Laser Vision Correction | Laser eye surgery: LASIK

Laser Vision Correction

Laser Vision Correction is corneal surgery. Choose your corneal surgeon as carefully as you would choose any other physician. Joel Engelstein, M.D., has been Chief of the Corneal Service and the Corneal Transplant Unit at the Washington Hospital Center for more than 20 years. He performs LASIK at The Johns Hopkins Hospital's Wilmer Eye Institute.

Dr. Engelstein will personally evaluate whether or not you are a candidate for Laser Vision Correction, discuss this with you, perform the surgery if indicated, and provide your post-operative care.

Commonly Asked Questions about Laser Vision Correction.

Why would I be interested in Laser Vision Correction?

Probably because you are nearsighted, farsighted, or have an astigmatism. When light rays enter the eye, they get bent or "refracted" into focus. If the refractive power of your eye is just right, the image will focus on the retina -- a thin layer of tissue in the back of the eye that processes images and sends them to the brain--and you'll see clearly without glasses. But if the eye is a little too long (myopia) or too short (hyperopia) or irregular in curvature (astigmatism) your vision will be blurry.

How does laser vision correction compare to glasses or contacts?

Glasses and contacts temporarily adjust the eye's refractive power to focus images on the retina while you're wearing them, but don't actually "cure" the underlying problem. Laser vision correction offers a more permanent solution by surgically reshaping your cornea -- the outer layer of your eye, which covers your iris (the colored part) and pupil, resulting in improved focus of the image on your retina.

What is laser vision correction?

In laser vision correction, a surgeon uses a laser to carefully remove a very thin layer of your cornea, changing its curvature. This alters its refractive power to suit your eye's focal length better, improving your vision. Many patients no longer require glasses or contacts for distance vision after laser surgery. There are two popular forms of the procedure: PRK (photorefractive keratectomy) and LASIK (laser-assisted in-situ keratomileusis).

What's the difference between PRK and LASIK?

In PRK, the surgeon removes a thin layer from the front of your cornea. In LASIK, the surgeon removes tissue from the middle of the cornea instead of the very front. Both procedures use a laser, but LASIK also requires a special instrument called a keratome that the surgeon uses to create a "flap" in the cornea. The surgeon applies laser energy to the area underneath the flap, then replaces the flap. In general, PRK is used to correct low to moderate refractive errors, while LASIK can be used for a wide range of refractive errors..

How safe is the procedure?

As with any surgical procedure, there are potential risks. Laser vision correction is a comparatively safe procedure and, although complications are possible, only a very small percentage of patients have a serious complication. As with any surgical procedure, the potential benefit must outweigh the possible risk for the procedure to be a wise choice for any individual patient. In our practice, the operating corneal surgeon evaluates and discusses the risks and benefits for each patient, and provides the post-operative care necessary to maximize the likelihood of a good result.

How well will I see after the procedure?

Laser vision correction cannot guarantee that you won't need glasses or contact lenses after the procedure, but it usually decreases your dependence on these corrective lenses. After surgery, the great majority of patients see 20/40 or better, most patients see 20/25 or better, and very many even see 20/20. Sometimes enhancement surgery is worthwhile to "fine tune" the results. The goal is to achieve good distance vision without contact lenses or glasses. Reading glasses will still be necessary for patients over 40 years old.

How painful is the procedure?

You'll feel no pain during the surgery. The laser doesn't actually burn tissue away; it breaks the bonds between molecules to "vaporize" corneal tissue. However, there may be some pain in the days following the procedure. Usually it is minor.

How soon can I go back to work?

Two or three days after the procedure, your vision will improve enough for you to perform most visual tasks. You probably will be ready to drive by the fourth or fifth day after the procedure.

How long does the procedure take?

The laser surgery itself typically takes less than 30 to 60 seconds, and the entire procedure usually takes less than 15 minutes. LASIK takes slightly longer than PRK.

How long has the surgery been available?

Laser vision correction has been available in the United States since 1995 but has been performed for over 10 years around the world. It is estimated that more than one million people worldwide have undergone the procedure.

If I am interested in Laser Vision Correction, what should I do next?

If you are interested in Laser Vision Correction, call the office of Joel Engelstein, M.D., (301) 588-1177, and arrange for a courtesy evaluation.