Prof. Michael Mimouni worked extensively with advanced laser vision correction technologies during his fellowship in Toronto, Canada. In recent years he has published dozens of scientific papers focused on improving the outcomes of refractive surgery procedures.
What does “laser vision correction” involve?
This is a fascinating field that offers multiple options, each of which must be tailored to the individual patient. The field is divided into two categories: (a) corneal-based treatments, which reshape the cornea so that it focuses light rays in a way that reduces (or eliminates) the need for glasses or contact lenses; and (b) intraocular treatments, which are based on adding a lens or replacing the natural lens in order to focus light rays and reduce dependence on glasses.
Is everyone a candidate for these procedures?
The answer is no. The first step is a conversation with the patient to understand their needs and expectations. Next, a thorough examination and evaluation using advanced diagnostic instruments is required to confirm that the eye is suitable for the treatment in question. Only then can we discuss the available treatment options, their success rates, and align expectations.
Types of laser vision correction
There are several types of laser-based procedures. All of them rely on the same principle: reshaping the cornea so that it focuses light rays exactly where they are needed. The two most common procedures are (a) LASIK, which stands for laser-assisted in situ keratomileusis, and (b) PRK, which stands for photorefractive keratectomy. In LASIK, a thin flap is created using a laser or a microkeratome, a second type of laser is then applied to reshape the cornea according to the patient’s needs, and finally the flap is repositioned. In PRK, the outer epithelial layer of the cornea is removed, the laser is then applied to reshape the cornea, and the epithelium is allowed to regenerate, usually within a few days.
What are the advantages of LASIK?
Because the corneal epithelium is not removed in LASIK, visual recovery is faster and there is almost no pain after surgery (compared with PRK). Most patients are able to return to normal activities within a few days. For this reason, LASIK is the first-line treatment offered to suitable candidates.
What are the advantages of PRK?
In PRK, no corneal flap is created. Therefore, patients who are not candidates for LASIK (typically those with a cornea that is not thick enough or is slightly irregular) can be evaluated for PRK. Numerous studies have demonstrated that PRK today achieves results very similar to those of LASIK, but the recovery period is longer. Most patients experience discomfort or pain for several days (while the epithelial layer regenerates), so it is standard practice to place a bandage contact lens at the end of the procedure to relieve pain and accelerate epithelial healing. In terms of vision, most patients achieve functional vision within a week and their best vision within about a month.
Would you like a personalized estimate? Try the return-to-driving calculator after PRK and the visual recovery calculator after PRK.
Are complications possible?
The answer is unequivocally yes, but the risk is low. Prof. Mimouni studied the outcomes of 70,000 surgeries performed over 20 years in order to determine the likelihood of any complication and how complications can be prevented. Among other findings, these studies showed that the risk of complications has steadily declined in recent years thanks to improvements in technique, technology, and knowledge. It is worth noting that several mathematical models have shown that the risk of a complication from long-term contact lens wear is higher than the risk of any complication from laser vision correction surgery.
What are the chances of getting rid of glasses?
Prof. Mimouni investigated the likelihood of requiring an additional procedure down the road, based on data from 70,000 surgeries, and reported that this likelihood has decreased steadily over the years. Fifteen years ago the answer was 5%; today it ranges around 1-2%, depending on the patient’s eye. In most cases, even when glasses cannot be eliminated entirely, dependence on them can be significantly reduced.
New: PRK recovery calculators
Based on research covering more than 180,000 laser surgeries, click here for the PRK recovery calculators