7 biggest misconceptions and fears when it comes to laser vision correction

Tired of hunting for your glasses, or of the daily ritual of putting lenses in and taking them out? Ready to be free of glasses for good, but held back by questions and doubts? Here are straight answers to the seven things people most often worry about before laser vision correction.

Myth 1: Laser vision correction isn’t safe

Laser vision correction has been performed worldwide for over 30 years, and more than 50 million people have had it. It is now the most commonly performed medical procedure carried out at the patient’s own request.

According to FDA studies, over 97% of patients are satisfied with the result — considerably higher than any other elective procedure, where satisfaction rarely exceeds 85% (breast, nose and lip surgery, liposuction and so on).

The laser is computer-controlled and guided, with a microscopic eye-tracking system that delivers the beam to exactly the right place throughout the procedure. An eyelid holder prevents blinking, and because the procedure is done under anesthetic drops and takes only a few minutes, discomfort is minimal and the procedure itself is painless.

With current technology and the experience of tens of thousands of procedures at Svjetlost Eye Clinic, the safety rate for these operations is over 99% — the highest standard in the world — with no complications that can permanently damage vision. Research has shown that the risk of infection or any other potentially sight-threatening complication is far lower than the risk that comes with putting contact lenses in the eye every day.

Myth 2: The prescription comes back

Results are permanent in 98% of cases. In very strong prescriptions, fewer than 2% of patients have seen some regression — and even then, far less than the prescription they had before surgery.

Even for these patients, if the original procedure was done within the last ten years, today’s technology makes it possible to repeat the treatment with no additional risk to the eye. Regression is not the result of a poorly performed procedure; it comes from the individual eye — genetics, environment, continued growth of the refractive error, or an irregular healing response. Where it does occur, the remaining prescription can be corrected with glasses or contact lenses.

Myth 3: You’ll have trouble seeing at night afterwards

Until about ten years ago, night-vision problems did affect people with large pupils and strong myopia. Newer lasers, advanced treatment algorithms and automated pupil measurement under any lighting condition have all but eliminated them.

The rule today is that the treatment zone must be at least as wide as the pupil at its widest. Where the examination shows a wide pupil and reduced quality of vision, we use personalized, wavefront-guided treatment — correcting not only the refractive error but every other optical irregularity in the eye that could reduce visual quality.

Glare and halos at night now occur only during the first few days or weeks, while the eye is healing.

Myth 4: Laser can’t correct astigmatism

If you have astigmatism, the surface of your eye is curved unevenly. Laser vision correction reshapes the cornea, correcting the refractive error and the corneal irregularities at the same time — so astigmatism is treated along with everything else.

Myth 5: You should wait until after you’ve had children

You don’t have to wait. Changes to the eye during pregnancy are uncommon, and most refractive changes that do happen are temporary — they settle once hormone levels return to normal.

Experience shows that women who have laser vision correction before pregnancy face no increased risk of regression or any related problem. And having had laser vision correction has no bearing whatsoever on how you give birth.

Myth 6: Your eyes stay dry afterwards

After laser surgery the eyes are drier than usual for at least six weeks, and artificial tears should be used during that time. According to recent studies using current technology, corneal nerve regeneration is complete and 99% of patients have no further symptoms by six months.

Of the three methods, SmartSight carries the lowest risk of dry eye, because it leaves the surface of the cornea intact.

Dryness that lasts longer than six weeks affects almost exclusively people who have worn contact lenses — especially soft ones — for many years. The cause is damage to the ocular surface from the lenses themselves: a lens sits on the surface of the eye, and normal blinking and eye movement grind it against those cells continuously.

This is why it matters that contact lens wearers use artificial tears over the lens, both to limit that damage and to keep the lens hydrated. Excessive dryness is the main reason people stop wearing lenses altogether, and after ten years of lens wear, dry eye is effectively universal. Where symptoms are pronounced, dry eye must be treated before laser surgery.

Myth 7: Every method is the same

SmartSight is the newest of the three — the third generation of laser vision correction, known as lenticular surgery. Instead of lifting a flap, the laser shapes a thin lens of tissue inside the cornea and the surgeon removes it through an opening of about three millimeters. Nothing is ablated from the surface, and no flap is created at all. Because far less of the corneal nerve layer is disturbed, the risk of dry eye afterwards is the lowest of any method. Most patients see well within a few hours and are back to normal activity the next day. SmartSight is performed on the SCHWIND ATOS laser, which was developed together with the team at Svjetlost Eye Clinic.

SmartLASIK has raised the safety threshold to 99.7%. In classic LASIK, the corneal flap is cut with a microkeratome — an automated blade — and the refractive error is then corrected with the laser. In the femtosecond method the flap is created by a laser instead. These flaps are far more uniform and better matched to the individual cornea, which matters most in strong prescriptions, in astigmatism and in thinner corneas. They also heal faster and more securely, and dry eye symptoms are less pronounced.

SmartSurface, performed in its improved form as T-PRK, treats the surface of the eye after removing the corneal epithelium. Removing the epithelium with a laser rather than mechanically means less discomfort and pain afterwards, faster healing and faster recovery overall. Vision recovery with this method waits on the epithelium to heal, and full stabilization often takes several weeks. It is mainly used today for people with thinner corneas or certain surface irregularities, though it can be used for anyone with myopia and astigmatism up to 3 diopters. Where more than one method is possible, SmartSight or SmartLASIK is more often chosen, for the lower discomfort and much faster recovery of vision.

There is no universal method — it is matched to each patient. For someone with thin corneas, where the amount of tissue the laser would need to remove is too great to be safe in the long term, we recommend a phakic lens instead. For someone whose near vision has begun to fade with age — presbyopia — the complete answer for both distance and near is a multifocal lens, or a lens with an extended range of vision.

That is why it matters to choose a clinic where both are available: laser correction and lens implantation. Your surgery should be decided by medical logic, not by whatever equipment happens to be in the building.