Vision Correction Surgery

What is vision correction surgery?

Vision correction surgery adjusts how your eyes focus light, improving your vision. It’s an umbrella term for a few different types of surgery that can correct refractive errors in your vision.

Your eyes are supposed to naturally focus light so it reaches the back of your eye at the correct point. Refractive errors are when your eyes don’t focus light correctly, affecting how well you see things.

There are two main places in your eyes where refraction happens:

• Corneas: The corneas of your eyes are dome-shaped sections of tissue at the front of your eyes. Your cornea is at the front of your eye, just in front of your pupil and iris. About 65% to 75% of refraction (light-bending) happens in your corneas.
• Lenses: The lenses of your eyes further bend and focus light as it travels toward your retinas at the back of your eyes. The lens of each eye is just behind your pupil.

Vision correction surgery can make changes to the corneas or the lenses, adjusting how they focus light. That’s how these procedures improve your vision.

What are the different types of vision correction surgery?

There are two main types of vision correction surgery:

• Laser procedures: These involve using a laser to make tiny changes in the shape of your corneas. Those changes affect how your corneas bend light, which can reduce refractive errors or resolve them entirely.
• Lens placement or replacement procedures: Lens placement or replacement surgeries involve placing an artificial lens into your eye (either with or without removing your existing lens). The artificial lenses are custom-made to bend light correctly.

Vision correction surgery can refer to any of the following:

• LASIK (laser-assisted in situ keratomileusis).
• LASIK procedures that involve specific tools or steps, like wavefront-guided or topography-guided LASIK (which uses special technology to “map” the surface of your eye).
• Photorefractive keratectomy (PRK).
• SMILE (small incision lenticule extraction).
• LASEK (laser subepithelial keratomileusis).
• Phakic intraocular lens (IOL) placement.
• Refractive lens exchange.

Which vision correction surgery option is best?

When it comes to vision correction surgery, “best” isn’t about which surgery is better. The surgery that’s best for you could be very different from what’s best for someone else with the same condition.

Many things can affect which procedure is best for you. The most likely factors include:

• The specific type of refractive error(s) you have. Some procedures are better for certain refractive errors. And it’s possible to have more than one refractive error in an eye (like being farsighted and having an astigmatism).
• The severity of the refractive error. Some procedures are only recommended if your refractive error is severe enough.
• Your eye health and whether you have any other issues. Some procedures aren’t recommended if you have other eye conditions, like glaucoma or dry eye disease.

Because the options can vary and are so personalized, your eye care specialist is your best source of information and guidance. They can explain the choices, offer recommendations and help you decide.

What does vision correction surgery treat?

There are four main types of refractive errors that vision correction surgery can treat:

• Nearsightedness (myopia).
• Farsightedness (hyperopia).
• Distorted refraction (astigmatism).
• Age-related loss of up-close vision (presbyopia).

How common are these procedures?

Vision correction surgery is very common. There are over 3.5 million refractive surgery procedures performed worldwide annually.

How should I prepare for vision correction surgery?

The preparations for vision correction surgery depend on the specific surgery you’ll undergo. But most of these procedures do have some pre-surgery steps in common, including:

• Vision testing: Your eye care specialist will want to thoroughly check your vision to determine exactly what you’re experiencing. They’ll also need to see your recent eye exams to make sure your glasses or contact lens prescription is “stable.” A stable vision prescription is one that doesn’t change a lot from exam to exam.
• Eye health check: Many eye conditions can affect your odds of a good outcome from vision surgery.
• Eye surface mapping and eye measurements: Eye surface mapping takes highly detailed scans of your eye. These maps can help your provider determine what changes you need and how best to make them. Eye measurements can also help with planning and doing the procedure.

Your eye care specialist can also guide you on what you’ll need to do before your surgery. Some things they should tell you (or that you can ask) include:

• If you should keep taking your regular medications as before, or if you should adjust how you take them at all.
• If you need to take specific medications before surgery, like antibiotic eye drops, and how and when to take them.
• If you’re undergoing a lens placement or replacement procedure, your specialist may tell you to fast (avoid eating solid food) for up to six hours before surgery.

The preparation steps you might need to go through can still vary. Be sure to ask your provider if you have any questions or concerns about what you might need to do.

What happens during vision correction surgery?

Vision correction surgery is an outpatient procedure. That means it happens in a surgery center outside a hospital, and you can go home soon after the procedure.

In general, these surgeries all start with numbing drops in your eyes so you won’t feel any pain during the procedure. Your provider will have you look upward, and they’ll place a special holder on your eye to keep your eyelid open and hold your eye still. Once your eye is secure, they’ll start the surgery itself.

The next steps vary depending on the specific procedure you’re undergoing. Your provider can tell you more specifically about the steps and what to expect during your procedure.

Laser surgeries involve making changes to the outermost layers of your eyes. Some of these procedures involve making a small incision on the surface of your eye or making a “flap” with the outer layer that they move aside. That lets the laser beam affect the underlying layers directly. Once they complete the laser alterations, your eye specialist will put the flap back in place.

Laser procedures that don’t involve a flap affect the outer surface of your eye. Changing the shape of the outer surface helps improve your vision.

Lens placement or replacement surgeries work similarly to cataract surgery, with the eye surgeon making a small incision to reach the lens in front of your eye. For phakic IOL placement, they’ll place the new lens in front of the existing lens, which they leave in place. For refractive lens exchange, your surgeon will remove your existing natural lens and replace it with an artificial lens.

