- Introduction
- Types of Laser Eye Surgery
- How Permanent is Laser Eye Surgery?
- Factors Affecting the Longevity of Laser Eye Surgery
- Dealing with Changes in Vision Post Laser Vision Correction
- Regular Eye Examinations
- Prescription Eyewear
- Enhancement Procedures
- Treatment of Underlying Eye Conditions
- Healthy Lifestyle and Eye Care
- Risks and Complications
- Conclusion
- Frequently Asked Questions
Introduction
Over the past few decades, laser eye surgery has emerged as a popular and effective solution for individuals seeking to correct their vision problems. With millions of successful surgical procedures performed worldwide, many prospective patients are curious about the permanence of the results.
As with any medical or surgical procedure, it’s essential to understand the details and weigh the potential benefits against the risks.
In this comprehensive guide, we will delve into the various types of laser eye surgery, discuss the long-term outcomes and permanence of the results, and examine the factors that can impact the longevity of the surgery’s effects.
By providing a clear overview of laser eye surgery, this guide aims to help you make informed decisions about your vision correction options and understand what to expect in the long run.
Types of Laser Eye Surgery
LASIK
LASIK (Laser-Assisted In Situ Keratomileusis) is the most common type of laser eye surgery. A thin flap is created in the cornea, and the cornea underneath the underlying tissue is reshaped to correct vision. The flap is then repositioned, which promotes quick recovery from blurred vision.
PRK
PRK (Photorefractive Keratectomy) is an older procedure that removes the outer layer of the cornea, known as the epithelium, before reshaping the underlying corneal tissue. The epithelium grows over time, leading to a longer healing process than LASIK.
SMILE
SMILE (Small Incision Lenticule Extraction) is a newer procedure that involves creating a small incision in the cornea to remove a thin layer of tissue. SMILE accounts for approximately 15-20% of laser vision corrections performed in North America.
This technique is sometimes reported as less invasive and has a faster recovery time than other methods. However, the literature is divided on whether this is the case.
How Permanent is Laser Eye Surgery?
Laser eye surgery has transformed the field of vision correction, allowing many patients to achieve stable vision without the need for glasses or contact lenses.
However, when considering laser eye surgery, it is essential to understand the potential longevity of the procedure and the factors that can influence the permanence of its outcomes.
Laser eye surgery usually yields long-lasting results, with many patients maintaining a stable vision for decades. Nevertheless, individual experiences can vary; some may require additional treatments or corrective lenses over time.
Several factors can impact the longevity of laser eye surgery outcomes, including age, eye prescription changes, and post-operative care.
Factors Affecting the Longevity of Laser Eye Surgery
Age
As the eye ages, it undergoes natural age-related vision changes that can affect vision, even after successful laser eye surgery. For example, presbyopia, or age-related farsightedness, is a common condition that develops as the lens of the eye loses elasticity.
This loss of flexibility makes it more difficult to focus on close objects, which may necessitate the use of reading glasses in older patients called presbyopia, even those who have had laser eye surgery.
Additionally, older patients may be at a higher risk of developing cataracts, which can cause vision to become cloudy or blurry and require surgical intervention.
Eye prescription changes
Significant changes in one’s eye prescription can impact the longevity of laser eye surgery outcomes.
While laser eye surgery can effectively correct refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, it cannot prevent natural changes in the eye’s structure that can lead to shifts in prescription.
Factors such as hormonal fluctuations, certain medications, or the development of eye conditions like keratoconus can contribute to changes in prescription over time.
Regular checkups with an eye care professional can help monitor these changes and determine whether additional treatments may be necessary.
Post-operative care
Proper post-operative care is crucial for ensuring the best long-term results from laser eye surgery.
Following your surgeon’s instructions for recovery, such as using prescribed eye drops, avoiding certain activities, and protecting your eyes from harmful UV exposure, can help promote optimal healing and reduce the risk of complications.
Additionally, attending follow-up appointments allows your eye care professional to monitor your progress and address any potential issues that may arise.
By adhering to these guidelines, patients can maximize the chances of maintaining stable vision and prolong the benefits of their laser eye surgery.
Dealing with Changes in Vision Post Laser Vision Correction
While laser vision correction can provide a long-lasting and stable vision for many patients, it is not uncommon to experience changes in vision over time due to various factors. In this section, we will discuss steps that can be taken to address these changes and maintain optimal vision post-laser vision correction.
Regular Eye Examinations
Routine eye examinations are essential for monitoring your vision and identifying any changes that may occur after laser vision correction. Your eye care professional can detect potential vision issues beforehand, assess your prescription, and recommend appropriate interventions to maintain your vision quality.
Prescription Eyewear
If your vision changes significantly after laser vision correction, you may need to wear prescription eyeglasses or contact lenses to achieve optimal vision. This could be due to natural aging processes, changes in eye prescription, or the development of other eye conditions. Your eye care professional can guide you in selecting the appropriate prescription eyewear to get good vision and suit your individual needs.
Enhancement Procedures
If vision changes occur after the initial laser eye surgery, patients may opt for enhancement procedures to address residual refractive errors and achieve more accurate visual outcomes.
These enhancement procedures, also known as touch-ups or retreatments, are tailored to each patient’s specific needs and can be performed using LASIK surgery, PRK, or SMILE techniques. Here, we discuss these enhancement procedures in detail:
LASIK Enhancement Surgery
LASIK enhancement surgery involves performing a second LASIK eye surgery to fine-tune the initial results. The surgeon may lift the original flap created during the first procedure or create a new one depending on the patient’s corneal thickness and the time elapsed since the original surgery. Once the flap is lifted, the corneal tissue is reshaped to address the remaining refractive error.
After the treatment, the flap is repositioned, and the healing process is similar to the original LASIK eye surgery.
