Laser Eye Surgery: The Cutting Edge?

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Laser eye surgery made headlines this spring when the California Medical Board unsuccessfully tried to suspend the license of San Diego laser eye surgeon Glenn Kawesch, claiming he had acted negligently with patients. A state administrative law judge rejected the board’s demand, ruling that the state’s evidence fell short, but another hearing is scheduled for January.

Dr. Mitchell Friedlaender, head of ophthalmology for Scripps Clinic, fears the flap may have given laser eye surgery a black eye. “Whether or not he’s at fault, it’s going to tarnish the image and make people leery about doing it,” he says.

There’s no reason for people to be concerned, Friedlaender asserts: Laser eye surgery, “when it’s done selectively, for the right reasons and under the right circumstances,” can correct many vision defects and eliminate the need for glasses or contact lenses.

Here are some frequently asked questions about the process:

Is all laser eye surgery the same?

In concept, yes. Laser eye surgery corrects vision defects by reshaping the cornea using a laser. But in practice, there are several different approaches, with PRK and LASIK being the most common.

The photorefractive keratectomy, or PRK, procedure involves the removal of the surface level of the cornea, the epithelium. This exposes the inner cornea. An excimer laser is then used to resculpt the curvature of the eye.

The situ keratomileusis, or LASIK, procedure involves cutting flaps into the side of the cornea with a device called a microkeratome, then rolling back the flap to expose the inner layers of the cornea. The refractive correction is then made on the inner cornea, using an excimer laser similar to the one used for a PRK.

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