Everything you need to know about eye surgery

What started as a brave experiment in the 1980s has morphed into an industry of solutions for flawed eyesight. Here’s a brief guide.
Few medical fields have progressed as fast as the realm known as “refractive surgery” — a catch-all term for a dizzying array of primarily laser-based corneal corrections. While they are all technically sophisticated, it’s helpful to understand which methods are available and which might be the best for your particular situation. Remember, though, that no surgery promises a 20/20 vision outcome. You may still require some kind of corrective eyeglasses.

Since the early ’90s, photorefractive keratectomy (PRK) has been the vision correction of choice for people with irregularly shaped corneas and those who suffer from dry eyes. When eye-drop anesthetic is used, this procedure can be accomplished in 15 minutes in an outpatient setting.

It involves removal of some of the epithelium, or outer eye, without a blade. Then an excimer laser re-sculpts the cornea to a more perfect shape. Risks include mild to severe pain for a week or so, temporary hazy vision, and occasionally, regression, which may require additional surgery.

Similar to PRK in terms of producing a recontoured cornea, the major difference with Laser Assisted in situ Keratomileusis is that an actual incision by blade or beam is made that allows the cornea to be peeled back as a flap.

Once the laser corrections are done, the flap is reattached. A key benefit is rapid healing, though risks include post-operative infection, reduced night vision, dry eyes and regression. A new computer technology called Wavefront gives LASIK surgeons a more complete assessment of the shape of the eye.

These are two recent modifications of the previous techniques. The former involves blade-cutting the entire epithelium, which is then lifted en masse by an alcohol solution while the laser does its corrective work. It’s most appropriate for those requiring only minor correction.

The latter procedure begins with a plastic blade that gently separates the entire epithelial sheet, not just a flap. Because LASEK flaps can be dislodged by a blow to the eye, epiLASIK is often recommended for people like boxers and squash players.

The lens of your eye is meant to be crystal-clear. But clouding of the lens, commonly known as cataracts, is frequently a problem for elderly patients. Historically this resulted in a need for thick eyeglasses after surgery. But that has changed with the advent of intraocular lenses.

During cataract surgery, an IOL, which is much like a contact lens formed to your precise visual needs, is inserted into the eye. As with all the above treatments, however, this procedure should only be decided on following an extensive examination and discussion with a qualified eye care professional.