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Lasik eye surgery: how it works and what to expect

Chandler Pullen

The eye is one of most complex organs in the human body. There are different muscles involved in moving your eyes across this page to read, and many internal components allowing you to see the words and focus the light from your computer screen.

But in many cases, how your eyes refract light can be impaired, requiring you to wear glasses or contact lenses. Dr. Bryan Lee, a LASIK specialist who was named one of the top 40 ophthalmologists under 40 in the world, and serves on the Council of American Academy of Ophthalmology, speaks with us this week on “Take Care” and explains the alternative to eye glasses and contact lenses.

Lee says there are two forms of laser eye surgery—PRK, which stands for photorefractive keratectomy, andLASIK, which stands for laser assisted in situ keratomileusis. But what the “K” stands for in each of these is what sets the two surgeries apart.

Keratectomy means to remove surface cells, and keratomileusis means to re-shape the cornea, according to Lee.

“With LASIK, we make a flap in the cornea and we lift up the flap and we apply the treatment laser to re-shape the cornea, correct your refractive error, and then put the flap back down,” Lee said. “With PRK, you actually don’t make a flap; you just remove the surface cells, you directly apply the exact same treatment laser as LASIK, and then you let the surface cells re-grow.”

Although Lee says for some patients PRK can be a safer option if you have problems with your cornea, LASIK surgery is more popular. In most instances, patients who receive PRK surgery are subject to more discomfort, since cells are being removed from their eyes, and it can take one to two weeks to recover, leaving the patient with blurry vision during that time. Since LASIK does not remove any cells, the recovery rate is much faster, allowing patients to see clearly as soon as the next day.

There are certain screenings of the eye prior to surgery to make sure it is healthy enough, but Lee said most people are eligible candidates for LASIK. Qualifying reasons to undergo the surgery include near-sightedness, far-sightedness, and astigmatism. 

Lee said LASIK is a fairly simply surgery, it is an outpatient procedure, and only takes about 10-15 minutes per eye. However, the surgery does require sedation to keep patients safe from moving when the treatment laser is applied.

Although for many people laser eye correction fixes their refractive error on the first treatment, Lee says there’s about a 5 percent chance a patient may need to go back for an enhancement surgery.

“The worse your refractive error is, the greater the chances your first treatment may be a little bit off, but if you look overall at how patients do I’d expect 98, 99 percent of patients to see well enough to be able to drive without correction. So that’s 20/40 or better vision,” Lee said.

Because a laser is puncturing your eye in LASIK surgery, some people may worry that loss of vision could be a side effect, but Lee assures that the risk of this is almost zero at less than 1 percent. Other side effects, however, can include dry eyes, glares and halos around light at night time, slight pain, infection, and scarring.

Lee also said that over a long period of time it is possible for eyesight to regress a bit back toward its original refractive error.

“The amount of regression is very difficult to study and to define because the technology has changed so much over that time period, but I would say for most patients if you look 10 years later, in general they’re doing great,” Lee said.

Some patients may find that by their mid-40s they require the use of bifocals however, but Lee says this is a process that would happen naturally with age even for a person that never received laser eye surgery.

“The lens inside the eye, over time, does become less flexible. That’s going to happen regardless,” Lee said.

But if you’re sick of dropping contact lenses down the sink and reaching for your glasses just to read a simple sentence, LASIK eye surgery may be something to consider.