Are You a Good Fit for Refractive Eye Surgery?

When you have a patient that’s interested in refractive surgery, where do you start?

We schedule a consultation, and I'll try and get a feeling for what the patient’s  visual needs and expectations are. In other words, what are their goals? For some, it’s seeing clearly for work. But I also have patients who have a goal of being able to ski or be involved with other outdoor activities and sports without glasses. Others say they’ve become less tolerant to contact lenses.

Then, I will look at their overall refractive error and do some screening tests. Looking at the corneal shape, for example, tells us whether there are any abnormalities that would rule out a patient for laser vision correction, but may instead be able to have an alternate procedure, such as phakic IOL or RLE surgery.

What are the typical results of these surgeries?

The majority of patients see 20/20 uncorrected.  About 5% will need a touch up or enhancement in my practice.

What is recovery like with refractive surgery?

With LASIK, many patients report a little bit of pain following the procedure, sort of like wearing contacts for too long. But by the next day, they are generally comfortable with minimal pain. Visual recovery is rapid and usually occurs within a few days of the procedure.  Typically, I will perform LASIK on a Thursday and the patient is back to work by Monday.

With PRK, recovery time can be a bit longer. Vision can be blurry for a few days. It can be a few weeks before vision becomes useful and up to three months before optimal vision is reached. But at the end of the day, and within a year, outcomes are similar to LASIK.

Who are ideal candidates for refractive surgery?

We usually see patients who are between the ages of 25 and 45 and have good overall health and a stable prescription for their glasses or contacts. Once you’re in your 50s, we start looking for cataracts and other pathology that might rule you out as a candidate.

We can determine good candidates through consultation and a complete eye exam. We want to make sure overall eye health is good and that the corneas are thick enough for the procedures such as LASIK or PRK.

What are the risks for these surgeries?

 I always tell people that while the risk for complications is low, this isn’t getting a haircut. It’s still surgery. There’s a possibility of loss of vision, but this is a rare occurrence. In all of these procedures, there’s risk of infection, roughly less than one in 1,000 surgeries, and they can often be treated with antibiotics.

Other risks include dry eye, especially with PRK and LASIK, but it tends to be temporary and goes away within the first three to six months. Night vision issues are also very common in the first month with all these procedures, but they tend to fade away as your brain assimilates to your new vision. Generally, night vision issues that persist more than one year following surgery are around 1%.

Visit the UCHealth LASIK information page to learn more about refractive surgery.