Is Laser Eye Surgery Safe?

Posted on November 4, 2011 by MarthaCook

Is Laser Eye Surgery Safe?Refractory vision problems such as myopia (nearsightedness), hyperopia (farsightedness) or astigmatism can often be corrected with laser eye surgery. Two of the main types of refractive eye surgery are Photorefractive Keratectomy (PRK) and Lasik eye surgery, one of the latest versions of laser surgery. Both are seen as safe procedures. Only an eye doctor (ophthalmologist) can tell you if PRK or LASIK procedures should work for you. With any surgery, there are possible risks and complications.

Pre-Surgery

After undergoing a complete eye examination, the doctor will give you his or her opinion about whether the surgery will be effective for your vision problem. Discuss the possible risks and complications of the procedure you are interested in undergoing. While this article discusses some of these potential risks, it is not all inclusive. Do your research and discuss these concerns with your eye surgeon before having laser eye surgery.

Photorefractive Keratectomy

Photorefractive Keratectomy was one of the first procedures using a laser in eye surgery. RK (refractive keratectomy) was invented in the early 1980s. In 1995, the FDA granted approval of an excimer laser for PRK. An excimer laser uses a cool ultraviolet light beam to reshape the cornea by precision removal (called ablation) of very small layers of tissue from the surface of the cornea. Reshaping the cornea (the clear covering of the eye) allows it to focus light more accurately onto the retina, providing better vision than before.

LASIK Surgery

Laser-Assisted In Situ Keratomileusis (LASIK) is another type of refractive surgery that corrects the shape of the cornea. When the cornea is even slightly misshapen, light cannot focus as directly on the retina (light sensitive cells on the back of the eye), and the images are blurry. With a LASIK procedure, the cornea is gently cut, using a laser or blade to make the incision so the cornea can be revealed. A computer will guide the laser in order to change the shape of the cornea, and then the membrane tissue that was moved aside to expose the cornea is reattached.

Recovery

While recovery from the discomfort of surgery takes only a few days, it can take up to six months before you have reached the maximum in vision improvement. Your ophthalmologist will schedule several follow-up appointments during that time to make sure your eye is healing correctly and to check the level of your vision.

Most patients are happy with the results of both PRK and LASIK surgery. Still, it is important to carefully weigh the risk and benefits of such a procedure, including your expectations for improved vision, age and health.

Surgical Risks

Although rare, some people lose vision after surgery. This loss of vision may uncorrectable even with glasses, contact lenses, or further surgery. When contemplating this risk, many people are happy to stay with contact lenses or glasses.

Post-surgery, a small percentage of people notice unusual vision complications, like having a halo effect around what you are seeing, glare, and/or double vision. These complications can all seriously impair vision, especially at night. After having these procedures, some patients do not see as well in situations of low light and contrast. This might be helped with corrective lenses, and may or may not diminish over time.

Another side effect of laser eye surgery is severe dry eye syndrome. This is when the eye can’t produce enough moisture. So it dries out and is extremely uncomfortable. This condition can cause occasional blurry vision and other sight issues. It may be permanent and can require the use of intensive drop therapy and further surgical procedures to correct the problem.

Results Differ from Person to Person

Although many people achieve 20/20 vision after surgery without glasses or contacts, not everyone does. Additional treatment may be required to achieve better vision, but it may not be recommended. Others experience improved vision but still need to wear corrective lenses. It is also likely that if you used reading glasses before surgery, you will still need them after surgery.

People whose farsightedness has been corrected through laser eye surgery may experience a diminishing of results with age. Discuss this possibility with your doctor before deciding to have surgery.

Possible Complications of Surgery

  • Cornea infection
  • Flap problems – These can include a growth of cells under the flap necessitating surgery, irregular or incomplete flaps, and irregular healing resulting in a distorted cornea. This problem can only be corrected with a corneal transplant.
  • Contrast sensitivity - sharpness, or crispness in vision can actually decrease. Objects may be fuzzy or grayish, even though you may have 20/20 vision. This is referred to as “Lasik 20/20 or 20/40.”
  • Under-or over-correction - These can be improved with glasses, contact lenses or retreatments.
  • Loss of visual acuity - Even with glasses or contacts, you might not be able to see as well after surgery.

