Corneal surgery

Definition

Corneal surgery corrects mild to moderate nearsightedness so you no longer need to wear glasses or contacts.

Alternative Names

Description

The health care provider will place numbing drops into your eye so you do not feel pain during surgery.

The exact type of surgery done varies with each person. In many cases, the surgeon will use an instrument called a keratome to lift a piece of tissue from the surface of the cornea. A laser re-shapes the surface of the cornea and the tissue is put back into place.

This method of refractive surgery offers fewer side effects compared to radial keratotomy, which was common in the 1980's. Usually both eyes are done in the same session.

Indications

Refractive surgery is used to treat nearsightedness so you no longer need to wear glasses or contact lenses. Procedures are also available to treat farsightedness and astigmatism.

Risks

The 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 due to glare (light sensitivity)
• Dislodgement of the flap, even long after surgery
• Infections of the cornea that may lead to permanent vision loss (unusual)
• Scarring that may lead to permanent vision loss (unusual)
• Dry eye

Expectations after surgery

The procedure is usually painless. You should have an immediate improvement in vision.

Long-term studies show that most people who have this procedure will see close to 20/20 without glasses. A few people (about 10%) will continue to need glasses or contact lenses. Rarely, there are serious complications that permanently decrease vision.

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

Convalescence

Protective glasses may be worn for several days, although full recovery can take several months.

You can quickly return to most activities. However, avoid bumping the eye or placing it under in water (swimming, for example) for at least 4 weeks.

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.