A Better View

Laser Eye Surgery — What You Need to Know

By Mimi Greenwood Knight

When eyeglasses were invented in Venice in 1284, known as the “roidi da ogli” or “round glass for the eyes,” they were a giant leap forward in vision correction. Imagine what those ancient Venetians would think about laser eye surgery. The procedure was discovered by accident in 1974 (almost 700 years later) by a surgeon who operated on a young boy after a corneal accident with astounding success. Over the next 47 years, laser eye surgery improved to the point that it’s now one of the most commonly performed elective surgeries in the country, freeing over 700,000 Americans from dependence on their “roidi da ogli” each year.

Today, a variety of laser procedures can correct nearsightedness, farsightedness, and astigmatism, cutting down — or even eliminating —your need for glasses and can usually be performed on an outpatient basis. Laser eye surgery works by reshaping the cornea, so it reflects light properly onto the retina. While not everyone who wears glasses or contacts is the right candidate for vision correction surgery, the majority of people qualify for at least one of the following procedures.

Photorefractive Keratectomy (PRK)

The first refractive surgery approved by the FDA, PRK, involves an ophthalmologist removing the cornea’s outer surface layer and using a laser to reshape the cornea into a new curvature fitting the prescription of the patient’s eye. PRK is generally associated with some post-procedure discomfort and a slightly longer recovery time than a more advanced option. But it’s often the best choice for patients requiring a high level of correction who have thin corneas or if the corneal shape requires the surgeon to be more structurally conservative.

Laser-Assisted In-Situ Keratomileusis (LASIK)

The most popular refractive surgery, LASIK, hit the market in the late 90s. While it’s more invasive than PRK, LASIK delivers the same outcomes with quicker recovery and less discomfort. During LASIK, the surgeon creates a flap of outer corneal tissue and opens the flap to reach the cornea’s inside layers, which are reshaped with the laser. The flap is returned, and the patient experiences a quick return of vision with little discomfort. Again, not all patients qualify for LASIK.

Small-Incision Lenticule Extraction (SMILE)

The newest iteration of laser eye surgery for nearsightedness uses a very precise laser to create a disk-shaped piece of tissue inside the cornea that can be removed through a small incision without the need for a flap. It delivers similar vision correction as LASIK (but without the flap), so it’s less disruptive to the corneal nerves, and it can be a better option for people with dry eyes. It does, however, come with a slightly longer recovery period.

Ask your ophthalmologist to conduct a thorough and focused exam to determine whether you’re a good candidate for laser eye surgery and which option is best for you. You can expect to pay around $5,000 to cover the cost of the laser systems, the surgical team, and the cost of before and aftercare.