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________________________________________________ Perhaps the most valuable possession a person has is eyesight. Without it life is perceived as difficult, dull and at times unsafe. This is not to say that a person who cannot see is doomed to an unfulfilling life, but certainly challenges await those with less than perfect vision. Fortunately technology has advanced enough to combat vision problems and even correct various degrees of sight-impairment. Gone are the days when the only cure for near-sightedness was a pair of glasses. Instead, people are taking advantage of laser surgeries that permanently change the eye so that glasses, contacts and other forms of sight correction are literally out of sight. What is Laser Eye Surgery?
Laser surgery is a refractive technology that reverses the effects of refractive errors in the eye. Three main refractive errors exist, each with different defining characteristics:
Myopia affects people so that they cannot see objects that are far away, which makes them nearsighted. Hyperopia is the opposite, allowing for vision of far objects but anything up close is blurry and unrefined. Finally, Astigmatism is a disruption of vision caused by distortions within the cornea, or lens of the eye.
Various combinations of the three refractive errors cause an array of vision problems. In laser surgery, corneal tissue is removed so that the eye focuses in a new way. The permanency of laser surgery ensures that external corrective lenses are no longer required.
There are three main types of laser, or refractive, technologies: Radial Keratotomy or RK and Photorefractive Keratectomy or PRK and Laser-Assisted In Situ Keratomileusis or LASIK.
Radial Keratotomy (RK) is used to decrease near-sightedness through a series of specific incisions in the cornea. The number and location of the radial cuts are determined by the level of near-sightedness. As incisions are made with a highly precise diamond blade the cornea begins to flatten out. This process allows the focal point of the eye to be closer to the retina, thus reducing poor distant vision. Radial Keratotomy was originally developed in the 1970’s by Russian ophthalmologists and its first uses in the United States were in 1978 and based on the Russian techniques. Numerous studies have been conducted to determine the predictability and safety of this form of surgery and improvements continue to be made, particularly in regard to the type of blade used for making incisions.
Photorefractive Keratectomy (PRK) is used to treat myopia, hyperopia and astigmatism through the use of an Eximer laser. An extensive screening procedure is conducted prior to the PRK surgery. Contact lens wearers are asked to stop wearing contacts for 3 days to 3 weeks prior to evaluation depending on the type of contact worn. One or two refractions are then performed. These refractions show the ophthalmologist what level of correction is needed during surgery. Once back-to-back refractions are equal the doctor will perform a corneal topography to rule out any eye issues such as keratoconus and irregular astigmatism. During the surgery, the surface corneal cells are removed and a computer-driven laser delivers a treatment based on the refractive error previously determined. In PRK the corneal cells must heal post-operatively and the healing process takes longer than LASIK surgery. Laser-Assisted In Situ Keratomileusis (LASIK) is also used for treating the three main refractive problems. During LASIK a special knife called a microkeratome is used to cut a flap in the cornea. Pulses from a computerized laser vaporize portions of the underlying stroma and the flap is replaced. LASIK is thought to be safer than PRK due to less risk of scarring and infection. Laser Surgery: To Have or Not to Have Undergoing any laser surgery to correct a vision problem requires serious consideration. Make sure you realize the risks involved and that your physician has had significant credible experience. Do not go through with treatment if you feel uncomfortable with how your doctor conducts his pre-operative examinations or if you have any unanswered questions. Since laser surgery is permanent it is essential to know that you are getting yourself into. After all, they don’t say hindsight is 20-20 for no reason! Article contributed by Ellie Loveman
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