What is a Refractive Laser Treatment?

What is a Refractive Laser Treatment?
by Lee Hofer, M.D.
The question as to whether a laser will be used in treatment of a patient’s medical conditions, has been asked for nearly thirty years of the health care professional. Many new forms of laser applications have evolved in that time and today laser devices are used in many areas of medicine, none perhaps more than in Ophthalmology.
What began years ago as laser light treatments for diabetic eye changes and glaucoma conditions, has today grown to include several additional glaucoma laser applications, skin treatments, and intraocular cataract laser usage both prior to and post cataract surgery to name a few. The highly publicized LASIK and its cohort procedure, PRK, have been used to reduce or eliminate a patient’s dependency on spectacles for 20+ years. This is the area of refractive laser surgery, where a laser application is made to the front surface of the eye, the cornea, to reshape it and compensate for the optics of the eye.
Laser treatments are done to eliminate the common forms of eye glass correction.
You either choose laser correction for distance and use reading spectacles or you wear glasses for distance and read without.
These laser treatments are done to eliminate the common forms of eye glass correction, myopia (nearsightedness), and astigmatism (shadowing of images), and in some cases hyperopia (farsightedness). While the typical need for reading glasses can be addressed, you can not have your cake and eat it too in refractive surgery. You either choose laser correction for distance and use reading spectacles or you wear glasses for distance and read without. There are some variations of this but in brief, that is the choice.

However, more and more advances are being made in the technology of intraocular lenses which are placed into an eye with each cataract surgery as a replacement lens. There exists today, types of lenses known as Premium Lenses, which can offer some patients greater independence visually from spectacles, but not necessarily complete independence. When cataract patients choose such a Premium Lens to be placed at their cataract surgery, they are hopeful of good distance vision and an additional range of intermediate and near vision, often allowing them to read much of the typical printed materials in their daily lives.

“Because these promising advances of intraocular lens technology are available, the patient that chooses such a lens is understandably hopeful for a greater range of useful vision with less spectacle need.”

While our cataract removal procedures today are more precise than ever, as are the methods of calculating the lens power to be implanted, some occasions arise where the post cataract surgery result is short of the goal. This is the situation where the Refractive Laser comes into consideration. Usually, in these situations, some basic form of common refractive error, myopia or astigmatism remain.

If, after an adequate healing period of 4-6 months, this persists, a type of laser known as an Excimer laser can be used to treat this residual refractive amount by reshaping the cornea in the same fashion that has been done for 20+ years for patients seeking independence from glasses. It is a quick procedure, taking less than ten minutes in most cases and after healing, usually within 2 weeks, noticeable visual improvement is achieved with complete recovery at 2-3 months.

The addition of this procedure to compliment or complete the cataract visual recovery process has been of great benefit to many people. When discussing cataract surgery with your eye care professional, ask them if you would be a Premium Lens candidate and after any cataract surgery, if you feel your visual outcome is short of your expectation, engage your surgeon in the discussion of whether Laser Refractive Surgery would be advisable.

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