LASIK Technology Improvements Lead to Better Outcomes

Improvements and advancements in LASIK technology over the last ten years have resulted in better outcomes for this vision correction surgery, creating what one eye expert calls “high-definition” results for patients.

“People say we’re delivering ‘high-definition’ vision today, compared to standard definition we were years ago,” Dr. Kerry Solomon, director of the Carolina Eyecare Research Institute in Charleston, SC, told “We’re more automated and more accurate with what we do.”

According to Dr. Solomon, a member of the executive committee of the American Society of Cataract and Refractive Surgery, most LASIK surgery practices have a 90 to 98 percent success rate of achieving 20/20 vision in patients — this is compared to just 65 percent when the procedure was first FDA-approved in the 1990s.  

LASIK uses a laser to permanently change the shape of patients’ corneas to correct vision. Farsightedness and nearsightedness are both caused by distortions in the cornea. During the LASIK procedure, a flap is created in the cornea so that a computer-controlled excimer laser can vaporize part of the stroma, which is located in the middle of the cornea. The flap is then closed, correcting the cornea’s curvature, resulting in improved vision. 

When the procedure was first introduced in the 1990s, surgeons used a surgical blade to create the flap in the cornea, but now, the majority of ophthalmic surgeons use a femtosecond laser. The laser separates tissues by creating a layer of bubbles and then makes an incision to create the flap. If the surgery is disrupted, these air bubbles dissolve and no tissue is removed, unlike with a blade. 

Side effects associated with the LASIK procedure have also improved over the years. “The improved accuracy and precision with the [femtosecond] laser has allowed us to create thinner flaps…which have been shown to be beneficial at reducing one side effect of LASIK — dry eye,” Solomon said. 

Dry eye and night vision symptoms, which include seeing streamers, halos and starbursts, are the most common side effects associated with LASIK surgery. In the past, decreased vision was a common complication, but is rare today, Solomon said. 

Dry eye can occur immediately following the procedure, but should improve over the first 4 to 6 weeks, and outward of 3 to 6 months. While some patients may find they need to use eye drops on a regular basis, dry eye shouldn’t limit a person’s ability to function on a day-to-day basis. Solomon noted that, for some patients who had dry eye complaints with contact lenses, they actually had fewer symptoms after LASIK surgery. 

Night vision issues should also clear up in the same amount of time. “[Night vision symptoms] shouldn’t affect the ability to lead a normal life, but may change the way you see the world,” Solomon said. “There’s a rare chance it could limit your ability to function…which is why we’re very careful about selecting people.”

Anyone considering the LASIK procedure should be thoroughly screen prior to surgery. According the U.S. Food and Drug Administration (FDA), individuals who have experienced vision changes in the past year, have a disease or disorder that may affect wound healing, or actively participate in contact sports may be risk for complications from LASIK surgery. 

LASIK patients should still visit their ophthalmologist or optometrist for annual exams as it’s possible that a patient may need a touch-up LASIK procedure to fine tune his or her vision in the future, or may need reading glasses later in life. 

“Aging changes occurs within 100 percent of the population,” Solomon said. “…Occasionally things will change in [eye] shape and size.”

Though experiencing changes in eye size or shape are rare, they can occasionally occur among women after giving birth, or among people who may frequently strain their eyes with activities such as reading. Some people will also develop astigmatism as they age. 

As the body ages, the muscles that support the eye change, which may change the shape of the lens of the eye, leading to an inability to read without the assistance of glasses. To correct this with LASIK, surgeons may suggest monovision, where one eye is corrected for reading and one is corrected for vision. 

For someone looking for an alternative to glasses or contacts, LASIK surgery is a good option — but Solomon notes that the procedure does still carry some risks. 

“It’s still a procedure, it’s still surgery and no surgery is perfect…outcomes are better than they have ever been and technology continues to improve, yet it’s important to understand there is still a risk; complications, though rare, still occur,” Solomon said. “It’s important to get a thorough exam and be screened appropriately. If you’re not a good candidate, you should listen to the advice of your doctor and wait and see if the technology improves.” 





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