Razors vs Lasers: Vision Surgery Explained

Today I headed into town to see if I qualify for corrective eye surgery. After the rigorous testing, including the ever dreaded air puff test (which measures pressure and tests for glaucoma) I got to sit down and get my options laid down for me.

Laser-Assisted Sub-Epithelial Keratectomy (LASEK is a bit easier to say) is the type of eye surgery I remember from the the earlier days. With this the epithelium- a thin layer of cells separating the external (the air) environment from the internal (your inner cornea) environment - is weakened with an alcoholic solution and then removed from the laser treatment area, and then replaced after the cornea is then reshaped using an excimer laser (which uses UV light) or a microtome (I wish I could use a better analogy than a razor, but sorry its the best I can do). The epthielium regrows itself quickly, the inner cornea however does not regrow. This is a good thing, because it was just reshaped to improve your vision. This is also why however, you have to dress like a pirate while sleeping for your first week or so because the last thing you want is to rub your eye and move the epithelium around and distort your vision. NOT a good wake up.

Laser-Assisted In Situ Keratomileusis (LASIK in this case) is the more popular method now. Instead of removing the epithelium, a flap is created and then replaced after the surgery is completed. How is this flap created... with a microkeratome (so still with a blade... ick). However, with this flap method recovery is a bit quicker. The cornea is again blasted (maybe not the best choice of words, but wikipedia uses vaporize which I don't find any more reassuring) with an excimer laser. You still have to sleep like a pirate however because the flap is also prone being jostled if you rub your eyes.

Custom Wavefront: So... contacts and glasses are not really specifically created for your eyes. Based on the shape of your cornea the optometrist determines the best power lens for you and gives you that, of course accounting for things like astigmatism as well. Regular LASEK/LASIK works the same way. Wavefront technologies however, give the laser a specific layout of your eye (more points of reference if you will), therefore giving you a more customized eye surgery. This means you get better vision than if you went with standard eye surgery (and surprise, it costs more). According to one website, "surgeons can use Wavefront surgery to identify, measure and correct individual's eyes 24 times more precisely than with conventional methods used for glasses and contact lenses"(opticalexpress.co.uk). This is also highly recommended if you have aggravated conditions of astigmatism, myopia, or hyperopia.

IntraLase: Do the thought of little razors near your eye freak you out? Well for more money (of course) you can have a laser create the flap for LASIK rather than a microtome.

You can do a Youtube search and find LASIK/LASEK surgery videos so you can get a better understanding of exactly how the procedure works. Or you can watch the video below. I will warn you its a bit graphic, but personally I would rather know what is going on, like I said its your vision, which is pretty important.


One of the most important thing is if you wear contacts you do not wear them a week before surgery. Contacts actually morph the shape of your cornea (freaky) so if you wear contacts the day before then go for surgery, you run the risk of too much or too little being vaporized/blasted off. When dealing with something like eyesight I don't think this should be taken too lightly. Hard contacts are worse, and industry suggests not wearing those for a month before surgery. Ouch.

So-- a concern I had with this was SCUBA. As some people may know this is my favorite hobby. How long will I have to be sidelined from SCUBA if I get this procedure done? The recommendation for any watersports is one month, but they suggest and extra 2 weeks (6 weeks total) for something like SCUBA. And considering where I am living, this is not a huge deal.

Flying? Fear not. People have done eye surgery and flown the same day.