What Is Refractive Surgery?
Over half of the world's population suffers from inherently poor visual acuity sufficient to require the use of corrective lenses. Most people wear glasses and/or contact lenses however, many people around the world simply ignore their less than perfect vision or simply cannot afford corrective lenses.

It has long been a dream of the eye care professional to develop devices, techniques or procedures for the permanent correction of refractive problems. For over 100 years doctors have been exploring the use of surgery to reduce or eliminate total dependence on glasses and/or contact lenses.

The dream has finally become a reality with the introduction of refractive surgical techniques for the correction of nearsightedness and astigmatism. Refractive surgery involves modifying the shape of the front surface of the eye, the cornea, through one of several micro-surgical procedures.

Some of these techniques have been in use for over 25 years while others are in the experimental stage. Refractive surgical procedures have been performed on over a million people worldwide. With the development of exciting new technologies such as laser refractive surgery, millions more are predicted to undergo refractive surgery in years to come.

How Does Refractive Surgery Work?
Refractive surgery is primarily used for the correction of visual problems where people have difficulty seeing in the distance.
Poor distance vision can be caused by nearsightedness, farsightedness and/or astigmatism.

The cornea is the clear front surface of the eye that, under optimal circumstances, works with the lens in the eye to bend or refract light so that light rays focus on the retina at the back of the eye. Nearsightedness, farsightedness and astigmatism are hereditary conditions in which the cornea is too flat, too steep or slightly warped causing visual images to be distorted or out of focus.

Micro-surgical refractive techniques work by flattening the central cornea in the case nearsightedness, causing the central cornea to steepen in the case of farsightedness or by flattening only a portion of the cornea in the case of astigmatism. Astigmatism surgery is often done in conjunction with the flattening or steepening procedures.

Several other techniques are currently being studied that involve the implantation of lenses in the cornea or inside the eye to focus images on the retina.

What Refractive Surgical Techniques are Currently Available?
There are five commonly used refractive surgical techniques currently available to most people around the world:

*Radial Keratotomy(RK), *Astigmatic Keratotomy(AK), *Refractive Lamellar Keratoplasty (LK or ALK)
*PhotoRefractive Keratectomy(PRK), *Laser-Assisted In-Situ Keratomileusis (LASIK)
14 Steps of the LASIK Procedure 11 Steps of the PRK Procedure

All of these procedures work by modifying the shape of the cornea. Each surgical procedure has advantages and disadvantages for a particular visual problem. Your doctor will discuss the specifics of each procedure with you and decide which will provide the greatest benefit with the fewest potential side effects.

Are There Any Risks Associated With Refractive Surgery?
All surgery carries risk. Each surgical procedure has a unique set of side effects and complications. The most common side effects that occur during the immediate post-operative stage are:

Pain, Light Sensitivity, Blurred Vision During Healing, Inadequate Correction
Over Correction, Glare, Haze, Starbursting, Induced Astigmatism

These side effects usually diminishes as the eye heals. The surgeon may suggest further surgery to correct an undercorrection or astigmatism.

Complications can also occur as a result of refractive surgery. While significant complication is very rare, the following are some of the problems that have occurred:

Infection, Intraoperative Complications, Inadequate Healing
Persistent Irregular Astigmatism, Unstable Vision, Progressive Overcorrection

This is not a complete list of side effects or complications. It is extremely important that you discuss side effects and complications with your doctor. While your doctor/s will do everything in their power to minimize your surgical risk, you must have a thorough understanding of the risks and complications of refractive surgery prior to consenting to surgery.

How Do I Find Out If I Am A Candidate For Refractive Surgery?
Most people who now wear glasses or contact lenses for the correction of their distance vision and are free of significant eye disease or other major health problems are potential candidates for refractive surgery.

Eye Care for the Adirondacks recommends that you thoroughly research and understand refractive surgery prior to consenting to surgery. Attend one of the many seminars available that discuss refractive surgery. Ask people who have undergone refractive surgery. Obtain literature or video taped information about refractive surgery. Listen to one of the video seminars on television.

Schedule a refractive consultation and/or a routine eye examination to find out if you qualify for refractive surgery by calling Eye Care for the Adirondacks. If there is still some question about whether you are a good candidate, do not hesitate to obtain a second or third opinion.

Has the IRS ruled that LASIK sugery is a legitimate, tax deductible medical expense or is it considered unnecessary cosmetic surgery?
In 1995 the IRS issued a private letter ruling, stating that medical expenses for undergoing RK constitute payments for medical care under the Internal Revenue Code and are, therefore, deductible. However, the letter ruling applies only to the requester, that it is not binding on the IRS with respect to any other individual, and that, in theory, the IRS could change its position in the future.

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