Refractive surgery in Boston, and across the globe, should be performed by a surgeon with extensive training and experience. Dr Kornmehl is a leading expert in refractive surgery and laser vision correction. He explains on this webpage how refractive surgery improves vision and whether you should consider this surgery.
Refractive Eye Surgery
What is refractive eye surgery?
Most people are aware that there are new developments in eye surgery intended to reduce dependence on glasses and contact lenses.
Refractive surgery includes several surgical techniques designed to improve problems in focusing the eyes, also known as refractive errors. Until 1989 only glasses or contact lenses could correct refractive problems.
What are refractive problems?
Light is focused, or refracted, by the cornea, the clear front “window” of the eye. Your vision is clear if the cornea and lens combine to focus an image precisely on the retina. The retina is the inner layer of the eye that senses light and helps you to see.
Your vision is blurred if the cornea, lens and eye length place the image in front of the retina. This is known as myopia, or nearsightedness.
Your vision is blurred if the cornea, lens and eye length place the image in back of the retina. This is known as hyperopia, or farsightedness.
If the cornea is not round (like a basketball), but instead has unequal curves (like a football), the image is distorted. This is called astigmatism. An eye with astigmatism may have myopia or hyperopia as well.
Refractive problems such as myopia, hyperopia and astigmatism are solved by helping the eye to focus light using glasses, contacts or refractive surgery. Refractive surgery techniques aim to change the eye’s focus by changing the shape of the cornea.
How safe & effective is laser vision correction?
The Excimer laser is used to correct myopia, hyperopia and astigmatism. There are several thousand people in the United States who have had Excimer laser surgery through research studies that are authorized and reviewed by the Food and Drug Administration. The Excimer laser is now approved in the United States.
In a process called photorefractive keratectomy (PRK), the Excimer laser precisely sculpts the surface of the cornea using invisible, high-energy light. No surgical blades are used. The surgery takes about 15 minutes using eye drops to anesthetize the cornea. Complications during the procedure itself are very rare.
Following PRK or LASIK for mild to moderate myopia or hyperopia, 100 percent of patients are 20/40 or better and can drive a car without corrective lenses.
Some patients may experience halos for the first three months following LASIK or PRK that often resolves.
Over 70 percent of people report some halos or glare after PRK, especially at night; these symptoms usually decrease over 3 to 6 months. However, most people are pleased with the improvement in eyesight unaided by glasses or contact lenses following PRK.
Should you consider refractive surgery?
You might consider laser vision correction if you:
- Wish to decrease your dependence upon glasses or contact lenses;
- Are free from eye disease;
- Have the appropriate refractive error.
Refractive surgery offers an alternative to dependence upon glasses or contact lenses. You may not be a good candidate for refractive surgery if you are generally happy and comfortable with your glasses or contacts. After refractive surgery, a small percentage of people still use glasses or contact lenses for certain situations, depending on your previous refractive error or if you have presbyopia.
Laser eye surgery, contacts and glasses for the correction of refractive problems each have their benefits and drawbacks. The best method for correcting your vision should be decided after a thorough examination and discussion with Dr. Kornmehl.