4 Things to Think About When Considering Laser Eye Surgery (LASIK or PRK / ASLA)

When Considering Laser Vision Correction . . .

There are many reasons why you may be considering laser eye surgery, LASIK or PRK/ASLA.  Perhaps you are just tired of having to find your glasses or don’t like wearing contact lenses.  Whatever the reason and whatever the procedure, there are some important things to consider when making the decision.

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Has your vision been stable? 

Laser vision correction depends on a stable refraction, meaning that your glasses or contact lens prescription should be stable.  Most people’s eyesight tends to stop changing in their 20’s, but some people’s eyes continue to change over a longer period.  It is more common for your eyes to change for longer if you are near sighted (myopic) or are studying or reading frequently.  If your prescription is changing, it is possible that it will continue to change in the future, even after you have laser eye surgery.  If you are going to invest thousands of dollars in laser vision correction, you certainly want the result to be accurate and last.  As your refractive surgeon, I want to ensure you get the best possible outcome, and would like to see that your refraction is stable for at least that last year.

Your optometrist will have a good idea about the stability of your eyes.  When you come in for a consultation, you can bring in previous glasses or copies of old prescriptions for glasses or contact lenses. This will help determine if laser eye surgery is appropriate for your eyes and will help ensure your eyesight is stable.

What’s your time-frame for recovery?

Each type of laser vision correction procedure has a different recovery time.  The recovery time is an important consideration, when deciding what type of laser eye surgery is best for you.

LASIK is a popular procedure because the recovery time is short, and you usually have clear vision within 24 hours of the surgery.  Despite the rapid recovery, it is recommended to avoid getting water in the eye for the first week and to avoid contact sports for a month after surgery. 

PRK/ASLA is also popular, but does not give the instantaneous visual recovery offered by LASIK.  It usually takes several days to a week to get you back to all your day to day activities, and it may take up to several months to achieve your best vision.  The first couple of days after PRK/ASLA can be quite uncomfortable, and it is best to factor this in when scheduling your surgery.  PRK/ASLA does not have a flap, and therefore avoids some of the flap related risks that are possible with LASIK.  The recovery period is longer, as the epithelium on the surface of the cornea must first heal, and then remodel, before your vision stabilises. 

Are your eyes dry?

If you have a history of dry eyes, it is important that this is controlled prior to considering laser eye surgery.  LASIK cuts through the cornea nerves when creating the flap, which causes most patients to have a dry eye after surgery.  This can last weeks to months and usually resolves by 6 months after surgery.  If you have a pre-existing dry eye, this requires careful consideration. In this situation, I may recommend PRK/ASLA as it has less impact on the corneal nerves, and tends to be better for patients with dry eyes.  Contact lens intolerance may be a sign of dry eyes. You will be screened for dry eyes during your consultation to ensure you have the best procedure and achieve your best potential outcome. 

Is your cornea healthy?

Both LASIK and PRK/ASLA involve reshaping the cornea with an accurate excimer laser.  It is imperative that you have a healthy cornea prior to your surgery so achieve your best vision.  During your refractive surgery consultation, I will screen you for corneal problems such as keratoconus or Fuchs’ corneal dystrophy.  Some of these diseases can be inherited, so it is important to know if anyone in your family has had any problems with their cornea. 

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