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LASIK technology improvements lead to better outcomes

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Improvements in LASIK technology over the last decade have yielded better outcomes for the vision-correcting surgery – creating what one expert is calling “high-definition” results for patients.

“People say we’re delivering ‘high-definition’ vision today, compared to standard definition we were years ago,” Dr. Kerry Solomon, director of the Carolina Eyecare Research Institute in Charleston, SC, told FoxNews.com. “We’re more automated and more accurate with what we do.”

According to Solomon, a member of the executive committee of the American Society of Cataract and Refractive Surgery, most LASIK surgery practices have a 90 to 98 percent success rate of achieving 20/20 vision in patients — compared to just 65 percent when the procedure was first FDA-approved in the 1990s.

LASIK, laser-assisted in situ keratomileusis, is a surgical procedure that utilizes a laser to permanently change the shape of the cornea to correct vision. Nearsightedness and farsightedness are both caused by distortions in the cornea.

During the procedure, a flap is created in the cornea so that a computer-controlled excimer laser can vaporize a portion of the stroma, which is located in the middle of the cornea. The flap is then closed again, correcting the curvature of the cornea, and improving vision.

In the mid-1990s, surgeons used a surgical blade to create a flap in the cornea. But now, the majority of ophthalmic surgeons use a femtosecond laser. The laser separates tissues by creating a layer of bubbles, then making an incision to create the flap. If the surgery is disrupted, the air bubbles dissolve and no tissue is removed, unlike with a blade.

Side effects related to LASIK have also improved over the years.

“The improved accuracy and precision with the [femtosecond] laser has allowed us to create thinner flaps… which have been shown to be beneficial at reducing one side effect of LASIK— dry eye,” Solomon said.

Dry eye and night vision symptoms, which can include seeing starbursts, streamers and halos, are the most common side effects of LASIK surgery. In the past, decreased vision was a common complication, but is rare today, Solomon said.

Dry eye can occur immediately following surgery, but should improve over the first 4 to 6 weeks, and outward of 3 to 6 months. While some patients may find they need to use eye drops regularly, dry eye shouldn’t limit a person’s ability to function on a day-to-day basis. Solomon noted that, for some patients who had dry eye complaints with contact lenses, they actually had fewer symptoms after LASIK surgery.

Night vision issues should also clear up in the same period of time.

“[Night vision symptoms] shouldn’t affect the ability to lead a normal life, but may change the way you see the world,” Solomon said. “There’s a rare chance it could limit your ability to function… which is why we’re very careful about selecting people.”

A patient should be thoroughly screened before LASIK surgery. According to the U.S. Food and Drug Administration (FDA), people who have experienced vision changes in the past year, have a disease or disorder that may affect wound healing, or actively participating in contact sports may be at risk for complications from LASIK. The procedure is approved for adults for adults age 18 and over.

LASIK patients should still visit an ophthalmologist or optometrist for annual exams. It’s possible that a patient will need a touch-up LASIK procedure to fine tune his or her vision in the future, or may need reading glasses later in life.

“Aging changes occurs within 100 percent of the population,” Solomon said. “…Occasionally things will change in [eye] shape and size.”

Though experiencing changes in eye shape or size are rare, they can occasionally occur among women after giving birth, or among people who may frequently strain their eyes with activities such as reading. Some people will also develop astigmatism as they age.

As the body ages, the muscles that support the eye change, which may change the shape of the lens of the eye, leading to an inability to read without glasses. To correct it with LASIK, surgeons may suggest monovision, where one eye is corrected for reading and one for vision.

For someone looking for an alternative to glasses or contacts, LASIK is a good option – but Solomon notes that the procedure does still carry some risks.

“It’s still a procedure, it’s still surgery and no surgery is perfect…outcomes are better than they have ever been and technology continues to improve, yet it’s important to understand there is still a risk; complications, though rare, still occur,” Solomon said. “It’s important to get a thorough exam and be screened appropriately. If you’re not a good candidate, you should listen to the advice of your doctor and wait and see if the technology improves.”