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1 9 w w w. s p i r i t o f w o m e n . c o m FA L L 2 015 S P I R I T O F W O M E N I f you've spent a lifetime peering at the world through eyeglasses or contact lenses, there's nothing quite like the experience of waking up the morning after LASIK surgery and being able to see clearly. LASIK, an acronym for Laser-Assisted in situ Keratomileusis, is laser eye surgery that corrects some common vision problems, resulting in perfect or nearly perfect unaided vision. Laser vision correction has been around for more than 25 years, and while the basic procedure hasn't changed much, improvements in technology have made for better outcomes, says Dr. Sungjun Hwang, an ophthalmologist affiliated with UR Medicine's Thompson Health, Canandaigua, N.Y. CUSTOMIZING EYESIGHT Improvements in the customization of LASIK surgery mean the cornea can be viewed more three- dimensionally and the procedure can be "tweaked" to a greater degree for each individual patient. "It used to be that if someone came in with the same prescription, we would treat them with the same procedure," says Dr. Hwang. "Now you can identify even subtle differences in the same basic [prescription], which allows us to customize each procedure to give the patient a notably different visual experience." DIFFERENT PROCEDURES There are several different types of laser eye surgery procedures, including so-called "bladed" and "bladeless," but one is not necessarily better than another, says Dr. Hwang. Both have very similar outcomes, as well as their own set of possible complications, although complications from laser eye surgery are rare. Mild after-effects such as dry eye and poor night vision or "halos" usually resolve within the first six months or so. The most important factor in laser eye surgery success, Dr. Hwang notes, is finding a reputable eye surgeon. At the height of LASIK's initial popularity, SHUTTERSTOCK PRK (photorefractive keratectomy) has been around a bit longer than LASIK (Laser-Assisted in situ Keratomileusis) and is still used for patients who aren't good candidates for LASIK, perhaps because of thin corneas. In both procedures the cornea is reshaped using a laser, but with LASIK a thin, hinged fap is created on the cornea to access the treatment area. With PRK the cornea's entire outer layer is removed and replaced. As a result, it takes longer to recover from PRK and there can be signifcant discomfort; LASIK doesn't usually cause any discomfort. The outcomes in improved vision for the procedures— which are comparable in price—are nearly identical, and the same customization is available for PRK as for LASIK, says Dr. Sungjun Hwang, an ophthalmologist affliated with UR Medicine's Thompson Health, Canandaigua, N.Y. LASIK vs. PRK quite a few centers sprang up focusing only on laser vision surgery. Many are now closing, leaving their patients without follow-up care. "As a patient, you need to focus on both short- and long-term care and on finding a respected, experienced surgeon who will give you honest answers, because not everyone's a good candidate for LASIK," he says. Most providers charge $2,500 to $4,000 per eye, depending upon the type of surgery and the degree of correction and customization, and laser eye surgery is rarely covered by insurance. LOOKING TO THE FUTURE The holy grail of vision, says Dr. Hwang, is to have your new eyes work like those of a person who is 20 years old. And the future of perfect vision for everyone— no matter how thin your corneas are or how severely compromised your eyesight is—may be lens replacement surgery (also known as refractive lens exchange). As the name implies, your own imperfect eye lens is replaced with an artificial lens called an intraocular lens (IOL) that permanently corrects your vision. This is the same procedure now used to treat cataracts, but improved FDA-approved lasers may make it a more common procedure for those who are not good candidates for LASIK. Lens replacement surgery is permanent and prevents you from ever developing cataracts, but it's pricey and is usually covered by insurance only for correcting cataracts. As the technology becomes more common, however, lens replacement may become standard operating procedure for everyone. • The most important factor in laser eye surgery is fnding a reputable eye surgeon.