If I have LASIK or PRK, how long will
it be before I have my best vision?
Answer:
LASIK patients typically enjoy very rapid recovery of visual acuity, often
seeing well the day of or the day following the procedure. PRK patients take longer
to recover good vision, perhaps days to weeks before seeing as well as patients
undergoing LASIK. However, in patients who undergo PRK, those with very minimal
refractive error (e.g. -2.00 diopters) recover much more quickly than those with
high refractive error (e.g., -8.00 diopters). As such, some ophthalmologists still
prefer to recommend PRK to patients with low myopia (minimal nearsightedness).
Best vision typically occurs within 2 to 3 weeks in LASIK patients and within
6 weeks to 6 months in PRK patients. I
wear bifocals presently. Will I still need them after LASIK or PRK? Answer:
Most likely you will. There is no procedure as yet that has accurately and predictably
corrected presbyopia, which is the loss of near focusing capability that we all
experience as we age. Most people in their 40's and older begin to require near
correction, such as bifocals or reading glasses. However, all patients who undergo
refractive surgery might want to consider monovision. This is the correction of
the dominant eye for distance and the opposite eye for near.
A good method
to evaluate monovision pre-operatively is to wear contacts for monovision. Many
patients, however, will not tolerate this type of vision. Be sure to discuss monovision
in detail with your surgeon if you believe you might be a candidate. Do
the LASIK or PRK procedures cause pain? Answer:
LASIK and PRK procedures are not associated with any pain or discomfort during
the procedure, as the eye is topically anesthetized. LASIK patients are generally
very comfortable following the procedure, usually without even the slightest discomfort.
PRK patients, however, are more likely to experience mild discomfort during the
first 24 to 72 hours following the procedure while the surface epithelium of the
cornea heals. Can anyone with
refractive error have LASIK? Answer:
The great majority of patients with nearsightedness, farsightedness, and astigmatism
may now be treated with LASIK. However, individuals with refractive errors in
the extreme range may not be candidates. Both the type of laser used and the surgeon's
recommendations will play a role with these issues. How
long have the Excimer laser procedures (LASIK and PRK) been performed? Answer:
PRK was first performed in the U.S. in 1987 and LASIK has been performed since
about 1990. Clinical trials led to FDA approval of PRK in 1995 and to FDA approval
of LASIK in 1999. How many people
have recently had Excimer laser procedures (LASIK or PRK)? Answer:
In the U.S. alone, approximately 400,000 people underwent Excimer laser procedures
in 1998, 900,000 people in 1999, and about 1.3 million people in the year 2000.
The great majority of these procedures are now LASIK. Which
refractive procedure do ophthalmologists most commonly recommend and why? Answer:
Today, ophthalmologists most commonly recommend LASIK. This is certainly because
LASIK has shown an extremely low complication rate, a very high degree of success,
and rapid recovery of vision. Have
any ophthalmologists (Eye MDs) had LASIK or PRK themselves? Answer:
It is now known that at least several hundred ophthalmologists have underwent
either LASIK or PRK. This might be considered extraordinary testimony to the procedures
given that, in the U.S., there are only about 20,000 ophthalmologists in practice.
Besides Intacs corneal rings,
are any of the refractive procedures reversible? Answer:
Of the FDA approved procedures, only Intacs corneal ring prescription inserts
are fully reversible. Of the few patients who've had the Intacs removed, all have
returned to 20/20 or better best corrected visual acuity. LASIK and PRK are permanent
procedures and are irreversible. I've
heard about an implantable contact lens (phakic IOL). Are these FDA approved? Answer:
Implantable contact lenses (phakic intraocular (IOL) lenses) are presently considered
investigational, i.e., they are presently being evaluated in FDA clinical trials.
The implantable contact lens appears extremely promising, however, and may be
available soon. What is clear lens
replacement (CLR) and who is the best candidate for it?
Answer: Clear lens replacement entails removing
the natural lens of the eye and replacing it with an intraocular lens (IOL) implant.
This procedure is much more invasive than LASIK, PRK, or Intacs, as it is similar
to cataract surgery with a lens implant. This procedure is, therefore, associated
with a potential risk of infection inside the eye and retinal detachment, among
other risks. However, the procedure may still be an excellent option for those
patients who are not candidates for other refractive procedures due to extreme
degrees of refractive error.
Patients who undergo CLR will lose accommodative
(near focusing) abilities as well, and therefore, the procedure may best be considered
by those patients who are over 40 years of age. The Array multifocal IOL implant
might play a significant role in patients who undergo CLR, as this IOL allows
a much greater range of vision without spectacles than the traditional monofocal
lens implant Do refractive surgeons
still offer or recommend radial keratotomy (RK)? Answer:
Despite being an excellent procedure for low myopes, RK has largely been supplanted
by LASIK, PRK, or Intacs. Some surgeons still offer RK for low myopes (under approx.
-3.00 diopters), however, the procedure is obviously falling into disfavor even
for low myopes. This is likely either because of the perceived greater accuracy
and precision of the Excimer laser, the accuracy and reversibility of Intacs,
or because RK is known to weaken the cornea leading to a greater risk of wound
rupture with blunt trauma to the eye. Will
I be able to afford refractive surgery? Is the cost of the procedure tax deductible?
Answer: Many laser centers can recommend
financing options to allow a low monthly fee arrangement. Furthermore, some medical
flex plans will allow payment of the procedure with pretax dollars. Check with
your employer regarding this option. The cost of refractive surgery procedures
may also be tax deductible (on U.S. federal income taxes). Check with your accountant
to find out if the procedure may be considered a deductible health expense.
Type of the Refractive Surgery
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