Seeing well without glasses and contact lenses is the dream of millions of
Americans. Modern medical science has enabled this dream to come true.
Excimer laser surgery is the extremely popular treatment for
nearsightedness, farsightedness, and astigmatism, and it can permanently
eliminate the need to wear glasses or contact lenses for distance vision.
The original version of excimer laser treatment, PRK (photorefractive
keratectomy), uses a laser beam to reshape the surface of the cornea (the
outer layer of the eye) to diminish nearsightedness, farsightedness, and
astigmatism. Another kind of excimer laser treatment, LASIK (laser in-situ
keratomileusis), reduces nearsightedness, farsightedness, and astigmatism
by applying the laser treatment to the deep portion of the cornea. Both
procedures are quick--usually taking no more than five to ten minutes--and
painless. The results, as patients and their doctors will tell you, are
* Stacy, a forty-year-old music publisher, had been wearing corrective
lenses since she was in the sixth grade. For thirty years, she couldn't
get out of bed in the morning without putting on her glasses. "As a child,
I would play a game: If I had three wishes, what would they be? 20/20
vision, 20/20 vision, 20/20 vision. It's always been the first thing I
would change about my life." Three weeks after having LASIK, Stacy's
vision had improved from 20/800 to 20/20. "Your confidence level goes up,"
she said. "It's not so much the way you look. It's the way you feel. I
feel so good about myself."
* Ted was so nearsighted and astigmatic that he could barely see his hand
in front of his face without glasses. Before having surgery, he went
sailing with his nine-year-old son. The boom knocked Ted's glasses off. He
grabbed them just before they landed in the water. Without them, he
couldn't see the shore. That close call convinced him that it was time to
get rid of his glasses. LASIK surgery gave him 20/25 vision. "What's
dramatic," the forty-eight-year-old teacher said, "is being able to open
your eyes in the morning and actually being able to see."
* Ethan, a thirty-two-year-old actor with 20/800 vision, had been wearing
contact lenses for years. By the end of the day, his eyes were tired and
red. Now that he's had PRK, he has 20/25 vision in the left eye and 20/20
in the right. "It's one less worry in my life," he said. "It's made my
life a little less complicated. I don't have to put in contacts or get my
glasses. I just feel freer."
* LASIK surgery gave Diane, a forty-five-year-old physician's assistant, a
newfound sense of freedom, too. Before LASIK, she couldn't clearly see her
feet when she was in the shower. Now she's taking rock-climbing lessons
with her twelve-year-old daughter, something she would never do when she
had to wear glasses or contacts. "I always believed I was entitled to see
well," she said. With 20/30 vision in her left eye and 20/40 in the right,
she finally does. "It's within a person's grasp. It's wonderful that
technology has come this far."
However, excimer laser surgery is not for everyone, and it is not risk
free. It is also not 100 percent effective for all patients.
Radial keratotomy, invented in 1973, was the first technique used to
enable people to see without glasses or contact lenses. Now, over
twenty-five years later, dramatically advanced techniques using lasers
controlled by computers perform even more accurate treatments. Because of
the ease of treatment and the accuracy of results, excimer laser
procedures have become one of the most commonly performed surgeries in the
United States. More than one million excimer laser procedures will be
performed this year in the United States alone, and a similar number in
the rest of the world.
I have written this book to explain to you the pros and cons of excimer
laser surgery and to present other information necessary to help you make
an informed decision. Part I provides basic information and should be read
by everyone contemplating this procedure, Part II provides additional
information for those who want to know more, and the Afterword describes
my own experience as a patient having excimer laser vision correction.
Part I includes simple background information, the characteristics of a
good candidate for excimer laser treatment, and how the procedure works.
Part I also describes the procedure itself, from the presurgical
consultation through the postoperative phase. Finally, it points out what
results you can expect and what can go wrong.
The last section of Part I answers the most commonly asked questions about
excimer laser eye surgery. All readers will find this particularly useful.
Part II is for people who require additional information, a
behind-the-scenes exploration. It describes what a laser is, the role of
the FDA in evaluating the laser procedure, alternatives to excimer laser
treatment, as well as possible future developments.
This book provides the consumer with important background information
concerning excimer laser treatment. Every effort has been made to provide
accurate information and a balanced viewpoint, but the accuracy of
information cannot be guaranteed. When statistics are given, they are
usually taken from FDA supervised studies, but multiple studies conducted
in different fashions produce varying statistics. The decision to have
excimer laser treatment must be based upon an evaluation and critical
discussion with your doctor of your specific medical condition, lifestyle,
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SURGERY IS EASY
Excimer laser treatment is a very easy procedure to un-
dergo. No injections are needed, and there is no pain during the
procedure. These are the steps you will experience:
1. Your doctor will measure your eyes to determine your amount of
nearsightedness, farsightedness, and astigmatism. During this presurgical
consultation, your doctor will complete a thorough examination of the
health of your eyes and discuss the procedure in detail with you.
2. The excimer laser will be calibrated and tested for accuracy.
3. The correction desired for your eye will be entered into the laser's
4. The computer will determine the specific set of excimer laser pulses
5. You will be brought into the laser room and asked to lie down.
6. A patch will be placed over the eye not having the procedure.
7. Anesthetic eyedrops will be placed in your eye. No injections or IVs
8. Your eyelid will be held open with a small speculum, which causes no
9. You will be asked to look at a small blinking light.
10. In LASIK, the flap will be created with the keratome. In PRK, the
doctor will wipe away the most superficial layer of the cornea.
11. You will hear a clicking noise, the sound of the laser.
12. The blinking light will get hazy as the treatment progresses.
13. The treatment will usually take less than sixty seconds of laser time.
14. Eyedrops will be placed in your eye. In some cases, a temporary
contact lens will be placed in your eye as well.
15. You will sit up and rest for a few minutes before going home. Your
stay in the treatment room has lasted about five to ten minutes.
Excerpted from The Eye Laser Miracle by Andrew I. Caster, M.D.. . Excerpted by permission of Ballantine Books, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.