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With technological advancements happening at a rapid pace, the options for refractive vision correction have increased dramatically during the last few years. We are proud that MEEI physicians and researchers have been at the forefront of many of these developments and have participated in many of the FDA reviewed clinical trials.
If your vision is affected by nearsightedness (myopia), farsightedness (hyperopia), astigmatisms, or presbyopia, you can trust the physicians at the Massachusetts Eye and Ear Infirmary to help you choose the right solution to achieve your vision goals. Our physicians perform more than 1200 vision correction procedures annually, using the most advanced techniques and technology available today. Our goal is to provide you with the facts and resources you need to make the decision that is best for your situation.
Laser Vision Correction (Refractive Surgery) is a term given to surgical procedures designed to correct certain vision problems such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. These procedures use an excimer laser beam to help reshape the cornea. An excimer laser produces "cool" light beams which are ideal for refractive surgery, and these procedures are done on an outpatient basis. The two most common procedures performed with the excimer laser are photorefractive keratectomy (PRK) and laser in-situ keratomileusis (LASIK).
There are risks involved with laser vision correction just as there are with any surgical procedure. Some risks are loss of vision, dryness to the eyes and visual side effects such as hazy vision, glare, halos and other night vision disturbances. An in-depth review of the various risks associated with refractive surgery is included in the Massachusetts Eye and Ear Infirmary surgical consent forms. The use of several excimer lasers, including those used at the Massachusetts Eye and Ear Infirmary, has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of myopia, myopia with astigmatism, hyperopia and hyperopia with astigmatism.
The surgeons at the Massachusetts Eye and Ear Infirmary have been performing refractive surgery for many years and have performed thousands of procedures during this time. In addition to performing a large number of surgeries, many of the Massachusetts Eye and Ear Infirmary surgeons are involved in cutting-edge research in the laser surgery field. Dr. Azar has been studying corneal wound healing following laser surgery for many years and has identified several of the key mediators of the wound healing process.
See the current list of procedures performed at MEEI and read about the various uses.
Your personal goals and medical and vision history play an important role in determining which refractive surgical option
is right for you. During your initial examination with members of MEEI's Laser Vision Correction team, you will undergo
a very thorough evaluation that will help your physician determine the options available to you. The evaluation steps
include:
In the normal eye, the cornea focuses light onto the retina, producing an image that is crisp and clear. In the nearsighted eye, the cornea focuses light in front of the retina, while in the farsighted eye light is focused behind the eye. For those with an astigmatism, an oval shaped cornea causes light to be focused at two different points in the eye. Regardless of the condition, the result is the same - images appear blurred or fuzzy.
Presbyopia is a condition which makes it difficult to focus for up close or reading vision. A result of the natural aging process, presbyopia occurs in patients who have perfect distance vision after age 40-45, as well as in patients who have nearsightedness, farsightedness and astigmatism. The FDA has recently approved surgery to correct presbyopia and your eye care physician can discuss options available to address this condition.
A number of patients return to work the day after surgery while others take one to two days off following the surgery. Visual recovery can vary with each patient, but a majority of patients will notice a significant visual improvement the first day following surgery. Fluctuations with the vision, however, are not unusual for the first one to two weeks following surgery and should be expected.
Depending upon the procedure you are having performed, treating both eyes on the same day may be possible. We typically recommend, however, that each eye be treated on different days for your individual healing response to be monitored. This can often give us useful information when treating the second eye at a later date.
LASIK has been performed outside of the United States for approximately fifteen years and in U.S. clinical trials since 1991. It is now the most commonly performed refractive procedure in the United States. Long-term studies indicate that LASIK is safe and effective. The FDA has approved three commercial excimer lasers, including those used at the Infirmary, for the treatment of myopia and myopia with astigmatism. Treatment of hyperopia and hyperopia with astigmatism is not approved on all excimer lasers but in those cases is considered "outside the scope of current approved labeling." The FDA considers the decision to conduct LASIK in these cases as the "practice of medicine" meaning that a physician can perform LASIK for these conditions should the physician and the patient make the joint decision to do so. At the Massachusetts Eye and Ear Infirmary, the lasers that we use have been approved by the FDA for both myopia and hyperopia, with or without astigmatism.
After surgery you will be given specific information about any prescribed eye medications and your initial follow-up appointment will be scheduled. As your surgery may require that you briefly wear protective eye shields, please have a friend or family member available to accompany you home and ensure your care and safety. For the first few days following surgery, please follow any postoperative instructions you receive and consider wearing sunglasses as you may find yourself unusually sensitive to light.
We also recommend that you avoid rubbing your eyes and participating in contact sports. Finally, absolutely do not wear eye make up on the day after surgery and it is advisable to avoid it for several days. It is important to remember that depending on the type of procedure chosen, your vision may take some time to stabilize.
MEEI staff is always available to answer any questions or concerns you have during your recovery period.during normal business hours (9 am - 5 pm, Monday - Friday), please call the MEEI Laser Vision Correction Center at 617-573-3234. Should you experience problems after hours, please call the MEEI Emergency Room at 617-573-3431.
It is very important to keep all scheduled follow-up appointments even if you feel you are doing fine and are not experiencing any problems. These visits will allow your doctor to monitor your recovery and check for subtle changes that you may not detect.
Fast visual recovery characterizes LASIK, and many patients achieve good vision within 24 hours of surgery. Others, however, heal at a slower rate and may notice that the best vision takes up to several months to achieve. If necessary, a retreatment procedure can be done if your doctor believes that it would be beneficial. Patients who undergo hyperopic LASIK often need to wait longer for full visual improvement and may experience larger fluctuations during the healing process.
Many patients who have had LASIK do not require glasses for their normal daily activities. However, some patients may require distance glasses under certain conditions such as driving at night, etc. where critical vision is essential. Patients over the age of 40, or once they reach the age of 40 and beyond, will likely also require reading glasses if the distance vision is adequately corrected. This is caused by the normal aging process of the eye known as presbyopia (presbyopia occurs with or without LASIK).
Some patients will see glare, halos or starbursts around lights in dim or low-light conditions. For the vast majority of patients, these symptoms are temporary. However, a small number of patients will continue to experience these disturbances for several months or even permanently. Although these symptoms do not necessarily interfere with visual acuity as it is measured by an eye chart, for some patients, the experience can interfere with daily activities and driving at night.
page updated: 7/16/07