Refractive Surgery

Refractive Surgery and Laser Vision Correction

The USC Roski Eye Institute offers innovative and laser corneal and lens-based refractive surgery for the correction of refractive errors in the eye. Conditions treated include: Astigmatism, Hyperopia (farsightedness), Myopa (near-sightedness) and Presbyopia.

Laser Refractive Surgery
Our laser refractive surgeons are all fellowship-trained corneal specialists. The Refractive service offers patients the most advanced eximer laser technology including LASIK and PRK procedures. The Alcon WaveLight EX500 excimer laser is known for its unparalleled outcomes and variety of treatments available for individual patients, while the VisuMax Femtosecond Laser allows for precise flap creation and has eliminated the need for any blade use during the LASIK procedure. It is essential to determine whether you are a good candidate for laser refractive surgery. To ensure that you benefit from safe refractive surgery, we will take the time to assess your risk and proper candidacy. Our surgeons also provide specialized care to patients referred to us who have experienced complications resulting from previous laser refractive surgery.

Laser Vision Correction Options
LASIK (laser in situ keratomileusis) is the most popular refractive procedure due to its outstanding outcomes and rapid, pain free visual recovery. PRK (photorefractive keratectomy) or advanced surface ablation is a similar laser procedure that is also a great choice, especially for patients who are not ideal LASIK candidates. Both procedures are performed using the latest excimer laser technology to precisely reshape the cornea. Both procedures are also customized to provide each individual patient the best outcome. #USCLASIK
 

Figure 1
Alcon WaveLight EX500 excimer laser

Custom Laser, Blade-Free LASIK and PRK

LASIK Explained
In LASIK, the surgeon uses two separate lasers: the femtosecond laser to create a precise flap and the excimer laser to reshape the cornea beneath the flap. Once complete, the flap ks put back into position without sutures and heals in place. Visual recovery is rapid and there is minimal discomfort. The vast majority of patients can return to their daily activities the day following surgery.

PRK Explained
In PRK (also called advanced surface ablation), the surgeon uses the excimer laser for corneal reshaping, but treatment is performed on the surface of the eye instead of underneath a corneal flap. The surgeon removes the corneal surface cell layer (epithelium). This cell layer regrows over the first few days. A contact lens is typically applied to aid with comfort and healing over the first few days, and the eyes may be light sensitive and have a burning sensation during this time.

 

Figure 1
Zeiss VisuMax Femtosecond Laser

Choosing Between LASIK and PRK
Long-term results are identical between LASIK and PRK for good candidates, but LASIK heals quicker and with less early discomfort than PRK. Most patients who are good candidates for either procedure opt for LASIK due to these comfort advantages. However, some patients are better candidates for PRK, especially those with thinner corneas or for individuals who have had previous corneal surgery.

Customizing Treatments at USC
All laser vision corrections performed at USC are customized for each patient. A variety of specific treatments are available, including wavefront-optimized (specifically designed to minimize glare and halos), wavefront-guided (best for patients with significant corneal aberrations) and topography-guided (for less regular corneas). The best procedure for each patient is determined through an exhaustive evaluation and detailed discussion with the surgeon.

Therapeutic Refractive Surgery
While complications are rare from laser refractive surgery, a small number of patients have suboptimal outcomes, especially patients who had surgery many years ago using first-generation technology. At the USC Roski Eye Institute we are able to retreat eyes and improve quality of vision in most cases where initial outcomes were not as expected, or in cases with initially good outcomes that worsened over time. USC Roski Eye Institute’s corneal imaging suite has the latest equipment available to diagnose past surgeries and provide detailed treatment plans to improve visual quality and patient satisfaction.

The USC Roski Eye Institute Difference
At the USC Roski Eye Institute, we pride ourselves on providing the foremost treatments proven to provide the best vision outcomes with the least risk of complications for all of our patients. We do not perform “basic” or conventional treatments at USC, as these have proven to be less effective at providing the best vision for our patients. Similarly, we no longer use mechanical microkeratomes; all LASIK procedures are blade free and all laser surgeries use a femtosecond laser for flap creation.

Frequently Asked Questions

I HAVE ASTIGMATISM. AM I STILL A CANDIDATE FOR LASIK?

LASIK (and PRK) can effectively treat near-sightedness, farsightedness and high astigmatism. LASIK is able to treat more than 95% of all refractive errors.

 

I AM NOT A GOOD LASIK CANDIDATE. DO I HAVE ANY OTHER OPTIONS?

The surgeons at USC Laser Vision provide the full spectrum of refractive surgical options including PRK, phakic lenses and refractive lens exchange. We provide extensive screenings to determine the best procedure for you.

 

IS LASIK DANGEROUS?

While there are possible complications with any surgery, the risk of poor outcomes is significantly low with LASIK for good candidates. In fact, many recent studies have found the risks of LASIK are less than those for extended contact lens wear, especially the risk of infection.
 

IS LASIK PAINFUL?

LASIK is generally a pain-free procedure. The process can seem intimidating before treatment begins. Before surgery, numbing drops are placed in the eyes to prevent discomfort. There are a few moments of pressure during surgery. The procedure usually takes a few minutes. After surgery, the eyes may burn, itch or feel like there is something in them for several hours. Eye drops and a mild pain reliver usually provide relief.
 

WHY DOES LASIK SEEM SO EXPENSIVE?

For most patients who wear glasses and contact lenses, the cost of LASIK is significantly less expensive over a short period of time when compared with the cost of glasses, contacts, solutions, and trips to the doctor to get your prescription checked. Many people find that LASIK and similar procedures qualify for their medical spending accounts, which further reduces the final cost.
 

IS IT REALLY IMPORTANT WHICH DOCTOR PERFORMS MY LASIK SURGERY?

Experience counts. When considering a surgeon, look for the proper credentials, including state licensing, board certification and subspecialty training in refractive surgery. Ask questions such as “How many procedures have you done?” and “What is your complication rate?”. Also make sure the doctor is comfortable and experienced with several types of eye surgery so all options are considered to provide the best outcome.

USC Roski Eye Institute Cornea, External Disease & Refractive Surgery Service

The Corneal, External Disease & Refractive Surgery Service physicians provide treatment and management of the full spectrum of corneal and external eye diseases.
 
Available Treatments for:

  • Cataracts
  • Corneal Astigmatism
  • Corneal Dystrophies
  • Corneal Infection (Keratitis)
  • Corneal Scarring
  • Corneal Ulcer
  • Dry Eye
  • Fuchs Endothelial Dystrophy
  • Keratoconus
  • Presbyopia
Randleman
J. Bradley Randleman, MD
Professor of Clinical Ophthalmology
Director, Cornea, External Disease & Refractive Surgery Service
Flowers
Charles W. Flowers, Jr., MD
Associate Professor of Clinical Ophthalmology
Heur
J. Martin Heur, MD, PhD
Associate Professor of Clinical Ophthalmology

Jonathan Song, MD, MBA
Associate Professor of Clinical Ophthalmology
Reiser
Bibiana J. Reiser, MD, MS
Assistant Professor of Clinical Ophthalmology