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LASIK/Refractive Surgery

Pros and Cons of Vision Correction Surgery

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Published: July 8, 2009
Updated: July 8, 2009

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Shared Advantages of LASIK, LASEK and PRK
Advantages of LASIK over LASEK and PRK
Shared Disadvantages and Potential Complications

Shared Advantages of LASIK, LASEK, and PRK

  • Excellent precision, accuracy, and predictability results in a substantial improvement in unaided vision
  • A large range of refractive correction is available for both procedures
  • Excellent long-term stability
  • No significant decrease in the structural integrity of the eye (except with extremely high correction)

Advantages of LASIK over LASEK and PRK

  • Rapid recovery of visual acuity
  • Fewer post-operative follow-up visits needed
  • Fast return to normal, everyday activity
  • Shorter duration of postoperative medication (typically four to five days of drops)
  • Preservation of the normal corneal surface layers (epithelium and Bowman’s layer) which are both removed during LASEK and PRK procedures, resulting in slower healing
  • Little or no post-operative pain; any initial irritation after LASIK is usually gone by the following morning
  • Reduced light sensitivity during the healing stage (may occur for a week or two after LASEK or PRK)
  • Routinely perform simultaneous bilateral treatment (both eyes treated at the same time)

Shared Disadvantages and Potential Complications of LASIK, LASEK, and PRK

  • Risk of infection. Infections occur in fewer than one case out of every four thousand.
  • Small risk of over- or under-correction. This can require continued use of glasses or contact lenses or possibly additional surgery; Duke's overall retreatment or enhancement rate is under 2 percent.
  • Possible reduction in best-corrected visual acuity. Even in patients who experience a substantial improvement in their unaided vision, the clarity of image detail seen through corrective lenses may be somewhat less than it was preoperatively. A loss of two or more lines of visual acuity is extraordinarily rare occurring in less than one patient in a thousand.
  • Difficulties with eye coordination. If both eyes need correction and only one is operated on initially, there may be problems with depth perception and coordinating the use of both eyes together.
  • Night vision complaints including blurry vision, streaks, halos, or "starbursting” around bright lights. This tends to be more common in patients with pre-existing night glare, high corrections, or large pupils. Fortunately, with the advent of larger ablations along with newer technologies such as CustomVue and WaveFront optimized surgery, pupil size and night glare are now much less of a concern.
  • Cost is prohibitive. Laser procedures are more costly than more traditional approaches since they involve expensive technology and an extensive educational process for the surgeon, laser technicians, and surgical assistants. Additionally, the latest technology requires several “royalty” fees in addition to the expensive acquisition cost.  While older technology may be cheaper, Duke's commitment to providing the best and safest in modern medicine prevents them from trading quality for cost. On customer satisfaction surveys, Duke patients consistently indicate that the ease they feel knowing they are receiving premium treatment with low risk for re-treatment and complications justifies the money spent for the procedure. Financing is available for each of these procedures as we do not want this to be the limiting factor in any of your decision-making.