Laser Refractive Surgery - Best Doctors

Laser vision correction surgery reshapes the cornea - the clear layer at the front of the eye — so that light is focused more precisely on the retina. The surgery is designed to correct nearsightedness, farsightedness and astigmatism (cylinder), and to reduce dependence on glasses and contact lenses.

The three main methods of laser vision correction

Surface laser (PRK) — the thin top layer of the cornea is removed, and the cornea is then reshaped with a laser. A contact lens protects the eye during healing. This is the method with the slowest recovery, and the pain usually lasts two to three days.

LASIK — LASIK surgery is a short procedure in which the shape of the cornea is changed with a laser to correct nearsightedness, farsightedness or astigmatism. During the surgery, a thin layer is created in the cornea, the correction is performed with a laser, and the layer is put back in place. The procedure usually takes a few minutes per eye, and recovery is relatively fast. Many patients experience a significant improvement in vision within the first few days, but vision may continue to stabilize over the weeks following surgery.

SMILE — the laser creates a tiny piece of tissue (lenticule) inside the cornea, which is removed through a very small incision. Unlike LASIK, there is no need to create a corneal flap. The procedure usually takes a few minutes, and recovery is usually fast. Vision improves within the first few days, but may continue to sharpen and stabilize over the weeks following surgery.

There is no single method that suits everyone. The choice depends on the structure of the cornea, the glasses prescription and lifestyle, and is made together with the surgeon after a candidacy evaluation.

The candidacy evaluation for laser vision correction

Not everyone who wears glasses is a candidate for surgery. The candidacy evaluation examines, among other things, the thickness and shape of the cornea, the stability of the prescription over time, the size of the pupils in dim light and the moisture level of the eye. Certain conditions — such as a thin cornea, significant dry eye, a prescription that is still changing or eyelid inflammation — may make the surgery unsuitable, or lead to a different method.

Anyone who undergoes surgery expecting perfect vision without glasses may be disappointed. Even after successful surgery, glasses may be needed for certain activities, such as reading or driving at night. And for those who feel comfortable with glasses or contact lenses — the surgery may simply not be necessary.

For those who are not candidates for laser surgery, for example because of a very high prescription or a thin cornea, there are alternatives such as lens implantation, phakic lens implantation, Collamer lens implantation and more.