Aging Begins at 30

Better Sight Without Glasses

Creation Date: July 2000
Last Revision Date: July 2000
Peer Review Status: Internally Peer Reviewed

You want to see well without glasses? No, I don't mean your aging eyes (presbyopia Greek for "old eyes"). You can be old and have your short or long sight surgically corrected. You will still need reading glasses. It's refractive surgery, from refringere which means "to bend light." Eyeglasses bend light so that the image is sharp in a long eyeball (short sight) or in a short one (farsightedness). Since 1988 lasers have reshaped corneas replacing glasses. Now astigmatism (no point focus of right-angled lights) can be treated.

Why would you want surgery instead of glasses? For good eyesight without glasses or contact lenses? You don't want to wear glasses during sport or recreation? You are intolerant to contact lenses? You think you would look more handsome or have better self-esteem without glasses? There are occupational, convenience, or safety reasons? A onetime operation expense is good value compared to lifetime glasses expenses?

Candidates are healthy-eyed adults with moderate nearsightedness of +1 to +14 diopters. (A diopter is the lens bending power named after an ancient Greek theodolite angle measurer.) Farsighted people are eligible with + 1.5 to + 4.0 diopters. The operation will give better, but not necessarily perfect vision. About 95% of treated eyes improve to 20/40, the usual legal driving limit. About two thirds will improve to normal 20/20. Both eyes are done on the same day, but sometimes delays are needed.

There are three operations with difficult names, so initials are used. LASIK stands for Laser Assisted In-situ Keratomileusis (corneal reshaping under a flap). PRK or photo refractive keratectomy is corneal surface shaving. INT ACS (a patented name) is lens ring insertion to bend the cornea for mild (- 1.00 to 3.00 diopter) shortsightedness In LASIK the removal of tissue, to change the bend, is 30% below the surface and in PRK 10% is shaved off the surface. The laser cuts to an accuracy of 0.00004 of an inch. INTACS is different as two outer edge corneal tunnels are made and two plastic half rings (removable later if unsatisfactory) are inserted to bend the cornea.

A free exam is available to assess you as an operation candidate. A full preoperative examination, with dilated eye examination, costs about $150, absorbed in the later laser fee. It may be insurance covered. A corneal computerized map is made and its thickness is measured by ultrasound. When you wish to have an operation you will sign that you understand the risks and benefits.

You will be awake with a painless eye. Your eyelids are immobilized to prevent blinking. The laser procedure takes 60 seconds but the computer calculates how much cornea to remove and you are in the clinic about 2 hours. A friend should drive you home as your vision will be blurry and you may need sunglasses.

The most common complication is under or over correction rectifiable after 6 months. Discomfort may be present a few days. Some see nighttime bright light halos. Visual stabilization may take several months. The most serious complication is infection, which is rare, due to postoperative antibiotics.

The fees, subject to change, covering all charges and one year follow, are $2,000 per eye for LASIK or PRK and $2,250 per eye for INT ACS. Fees are subject to change. Medicare or Medicaid does not cover PRK and LASIK. Information is available at 319-353-7625.

Section Top | Title Page

See related Patient Topics Eye Wear or Eyes and Vision.

See related Provider Topics or Eyes and Vision.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

http://www.vh.org/adult/patient/internalmedicine/aba30/2000/withoutglasses.html