Summary

Most people experience better vision with laser eye surgery, but as there are always risks to surgery, it is wise to discuss the risks thoroughly with your eye doctor. Some serious complications can include irregular healing that may lead to a misshapen cornea, infection of the cornea, improper reattachment of the flap (requiring additional surgery), and uncomfortable severe dry eyes.

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How Much Does Laser Eye Surgery Cost?

Posted on October 28, 2011 by MarthaCook

How Much Does Laser Eye Surgery Cost?Completed on an outpatient basis, most laser eye surgeries, including Lasik, only last from 10 to 15 minutes on each eye, from start to finish. The only anesthetic is in the form of eye drops that numbs the surface of the eye. One the eye is numb, surgery can begin. Typically a surgeon will take care of one eye, and then wait to see how it responds before working on the second eye. Occasionally the doctor will do the surgery on the left and right eyes during the same procedure.

The Procedure

During Laser-Assisted In Situ Keratomileusis surgery or LASIK, the cornea’s shape is changed permanently through use of an excimer laser. The doctor will first use a blade or laser devise to cut a flap in the eye’s membrane, leaving a hinge on one end. The stoma, or middle section of the cornea, is revealed when this membrane door is lifted back so the surgeon can use a computer generated pulse technology laser to adjust the cornea before reattaching the membrane.

Average Laser Eye Surgery Costs

Cost for laser eye surgery will vary greatly depending on the type, provider, and included costs. Typically the prices are given per eye, so if you are having surgery on both eyes, you will need to double the quote.

  • As of the last quarter in 2010, the average price for all types corrective vision procedures that utilize lasers, was $2,150 (remember, that is per eye) with the price typically including care after the surgery. This overall average amount includes all varieties of laser surgery, whether it is LASIK, Epi-LASIK or any others.
  • For microkeratome which utilizes a blade to excise the corneal flap, as well as excimer lasers that don’t use wave front analysis, the cost for one eye drops to $1,580.
  • A wave front-guided LASIK procedure, which uses a laser-created flap, the price is $2,170.

Extra Charges?

Extra charges might be added by LASIK surgeons for new technologies, including a custom wave front LASIK procedure they use for very precise corrections. Surgeons might also charge extra for a bladeless or all-laser LASIK procedure.
Wide variations can exist between an advertised price and what the procedure will include. Very few people actually qualify for a low price per eye, because most eyes require more extensive corrections, or more intensive follow-up post-surgery.

Actual Costs

The price you will actually pay for laser eye surgery depends on a number of factors, including which type of laser technology is chosen, whether a blade or laser is used to create the corneal flap, as well as the skill and experience of your ophthalmologist (eye doctor).

In addition, some surgeons include the cost of pre-operative examinations and follow-up visits in their fee, while others quote it separately from the surgery. This is the same for any post-operative medications. Some doctors include them, others list them separately, so be sure to get a detailed list of what is included in the price quoted to you.

Two other factors that determine the cost of laser surgery is whether or not retreatments are necessary and what part of the country you live in.

Options for LASIK Surgery

The standard LASIK procedure with the corneal flap created with a blade is the least expensive LASIK procedure and the oldest of the laser techniques. While the results of standard LASIK can be very gook, there is a higher incidence of complications. This includes problems with the flap, and vision issues that can include nighttime glare. These resulting vision issues are more prevalent with these older LASIK procedures versus the latest wave front technologies.

Wave front-guided LASIK is typically the highest-priced option for laser surgery. This new technology uses Excimer laser, creating a flap in the eye membrane with a device known as femtosecond laser. The use of this technology maps the eye with a computer to move the laser while it changes the shape of the cornea. The outcome of this type of surgery is typically better than standard LASIK.

Not only does the use of a laser to create the corneal flap eliminate the risk of most flap complications, it is seen as a safe, more comfortable procedure. This does come with a higher price tag however. Expect to pay about $500 to $600 more per eye for this technology.

Summary

Due in large part to the economy, average LASIK prices have not raised very much in several years. That trend looks like it will continue for a while until things change for the U.S. economy. This is due in part to the cost, causing potential candidates for laser surgery to stick with glasses and contact lenses for the time being instead of more expensive, although permanent vision correction choices.

Consumers need to be cautious about low-cost LASIK surgery advertisements. Make sure to read the small print, since as few as 10% of patients may actually qualify for the very low pricing. Know what is included and what is considered extra services for the cost of laser eye surgery.

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How Does Laser Eye Surgery Work?

