Laser Refractive Surgery


It’s a bit more than just shooting lasers into your eyes.

Laser refractive surgery has seen a significant increase in popularity over the past decade. Millions of these procedures have been performed throughout the country with an overwhelming rate of satisfaction.

Laser refractive surgery is a safe and effective way to reduce your dependency on glasses. Currently, there are two variations of the surgery, LASIK and PRK.  Both surgeries use the same VISX laser to reshape the cornea and can be used to treat nearsightedness, farsightedness, and astigmatism. 

LASIK is a more well know version of laser vision correction as it offers faster visual recovery and less pain.  In recent years however, feedback from patients has led the FDA to reexamine LASIK for several reasons.  While it is a safe surgery, some patients can suffer side effects, such as severe dry eye and disabling visual disturbances.  There can also be long term issues related to the presence of the LASIK flap, such as traumatic flap dislocation or infections under the LASIK flap.  

These issues have led some ophthalmologists to rethink the surgical options and lean more towards PRK.  Because PRK does not involve the creation of a flap, it is a much safer procedure, both in the short and long term.  In addition, some studies have shown that visual outcomes are actually better in PRK than LASIK.

At Eye Physicians and Surgeons we offer both LASIK and PRK and our surgeons and staff can help you pick the surgery that is right for you.

In addition, we are the first and only practice in Iowa to offer surgery using the iDesign 2.0 Refractive Studio from Johnson and Johnson.  This technology allows for detailed customized mapping of the cornea which is integrated into the wave front guided ablation.  Together, this technology produces a highly customized outcome for the patient.  



PRK (photorefractive keratectomy) was the first FDA approved laser eye surgery.  It uses the same excimer laser as the LASIK procedure to reshape the outer layer of the cornea to correct for nearsightedness, farsightedness, and astigmatism.  LASIK is a more well know procedure, however PRK offers serval advantages over LASIK including a much better safety profile and in some studies better visual outcomes.

Why would you choose PRK?

  • Nearsightedness (myopia)

  • Farsightedness (hyperopia)

  • Astigmatism (irregularly shaped cornea)

  • Cornea too thin for LASIK

  • Pupil too large for LASIK

  • Eyes too dry for LASIK

  • Less risk than LASIK

  • Potentially better outcomes than LASIK 


The Procedure

In preparation for surgery, anesthetic eye drops are administered.  Next, a speculum is placed in the eye to keep the eyelids open, which is normally not uncomfortable.  While the patient fixes his or her gaze on a target, the laser reshapes the cornea by removing tissue (a process called ablation), which is controlled and closely monitored by the doctor. 

The laser is actually guided by a detailed map of the patient’s eye which has been programmed into a computer beforehand.  The iDesign 2.0 system is the most advanced and up to date mapping program currently on the market for use with the VISX laser.  The ablation usually takes less than a minute for each eye, depending on how high the patient’s vision prescription is.  Most patients feel no pain during the procedure. 

After the procedure is complete, a bandage contact lens is placed on the eye.  The patient may go home shortly after the procedure; however, someone else must drive or alternate transportation must be arranged.


The Recovery

The doctor will likely prescribe pain medication as the post operative period may be painful for 1-3 days.  Your vision will be blurry for the first few days and then start to improve slowly over the next few weeks. The doctor will also schedule several check-up appointments to monitor the healing process, followed by periodic visits over the next several months.  

During the recovery process, you should rest, and refrain from any strenuous activities for at least a week.  Most patients can return to work in a day or two, though it is best to take a few days off to ensure a smooth recovery.



LASIK (laser assisted in-situ keratomileusis) is the most commonly performed and well known vision correction surgery.  Using an excimer laser, the doctor re-shapes the cornea (the stationary refractive element at the front of the eye) so that images are focused to the correct spot on the retina (the light receptor of the eye).  The success rate with this procedure is excellent, with most patients achieving 20/20 vision or better upon completion.

The LASIK procedure itself involves little or no discomfort (or pain) both during the procedure and through the recovery process.  Also, eyesight improvement is almost immediate, and maximum vision is typically achieved within a few days.

why would you choose Lasik?

  • Nearsightedness (myopia)

  • Farsightedness (hyperopia)

  • Astigmatism (irregularly shaped cornea).

  • Desire to decrease or eliminate dependence on glasses or contacts.


The Procedure

During the procedure, the doctor first administers a local anesthetic via eye drops, so the patient will feel no pain during the surgery.  A speculum is then placed over the eye to prevent the patient from blinking.  Next, the surgeon cuts an extremely thin flap from the outer layer of the cornea, using a microkeratome (a small blade specially designed for this purpose). 

The flap is folded to the side, and the excimer laser, programmed with the individual map of the patient’s eye, removes excess tissue with quick pulses of concentrated light.  This process usually takes less than a minute.  Once this is done, the doctor folds the flap back into place and surgery is complete.


The Recovery

The patient may go home shortly after the procedure; however, someone else must drive or alternate transportation must be arranged.  Patients will be asked to get lots of rest, avoid any strenuous activities, and avoid rubbing the eye area for a period of time. 

There are follow up appointments with the doctor 24 to 48 hours after the procedure and periodically over the following weeks and months.  Vision should dramatically improve in the first few days following surgery.  The patient often may return to work in a day or two, though it is best to take a few days off to ensure a smooth recovery.


Need help deciding?

We’re here to help you decide, weigh your options, and choose whichever procedure is best suited to your needs. Reach out to us and schedule a consultation today!