Generally, LASIK eye surgery enhancements can be performed after 3 to 6 months from the initial surgery, once the eye has healed and stabilized.
PRK Enhancement
PRK enhancement can be performed on patients who initially underwent LASIK surgery, PRK, or SMILE surgeries. In PRK enhancement, the surgeon removes the epithelium (the cornea’s outermost layer) and reshapes the corneal tissue using an excimer laser to correct the residual refractive error.
The epithelium then regenerates over time, covering the treated area. This enhancement option is particularly suitable for patients with thinner corneas or those not suitable for LASIK surgery enhancement due to flap-related issues.
The recovery period for PRK enhancement is typically longer than LASIK enhancement, with patients experiencing gradual vision improvement over several weeks.
SMILE Enhancement
Currently, refractive enhancement following SMILE surgery is typically conducted using surface ablation, CIRCLE cap-to-flap conversion, or thin-flap LASIK surgery. All these options provide safety and effectiveness that are comparable to LASIK eye surgery retreatments.
When considering an enhancement procedure, it is essential to consult with your eye surgeon to determine the most suitable technique based on your individual needs, corneal thickness, and the specifics of your initial surgery. The surgeon will also discuss the potential risks, benefits, and expected outcomes to ensure you make an informed decision about your vision correction options.
Treatment of Underlying Eye Conditions
If an underlying eye condition is causing changes in your vision after laser eye surgery, it is crucial to address the issue appropriately. Conditions such as dry eye, cataracts, or glaucoma may require specific treatments or interventions to manage the problem and preserve your vision. Working closely with your own eye doctor or care professional can help ensure you receive the proper care for your unique situation.
Healthy Lifestyle and Eye Care
Maintaining a healthy lifestyle and taking care of your eyes can contribute to preserving your vision after laser eye surgery. This includes wearing UV-protective sunglasses, consuming a balanced diet rich in eye-healthy nutrients, managing chronic health conditions such as diabetes, and avoiding eye strain by taking breaks during prolonged screen time.
Risks and Complications
While laser eye surgery is generally safe, surgical procedures have potential risks and complications, including infection, dry eyes, and glare. Discussing these risks with your surgeon and weighing them against the potential benefits is essential.
Conclusion
In conclusion, while laser eye surgery often provides lasting vision correction, it is essential to recognize that individual experiences and various factors can influence the permanence of the results of laser vision alone. By understanding these factors and maintaining regular eye examinations, patients can make informed decisions about their vision correction options and work with their eye care professionals to achieve the best possible outcomes.
Frequently Asked Questions
A: Laser eye surgery is a medical procedure that uses laser technology to reshape the cornea, the clear front part of the eye, to correct refractive errors such as nearsightedness, farsightedness, and astigmatism, improving vision.
A: In most cases, laser eye surgery provides permanent vision correction. However, some people may experience a regression in vision over time, often due to age or changes in the eye’s lens.
A: The most common types of laser eye surgery are LASIK (Laser-Assisted In Situ Keratomileusis), PRK (Photorefractive Keratectomy), LASEK (Laser-Assisted Sub-Epithelial Keratomileusis) and SMILE (Small Incision Lenticule Extraction).
A: Recovery time varies depending on the type of laser eye surgery. Most patients can resume normal activities for LASIK and SMILE within 24-48 hours. PRK and LASEK may require a longer recovery period of up to a week or more.
A: Laser eye surgery cannot directly correct presbyopia, which is age-related farsightedness. However, some patients may opt for monovision LASIK, where one eye is corrected for distance vision, and the other is corrected for near vision.
A: Some potential risks and side effects of laser eye surgery include dry eyes, glare, halos, undercorrection or overcorrection, infection, and corneal flap complications. However, these risks are generally low with experienced surgeons and modern technology.
A: Not everyone is a suitable candidate for laser eye surgery. Factors such as age, prescription stability, corneal thickness, and overall eye health can impact a person’s eligibility for the procedure.
A: The success rate of laser eye surgery is high, with over 90% of patients achieving 20/20 vision or better. However, individual results may vary, and some patients may still require glasses or contact lenses for certain tasks.
A: Most insurance plans consider laser eye surgery an elective procedure and do not cover the cost. However, some plans may offer discounts or flexible spending account options for the surgery.
A: In some cases, a second laser eye surgery, known as enhancement or touch-up, may be performed if the initial procedure did not provide the desired results or if vision regresses over time.
A: The laser eye surgery procedure usually takes less than 6-8 minutes per eye, with the laser application lasting only a few seconds to a minute.
A: Laser eye surgery does not treat cataracts. Cataract surgery, which involves replacing the cloudy lens with an artificial one, is the most common treatment for cataracts.
A: Most laser eye surgery candidates are between the ages of 18 and 55. However, depending on their overall eye health, older patients may still be eligible for the procedure.
A: Laser eye surgery is generally considered safe and effective, but there is a small risk of long-term complications such as ectasia, a thinning and bulging of the cornea. However, advancements in technology and surgical techniques have significantly reduced the risk of long-term complications.
A: To prepare for laser eye surgery, consult a qualified eye surgeon to determine if you are a good candidate. Follow any pre-operative instructions provided by your doctor, such as discontinuing contact lens use and avoiding certain medications. Arrange for transportation home after the procedure, and plan for adequate recovery before resuming normal activities.
Author
Dr. M. Ronan Conlon started his career in the field of ophthalmology at the same time as the development of refractive eye surgery in Canada. In 1996, he brought laser technology to Canada from Germany, which allowed him to perform laser eye surgery before it was available in the United States. With the establishment of the Conlon Eye Institute, Dr. Conlon has performed more than 40,000 refractive procedures and has advanced his expertise in LASIK and refractive cataract surgery.
