Laser in situ keratomileusis (LASIK) is a surgical procedure to reduce nearsightedness (myopia), farsightedness (hyperopia) and astigmatism by reshaping tissue in the cornea, the clear covering of the front of the eye. It evolved from a variety of refractive surgery techniques including photorefractive keratectomy (PRK). In LASIK, an automated device called a microkeratome is used to create a thin flap in the cornea that is lifted; an excimer laser is then used to reshape the underlying corneal tissue and the flap is replaced over the treated area.

The Food and Drug Administration (FDA) first approved the excimer laser in 1995 for the PRK correction of nearsightedness and in 1998 for the LASIK correction of nearsightedness with or without astigmatism.

Is LASIK Safe?

In January 2002, the American Academy of Ophthalmology — The Eye M.D. Association — looked at a number of scientific studies and found that LASIK is safe and effective for correcting low-to-moderate nearsightedness and astigmatism. However, the Academy also found the results of LASIK are less predictable in eyes with moderate-to- high nearsightedness.

The Academy found serious complications resulting in permanent visual loss happen rarely with LASIK, but side effects such as dry eyes, nighttime starbursts and reduced ability to see in dim light occur more frequently. Your doctor should talk to you about the possible risks and side effects of LASIK.

Who Shouldn't Have LASIK?

LASIK is an excellent procedure for many, but not all people with refractive errors. Those who are not good candidates should not have the surgery. If you have any of the following conditions, you may not be a good candidate for LASIK:

• Uncontrolled or advanced glaucoma
• Pregnant or breastfeeding
• Diabetes
• Some autoimmune disorders (e.g. rheumatoid arthritis, lupus, HIV/AIDS)
• Use of Prednisone pills or drops
• Dry eyes
• Irritation of the eyelids with itching and scaly skin
• Pupil size over seven millimeters
• Warped* or thin corneas
• Genetic or metabolic problems affecting the cornea

Is LASIK Better Than PRK?

LASIK has become more popular than PRK for a number of reasons, including:

• Vision stabilizes sooner after surgery
• Less discomfort after surgery
• Faster improvement in vision
• Less corneal haze
• For people who need higher levels of correction, vision is more predictable and stable, and the corneas are clearer
• Shorter time on medication after surgery
• Enhancement procedure, if needed, is easier

Will LASIK Give Me 20/20 Vision?

It might, but even after LASIK, you may not be able to "throw away your glasses and contacts." Studies have shown that the majority of people — but not all — who have LASIK will come away with 20/40 vision or better without the need of glasses or contact lenses. Some people choose to have a second surgery, referred to as an enhancement, to further refine their vision and reduce their dependence on glasses or contact lenses. However, most people who have had LASIK will need reading glasses as they get into their 40s and 50s.

What Should I Do If I'm Considering LASIK?

Talk to an Eye M.D. to determine if you are a good candidate for the procedure. If you have any of the conditions mentioned earlier, you may not be.

If your Eye M.D. determines that you are a good candidate, before setting a date for surgery, find out:

• The possible risks and complications
• The experience of your surgeon
• The outcomes of the procedures performed by your surgeon
• The percent of patients returning for secondary procedures (enhancements)
• Whether your surgeon is using a laser approved by the FDA
• What is involved in after-surgery care
• Who will handle and be responsible for after-surgery care

Your Eye M.D. (ophthalmologist) is the best source of information on LASIK, as well as eye health and safety.

• National Eye Institute at 301.496.5248 or www.nei.nih.gov
• Food and Drug Administration at 301.827.4420 or www.fda.gov
• Federal Trade Commission at 1.877.382.4357 or www.ftc.gov