Laser surgery to correct ones near or farsightedness has been with us now for about 20 years. Essentially the cornea (the outermost covering of the eye) is reshaped with a cold laser beam to correct the eye’s focusing error. The procedure takes less than 30 minutes per eye and the actual lasering lasts only seconds.
There are two major types of laser refractive surgery: PRK (photorefractive keratoplasty) and LASIK (laser-assisted in-situ keratomileusis). PRK was the first type of laser correction developed. It works by reshaping the outside of the cornea after the outermost cell layer, the epithelium, has been removed. It is still commonly used for patients with thinner corneas or higher corrections.
LASIK is the newer of the two procedures. In this procedure the mid part of the cornea is reshaped after a gate-like flap of cornea is lifted from the eye. Although the flap was initially made by a bladed microkeratome, it is now typically made with the Intralase laser, which makes for a thinner and more regular flap. The advantage of LASIK over PRK is that healing is quite a bit faster and there is minimal discomfort. In both procedures a bandage contact lens is applied to the eye after the procedure to be removed only by the patient’s optometrist after ensuring that the healing stage is appropriate. There is no difference in the visual outcome between procedures and the proper procedure will be the one selected by your doctor for you.
Of note, is a newer refractive surgical option for those who may not be PRK or LASIK candidates because of the severity of refractive error. In a laserless procedure, a small lens is introduced into the eye and is positioned just anterior to the anatomical lens. The intraocular “contact lens” procedure is performed at an outpatient surgical center and is a wonderful new procedure for the correction of high refractive errors.