NWHRC: Women & Healthy Vision

Laser Eye Procedures

Lifestyle Corner: 10 Things You Can Do for Vision Health

Ages & Stages: Vision Care for Your Kids

Ask the Expert: Commonly Asked Questions about Vision

Volume 28
Number 1

This publication was developed in partnership with the Women's Eye Health Task Force based at the Schepens Eye Research Institute.

Published six times a year by National Women's Health Resource Center

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Red Bank, NJ 07701

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Laser Eye Procedures

Heard about the latest way to fix your vision? How about an implantable (aka, "intraocular") contact lens? It's just the thing for those of us who are so nearsighted we've been turned down for common LASIK surgery. It's just one in a plethora of sight-correction options, however. If you're considering laser surgery or intraocular lenses, this is not the time to pinch pennies, says Brian S. Boxer Wachler, MD, of the Boxer Wachler Vision Institute in Los Angeles. "You need to seek out the best surgeon you can find, who is usually going to be inversely proportional to the price," he says. In other words, the better the surgeon, the more the procedure costs. Also keep in mind these procedures are rarely covered by health insurance.

Procedure	What is it?	Best for…	May not be for you if…	Pros	Cons	Cost
Laser-assisted in Situ Keratomileusis (LASIK)	Most commonly performed laser eye surgery. Surgeon creates a flap in the top layer of the cornea, uses laser to reshape the cornea, then replaces flap	Nearsighted people Farsighted people up to +6 diopters Those with astigmatism²⁶	You are extremely nearsighted²⁷ You have dry eyes, thin corneas (something only your doctor can tell) or large pupils²⁸	High success rate (The American Academy of Ophthalmology reports that seven out of 10 patients achieve 20/20 vision, but 20/20 does not always mean perfect vision)28 Instantaneous results No discomfort Post-surgical haze (halos) virtually unheard of with wavefront-guided lasers	Irreversible Small risk of infection Glare with night driving Dry eye after procedure	$2,800 to $3,100 per eye
Photorefractive Keratotomy (PRK)	The outer skin of the cornea is gently removed and a laser applied to the surface of the cornea	Someone uncomfortable with the idea of the flap used in LASIK, or with thin corneas	Same as LASIK	Slightly safer procedure than LASIK	Irreversible Small risk of infection; slightly lower risk than LASIK Typically more discomfort during first day or two of recovery than with LASIK Slight risk of haze if you're very nearsighted	Approximately the same as LASIK
Limbal Relaxing Incisions (LRI)	Used to treat astigmatism Incision made on the cornea to make it rounder (in astigmatism, the cornea is football-shaped)	Only vision problem is astigmatism	Astigmatism worse than 4 diopters		Irreversible Small risk of infection May be combined with cataract surgery to reduce preexisting astigmatism, thus resulting in improved vision without glasses,²⁹ resulting in better postoperative vision without glasses. LRIs can be used in people whose primary refractive error is astigmatism	$2,000 to $2,500 per eye
Orthokeratology (Ortho-K)	Non-surgical procedure in which the cornea is flattened by wearing special gas permeable contact lenses overnight	Slightly nearsighted people who don't want or don't qualify for laser surgery		Non-invasive Reversible	Reports of infections on the rise Effect is temporary and only lasts as long as you wear the contacts at night	About $1,500 to $2,500 total cost
Laser Thermokeratoplasty (LTK) and Conductive Keratoplasty (CK)	Similar procedures in which small spots of heat--LTK via a laser and CK via radio frequency -- are applied to the circular area in the outer part of the cornea to treat farsightedness and presbyopia	Someone who needs reading glasses but whose distance vision is good		No cutting or tissue removal required Total treatment time about three seconds	You may still need reading glasses for very small print or in poor light³⁰	$2,000 to $2,500 per eye
Intraocular Lenses (IOC)	The newest addition to the vision improvement arsenal, it is a contact lens inserted in the eye in front of the lens³¹	Someone with healthy eyes who is severely nearsighted but has stable vision	Minor (no more than 2.5 diopters) astigmatism	Painless procedure with instantaneous results	Lens may be removed May increase risk of glaucoma or cataracts Small risk of infection Glasses may still be needed for reading, night driving or in low light	$3,500 to $4,200 per eye

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