How long does vision correction surgery take?

Vision correction surgery is almost always a quick procedure. The surgery itself takes up to half an hour (but usually less than half that). But, the pre-surgery preparation steps and post-surgery recovery period might last longer. The entire process often takes up to a few hours.

What happens after this procedure?

After your surgery, you may have a short recovery period in the surgery facility. That gives your eye time to begin the initial stages of healing. Most people go home within an hour after their surgery is complete.

What are the benefits of this procedure?

Vision correction surgery can improve or fix blurred vision due to refraction errors. That can make it easier for you to see while you go about work, hobbies, social activities and more. For some, these surgeries can improve vision significantly, allowing them to do activities they couldn’t before, or return to activities they once enjoyed but had to stop because of vision difficulties.

How successful is this procedure?

Vision correction procedures have high success and satisfaction rates. Laser procedures tend to have the highest success and satisfaction rates.

• Laser procedures: Between 92% and 95% of people who undergo laser-related procedures later report they’re satisfied with the outcome and happy with their decision. Up to 99.5% of people who undergo laser surgery achieve 20/40 vision or better, and 90% to 95% achieve 20/20 vision or better.
• Lens placement or replacement procedures: Up to 84% of people with implanted lenses achieve 20/40 vision or better after their procedure.

What are the risks or complications of this procedure?

Vision correction surgery has some risks and drawbacks. These include (but aren’t limited to):

• It’s usually elective. Insurance carriers don’t usually cover vision correction surgery. There are exceptions, like repairing injuries, fixing an issue from a previous vision correction procedure, etc. And while many insurance carriers don’t cover vision correction surgery, they may be able to get you a discount on the procedure. If you have questions about coverage, talk to your insurance provider about when this surgery might be covered or discounts they might offer.
• It has limited ability to treat presbyopia. Vision correction surgery can’t fix or improve presbyopia (age-related loss of close-up vision) directly. Instead, treating presbyopia with vision correction surgery usually involves giving you monovision, with one eye adjusted so it can see farther away and the other adjusted so you can see up close, or with multifocal lens implants with lens replacement procedures.
• You might still need to wear glasses or contacts. Vision correction surgery might undercorrect or overcorrect the refractive error you have. That means you might still need glasses or contacts (though your vision should still be better than before).
• Side effects are likely. Most forms of vision correction surgery have side effects. Most of these are minor. Dry eye and light sensitivity (photophobia) are among the most common. Most side effects are minor and go away within a few weeks or less. And you can use artificial tears, sunglasses or other aids your eye specialist recommends for treating the side effects.
• There’s a risk of complications. Like any surgery, vision correction surgery can have complications. You might need a follow-up surgery to correct complications, or have long-term vision issues when complications are severe (fortunately, this is rare).

What is the recovery time?

The recovery time for vision correction surgery varies. Laser procedures usually heal the quickest, while lens placement/replacement procedures may take weeks to heal fully. Ask your provider for more info about the likely recovery timeline and what you can do to make your recovery faster and/or easier.

Protecting your eyes after surgery

Immediately after surgery, your eye care specialist will give you a clear plastic shield (or something that works similarly) to wear. This protects your eye from injuries that could disrupt healing after the surgery. You should wear this shield (or any other eye protection provided or recommended by your specialist), which may include while you’re sleeping.

Some other things to keep in mind include:

• Don’t rub your eyes. Dry eye is common after many vision correction surgeries. You may want to rub your eye, but you need to resist that urge. Rubbing could affect how your eye’s outer layers repair and bond together, leading to complications later on.
• Wear sunglasses. Vision correction surgeries all affect the outer layers of your eyes. While those outer layers heal, your eyes are vulnerable to ultraviolet (UV) rays. Wear sunglasses exactly as recommended by your provider. UV rays can damage the healing cornea layers and cause scarring, which can cloud or decrease your vision.
• Follow your provider’s instructions on physical activity. You may need to take it easy for a few days after your surgery. If you push yourself into strenuous activity too quickly, it could affect how your eye heals.

When should I call my eye care specialist?

You should call your eye care specialist after vision correction surgery if you experience any of the following:

• Sudden changes in vision, like blurred vision, double vision or loss of vision.
• Symptoms of an eye infection, like eye pain, swelling, oozing or discharge.
• Burning or itching that doesn’t get better after a few days.

There may be other symptoms to watch for, depending on your specific surgery and other factors. Your provider can tell you more about these specific concerns and what you should do if you experience them.

What questions should I ask before vision correction surgery?

It’s a good idea to ask your eye care specialist about the following before you make a choice about undergoing vision correction surgery:

• Which procedure is most likely to help me?
• How much will the procedure cost?
• Does my insurance cover any of the costs or offer any discounts for vision correction surgery?
• What are the possible side effects of the procedure?
• What are the possible complications of surgery, and could my vision get worse?
• Will I need to change my usual routine and activities after the procedure?

Can eyesight be corrected by surgery?

Yes, it’s possible to correct your vision with surgery. But it’s important to remember that sometimes, the changes don’t fully resolve your vision issues. You may still need to wear glasses or contacts in some situations. But even when vision correction surgery doesn’t completely fix refractive errors, it almost always improves vision significantly.