.]  More...

People over 40 who have their nearsightedness reduced with surgery may find they need reading glasses after the procedure.

One way of managing the need for reading glasses in a patient who desires LASIK is to use a surgical technique called monovision. The surgeon corrects the dominant eye all the way to distance and slightly undercorrects the non-dominant eye so that the brain automatically makes the adjustment. When the patient looks in the distance the distance eye is at work when the patient looks down to read or use a computer the eye corrected for reading does the work.

Many patients in reading glasses enjoy this option. It allows the patient to have a limited need for reading glasses. This option does not give infinite levels of vision. A patient may feel more comfortable with a pair of glasses in their glove compartment that corrects the reading eye to distance if traveling on unfamiliar roads at night. A patient may pick up a pair or readers to thread a needle close to their face. However, this option does allow for more overall freedom and independence from glasses.

A small portion of people do not adjust to monovision and find it disconcerting. In this case the monovision eye can be enhanced and corrected all the way for distance vision. If this occurs, a patient would then need reading glasses.

The best patient for monovision is a patient who has tried monovision in a pair of contact lenses. Our refractive surgeons can arrange for you to try this in a pair of contact lenses prior to surgery.

Your First Step

To determine if you have healthy corneas and if you are a candidate for laser vision correction, a two and one-half hour full eye dilation and examination is necessary. At your screening exam we will review our surgical outcomes database with you and show possible projections based on the amount of desired visual correction.

People with certain medical conditions or pregnant women may not be good candidates

The Moran Eye Center offers its comprehensive refractive surgical screening at no cost. If it is determined that you are not a candidate, there is no charge. This $200-plus value free refractive screening is considered part of the global fee. If for some reason you elect to opt out of the surgery, there is no charge for the refractive screening. (If, however, some eye condition is discovered that is abnormal and should be treated, your insurance will be billed accordingly, or you may be held responsible for such payments.)