Refractive corneal surgery

• Alternative Names

  Nearsightedness surgery; Radial keratotomy; Refractive surgery

• Description

  Your surgeon will place numbing drops in your eye so you do not feel pain during surgery. The exact type of surgery done varies with each person.

  • Your surgeon may use an instrument called a keratome to lift a piece of tissue from the surface of your cornea. You may feel some pressure or discomfort during this step.
  • Your surgeon will use a laser to change the shape of the surface of your cornea. You'll be asked to stare at a light for about 1 minute during this time. Staring at the light helps keep your eye in one position while your surgeon works on it.
  • After the laser treatment, your surgeon will put the lifted tissue back into place.

  The surgery usually takes less than 30 minutes. Usually both eyes are done in the same session.

  This method of refractive surgery has fewer side effects than radial keratotomy, a method that was common in the 1980s.

• Why the Procedure Is Performed

  Refractive surgery is used to treat nearsightedness. You will not need to wear glasses or contact lenses for distance vision after this surgery. Procedures are also available to treat farsightedness and astigmatism.

• Risks

  Your vision may not be completely restored after surgery. This is called under-correction. In some cases, vision may be over-corrected.

  After surgery some patients may have:

  • Spots (halos) in the eyes
  • Difficulty seeing at night because of glare (light sensitivity)
  • A dislodged cornea flap, even a long time after surgery
  • Dry eyes
  • Infections of the cornea that may lead to permanent vision loss. This is rare.
  • Scarring that may lead to permanent vision loss. This is also rare.
• Before the Procedure

  You will have a complete eye exam before this procedure. You may be asked to stop wearing your contact lenses about 2 to 4 weeks before this exam.

  Tell your doctor about any medical and eye conditions you may have. Also tell you doctor what medicines you are taking, even drugs, supplements, and herbs you bought without a prescription. Tell your doctor if you have any allergies.

  Do not use creams, lotions, makeup, or perfumes for several days before your surgery.

  Have somebody else to drive you to surgery, and then home after surgery. Your eyesight may not be clear and you may be sleepy from the medicines you received. Driving may not be safe.

• After the Procedure

  You may wear protective glasses for several days. Full recovery can take several months. You will need to avoid rubbing your eyes or placing pressure on them after your surgery.

  You can quickly return to most activities. However, avoid bumping your eyes or putting them under water (swimming, for example) for at least 4 weeks. Sleep on your back to keep pressure off your eyes.

  Do not use any lotions, creams, or makeup for up to 2 weeks.

• Outlook (Prognosis)

  The procedure is usually painless. You should have an immediate improvement in vision, but it may take several weeks or months for your vision to become stable.

  Most people who have this procedure will have close to 20/20 vision without glasses. About 10% of the people who have this surgery (10 out of 100) will still need glasses or contact lenses. Serious complications that make vision worse after this surgery are very rare.

  People who needed bifocals before surgery will still need reading glasses after the procedure.

• References

  Yanoff M, Duker JS, Augsburger JJ, et al. Ophthalmology. 2nd ed. St. Louis, Mo: Mosby; 2004:127-132.

  Schallhorn SC. Avoidance, recognition, and management of LASIK complications. Am J Ophthalmol. Apr 2006; 141(4): 733-9.

  US Food and Drug Administration: Center for Devices and Radiological Health. Lasik eye surgery. Updated September 18, 2008.

Review Date: 2/17/2009

Reviewed By: Paul B. Griggs, MD, Department of Ophthalmology, Virginia Mason Medical Center, Seattle , WA . Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.