Types of Laser Eye Surgery

Search for the term LASIK on the Web, and you’ll receive over 22 million results on the subject. That’s a lot of information to take in, especially if you want to know specifics about a certain type of LASIK procedure. Here we will attempt to break down the most frequently-performed LASIK procedures and who are the best candidates for each.

Conventional LASIK

Conventional LASIK is one the most common laser vision correction procedures. It starts with the doctor cutting a small flap in the top layer of the eye’s cornea with a microkeratome blade. (A microkeratome blade is an extremely thin, machine-operated blade that oscillates back-and-forth very quickly.) Once the flap is gently pulled back, the doctor uses an excimer laser to reshape underlying layers of the cornea. According to the medical journal Cornea, this form of LASIK is virtually painless and has been proven safe for people with mild to moderate prescriptions. Conventional LASIK allows for vision correction within the first 24 to 48 hours (often sooner), with vision possibly continuing to improve in the weeks following the procedure. Current Opinion in Ophthalmology found that this type of LASIK was approved for use in the US Air Force in 2003 for non-flying military personal and for aviators in 2005.

IntraLASIK

Unlike conventional LASIK, IntraLASIK does not utilize a blade when creating the corneal flap. Instead, doctors use a femtosecond laser. According to the Journal of Cataract & Refractive Surgery, this allows doctors to have better control over the thickness of the flap created and helps them prevent any inconsistencies in thickness that may have been created by a conventional blade. As with conventional LASIK, individuals needing mild to moderate correction tend to benefit the most; however, individuals with glaucoma, or who may be at risk for glaucoma, may find IntraLASIK a better option. Some physicians believe that the use of the metal blade in conventional LASIK tends to raise a patient’s eye pressure. IntraLASIK significantly reduces this risk. Similar to conventional LASIK, recovery from IntraLASIK is generally painless. Patients see an increase in their vision almost immediately and may find their vision continues to improve in the weeks following the procedure. Perhaps the main difference between IntraLASIK and conventional LASIK can be found in the price. In an interview for All About Vision, Vance Thompson, M.D., assistant professor at the University of South Dakota School of Medicine, reports the cost per eye to be approximately $300 more for IntraLASIK when compared to conventional LASIK.

PRK

Unlike conventional LASIK and IntraLASIK, a corneal flap is not created for a photorefractive keratectomy (PRK) procedure. Instead, doctors use a solution to gently loosen and remove a very fine layer of cells on the cornea. The remainder of the procedure is the same in that an excimer laser is used to reshape the remaining corneal layers. Recovery for PRK differs as well. Patients typically experience some discomfort as the cells re-grow. Doctors usually place a bandage contact lens on the eyes after the procedure and may tell the patient to wear it for several weeks. This contact lens will have no prescription, but it protects the thin layer of cells as they re-grow. Although it is possible for PRK to be performed on any patient with healthy eyes, it is more commonly suggested for those who have thin corneas or whose professions put them at risk of being struck in the face and eyes. According to Current Opinion in Ophthalmology, the U.S. Army and Marine Core suggest PRK.

To Customize or not to Customize?

Custom software maps out almost the exact path needed to correct the patient’s vision. This map is as unique to an eye as a fingerprint is to a finger. A study in Ophthalmology showed that this software helps doctors reduce the possibility of error and even increase patient satisfaction. Custom LASIK and IntraLASIK both carry a slightly higher price tag; however, patients find it comforting to know that custom LASIK may eliminate the need for future vision enhancement procedures.

What’s on the Horizon for LASIK?

LASIK technology is continuously improving. Currently, young to middle-aged adults benefit the most from laser vision correction. However, patients experiencing presbyopic, or age-related, vision changes can get excited. According to Der Ophthalmologe, trials for presbyLASIK are currently underway and show positive preliminary results — 91 percent of participants no longer need glasses or contacts.

Which LASIK is right for you? Only a comprehensive consultation with a skilled LASIK doctor can give you that answer. It’s important to remember that every procedure carries a certain amount of risk, and outcomes will vary.