Posted on October 21, 2011 by MarthaCook

How Does Laser Eye Surgery Work?Basic Information about the Eye

Simply put, the eye works much like the lens of a camera, in that it focuses light to create an image. With the camera, the light is focused onto film. In the eye, the cornea helps focus light onto the retina. The retina is a layer of light-sensitive cells that converts the light rays into impulses.

These impulses are sent to the brain, which recognizes them as images. Known as refraction, this bending and focusing of light is dependent on the contour of the cornea, which is the clear covering over the eye. If the cornea and eyeball are not shaped perfectly, the image will be blurry or distorted. The eyes inability to focus correctly is referred to as refractive errors.

What is a Refractive Error?

Refractive errors, caused by an imperfectly shaped cornea, lens, or eyeball are categorized into three basic types, with variations.

  • Myopia – People with myopia are often called nearsighted, meaning that only nearby images are clear. Far away objects are blurry.
  • Hyperopia – Often referred to as farsightedness, those who suffer from this can see things that are far away better than things that are near.
  • Astigmatism- Makes images blurry, regardless of whether they are near or far.
  • Both Myopia and Hyperopia can individually be combined with astigmatism.
  • Presbyopia – Typically affects those aged 45 and older, this condition causes farsightedness due to a reduction in crystalline lens elasticity.

Glasses or Surgery?

In order to correct eye problems and to make it easier to see, eyeglasses and contact lenses can be made to correct specific issues. Experts suggest if you are happy with wearing glasses or contact lenses, then continue to stay with them. For those not happy with the results of glasses or contacts, surgery might be a viable option.

Only an eye doctor can tell you for sure if you are a good candidate for surgery. With surgery, the shape of the cornea is altered, improving the focusing power of the eye. This type of surgery is called refractive surgery.

What Happens Before Surgery?

A complete eye examination will need to be performed by your eye doctor. He or she will likely dilate your pupils to fine-tune your prescription, as well as examine your eyes to ensure they are healthy. Usually this includes a, a retinal exam, glaucoma test, and a dry eye assessment.

Your eye doctor will also take the measurements on the curvature of your cornea and your pupils. She will map the topography of your eyes to look for a condition called keratoconus, which is a cone-shaped cornea, or other irregular astigmatism.

She will also measure the thickness (pachymetry) of your cornea. This ensures you will have enough tissue left when your corneas have been reshaped.

Your doctor will then engage you in a thorough discussion of the risks, benefits, options, and possible complications of laser eye surgery. After reviewing the informed consent form thoroughly, you will be asked to sign it.

The eye doctor will have specific instructions for you to follow prior to surgery. Follow these carefully as they can affect the outcome of the surgery.

During Surgery

Most laser eye surgeries, including Lasik, are completed on an outpatient basis. An eye drop that numbs the surface of the eye is used as the only anesthetic. From start to finish, the surgery only takes 10 to 15 minutes for each eye.

Both the left and right eye can be completed during the same surgery. However it is more common for surgeons to take care of one eye and then wait for several days or even weeks to check how the surgery went, and then do the second eye.

LASIK Surgery

One type of refractive surgery is LASIK. This option changes the cornea’s contour by using a laser. Using a blade or laser device, a flap is cut in the cornea, with a hinge left in one end. The changes are made to the cornea and then the flap is reattached.

Healing after Surgery

Healing is pretty fast, but taking a few days off from work may be wise. Any sports activities should be avoided for three days post-surgery, with impact sports off limits for a month or so. Driving is also prohibited until your vision has improved enough to do so. You will also be asked to avoid hot tubs, whirlpools, and swimming in general for two weeks afterward.

A few hours after surgery your eyes might burn a bit. If this happens it is important to leave the eyes alone and not rub them. Your eye doctor can prescribe a pain medication if necessary, to take care of any discomfort you experience. Your vision may be blurred the day of surgery, but will steadily get better by the next day. Typically you will be re-examined by your doctor the day after surgery to ensure proper healing.

Summary

For many people with either nearsightedness or farsightedness, eye glasses or contact lenses work well in correcting the problem. Other people opt for laser eye surgery, to actually reshape the eye and help it to focus correctly without the use of eyewear. Laser eye surgery is an outpatient procedure, with relatively quick recovery, and a good rate of improvement. Eye doctors will need to examine your eyes to determine if you are a good candidate for this surgery.

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