25 Years in Myopia: Surgical Advances Improve Vision

A Kinder Cut

The quality of vision offered by modern refractive surgery is actually better than glasses or contacts could offer 25 years ago, Pepose noted.

"Glasses make the world smaller when you're myopic" – 2 percent per diopter, he said in an interview. "A -10 myope in glasses sees the world 20 percent smaller."

Like any surgery, refractive correction involves some risk, ranging from dry eyes and halos to the rarer complications of infection and even blindness.

LASIK substantially cut down on healing time and risk by using a "flap," with the surface peeled back as if on a hinge and then reattached after removing just a sliver of cornea underneath.

This relatively simple change represented a tremendous advance in patient acceptance, Pepose said.

"It took a procedure, which wasn't technically difficult to perform, but had a longer recovery for the patient -- four or five days during which they were light sensitive, they weren't seeing well, they were uncomfortable," he told MedPage Today, "and it converted it to a surgery where literally patients would have the procedure, go home, take a two-hour nap, and wake up and see with no discomfort."

The outcomes have improved over time as well.

With radial keratotomy, fewer than 50 percent of patients, typically mild to moderate myopes, reached 20/20 vision. Today, almost all patients get 20/20 vision with a single LASIK procedure, Salz said. "It's accurate almost beyond belief."

Nancy was ecstatic about her results.

"I wake up every day amazed that these are my eyes," she said. "Now I'm almost seeing 20/20. It's great. It's actually unbelievable."

And she isn't alone, Salz said.

"For some patients this is a life-changing experience," he said. "These people sometimes will just cry when they see how well they can see."

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