Guide to laser eye surgery

Most people are happy with the results of their laser eye surgery.
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  • Updated:3 Apr 2007

03.Techniques and technologies

LASIK (laser-assisted in situ keratomileusis)

The procedure
  • The surgeon cuts a tiny flap in the outer layer of the cornea so a laser can reshape the tissue underneath, before the flap is placed back over the treated area.
  • The flap is either cut with a miniature scalpel or created ‘blade-free’ with a fast, computer-guided femtosecond laser, which is also called by its brandname, IntraLase.
  • Currently the most popular procedure — your eyes should feel fairly comfortable the day after surgery, when you can probably resume normal activities.
  • The more effective option if you’re more severely short- or long-sighted.
On the downside
  • It has been linked to the rare condition ectasia, where the cornea bulges out because it’s been structurally weakened, resulting in poor-quality vision.
  • There’s a small but significant additional risk of surgical complications, mostly associated with the corneal flap — it can get lost or damaged, cut incompletely or completely cut off, to name a few. However, the developments in computer-guided femtosecond laser technology are designed to improve precision and make flap creation safer.

PRK (photorefractive keratectomy)

The procedure
  • A type of laser treatment to the surface of the eye that entails no flap creation. Instead the surgeon scrapes off a portion of the very top corneal layer — it’ll grow back naturally — before reshaping the surface with a laser.
  • A simpler procedure than LASIK with a lower potential for complications — the most common technique before LASIK gained popularity during the last decade.
  • Particularly suitable for correcting lower degrees of short-sightedness and astigmatism.
  • May also be recommended if you have a very thin cornea.
On the downside
  • Compared with LASIK you’re likely to feel more discomfort.

LASEK (laser-assisted subepithelial keratomileusis) and EpiLASIK (using a finer tool)

The procedures
  • Modified and refined procedures based on PRK, where the top layer of the cornea is pushed aside during the surgery and replaced afterwards to preserve more corneal tissue. However, both procedures still involve laser surgery on the surface of the cornea, not inside the eye, as with LASIK.
  • Developed as a treatment for people whose cornea is unsuitable for LASIK.

Wavefront-guided technology

  • The latest development in laser eye surgery that can be used with both types of procedure and has the potential to improve the quality of vision, especially when correcting larger refractive errors.
  • It involves taking a detailed scan of the eye that’ll reveal all its refractive errors and programming this information into the laser, which can then deliver a more tailored treatment.

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