Refractive Surgery

About Refractive Surgery

Although the institute was able to report the types and numbers of procedures completed during 2020, overall trends were not discernible due to the effects of the COVID pandemic.

Refractive surgery involves modification of the eye’s focusing power, usually through laser treatment of the cornea, to reduce or eliminate a patient’s dependence on glasses or contact lenses. Surgeons at Cole Eye Institute use several laser platforms to perform corneal refractive surgery: the Alcon WaveLight® EX 500 excimer laser which delivers the corrective photoablative profile, the Alcon FS200 femtosecond laser for flap creation, and the ZEISS VisuMax® femtosecond laser for flap creation and for performing a newer procedure called SMILE (small incision lenticule extraction).

This section reports outcomes of 364 eyes treated in 2020 with femtosecond laser-assisted laser in situ keratomileusis (LASIK, also referred to as FemtoLASIK) and photorefractive keratectomy (PRK), a flapless approach, also commonly referred to as surface ablation. Most treatments are performed using a wavefront-optimized (WFO) ablation profile with the EX500 excimer laser. In 2016, surgeons at the institute began offering a topography-guided laser treatment called Contoura™ Vision that offers further customization of the treatment based on an individual eye’s corneal shape. Contoura Vision can be applied with LASIK or PRK and also uses the EX500 system. Outcomes for all procedures are reported as the percentages of eyes with uncorrected visual acuity (UCVA) of 20/20 or 20/25, eyes with an exceptional outcome (UCVA of 20/16 or better), and eyes with UCVA meeting the requirements for driving without glasses (20/40 or better).

Some patients are not candidates for laser vision correction by LASIK, PRK, or SMILE, but may be candidates for lens implants (Visian® ICL and Visian Toric ICL phakic intraocular lenses for correcting high myopia or myopic astigmatism, respectively) or refractive lens exchange surgery. The results of these surgeries are not reported here. A VISX™ Star S4 excimer laser is used only for therapeutic laser treatments for corneal scars and dystrophies and therefore is not included in these refractive surgery outcomes.