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Lasik and its alternatives: an update. The Medical Letter 2004;46(1174):5-7.
Surgical procedures to correct vision are reviewed. Laser in-situ keratomileusis (LASIK) involves retracting a thin flap on the corneal surface and the use of an excimer laser programmed to correct myopia, hyperopia, or astigmatism. To reach the desired correction, 5% to 28% of patients who receive LASIK require a second lifting of the surgical flap, usually 3 to 6 months after the first procedure.
Postoperatively, more than 90% of patients do not need full-time glasses or contact lenses. About 3% of patients have lost two or more lines (such as, from 20/20 to 20/40) of best corrected visual acuity, and less than 0.5% have been left with best corrected vision of worse than 20/40. Minimal published data is available about wavefront technology and other newer procedures. Photorefractive keratectomy is similarly effective as LASIK but causes more discomfort. Conductive keratoplasty is effective for lower degrees of hyperopia and is relatively noninvasive.
Implantation of phakic intraocular lenses can correct high myopia or hyperopia without changing the shape of the cornea and is a reversible procedure. The long-term risks of all of these procedures are not known. No procedure corrects loss of accommodation with aging, so most patients will still need reading glasses.