Is vision correction surgery for you?

If you've thought about vision correction surgery -- also called refractive eye surgery -- and have even begun to do your research, you’ll know by now that there's a world of confusing options. Even the name can be confusing - sometimes called refractive surgery, sometimes laser surgery, sometimes laser refractive surgery.

Then there are the different types of laser surgery. There's the well-known, and still vastly popular, LASIK (laser in situ keratomileusis), but also wavefront-guided LASIK and Epi-Lasik, PRK (photorefractive keratectomy) and LASEK (laser epithelial keratomileusis), to name but a few.

The boom in options and acronyms is triggered by improved technology and better surgical skills. As a result, the scope of vision problems that can be corrected with refractive eye surgery has expanded greatly in the past few decades.

Problems that can be corrected include short-sightedness (myopia), astigmatism (unevenly curved cornea), long-sightedness (hyperopia) and presbyopia (focusing difficulty that occurs with age).

Overall, the results seem long-lasting, with a recent study published in the Journal of Refractive Surgery showing that nearly 95% of eyes corrected for moderate to severe short-sightedness have 6/6 (20/20) vision or better, and the results held over a seven-year follow-up.

Among the downsides: some people do need a second procedure or "enhancement" to get the best possible vision; some have complications that interfere with their life and work. Side-effects such as dryness of the eye, for example, can occur, because you are cutting through a nerve. It generally goes away after three months, and can be managed with medication.

If you're a candidate for refractive eye surgery, the surgery should be tailored not only to your vision problems, but also to such factors as age, occupation and lifestyle. There's no one-size-fits-all surgery and be wary if you are advised otherwise.

LASIK

LASIK, which has been performed since the mid-1990s, is the most common procedure currently offered in the UK. LASIK works by changing the shape of the cornea -- the clear covering of the front of the eye -- so that light rays focus on the retina and improve vision. A cut is made across the cornea using a mechanical blade called a microkeratome and a flap of corneal tissue is raised. The exposed surface is then reshaped using an excimer laser and the flap is replaced.

Another alternative to traditional LASIK is called Epi-LASIK, in which an instrument called an epi-keratome is used to separate a very thin sheet of the very top (epithelial) layer of the cornea, which is then moved aside so that the cornea can be sculpted for vision correction.

Wavefront-guided LASIK is yet another refinement. It takes into account the finer imperfections in the eye. These imperfections would affect your night vision in particular, so taking them into account would improve the chances of better night vision after the surgery.  This was a problem with some earlier LASIK patients.

For those who also need correction of their presbyopia -- the loss of focusing ability that occurs with age, making it difficult or impossible to focus on small print -- LASIK can be done with one eye corrected for distance and the other for near vision. Wearing contact lenses in this way first is advised so you can decide if you can get used to this approach. You must compensate for a lack of depth perception.