Glasses and contact lenses work well for most people, but plenty of patients eventually get tired of the daily maintenance. Refractive eye surgery offers a way to correct the underlying problem rather than compensate for it.
At his practice in Rapid City, South Dakota, Stephen Khachikian, MD, performs refractive surgery for patients who want clearer vision without relying on corrective lenses. Here’s how these procedures work and the conditions they most commonly treat.
Your eye focuses light by bending it through the cornea and lens until it lands on the retina at the back of your eye. When light doesn’t land precisely on the retina — because the cornea is too curved, too flat, or irregularly shaped — your vision becomes blurry.
Refractive surgery corrects this by reshaping the cornea with a laser so that light focuses where it should.
The most common procedure is laser-assisted in situ keratomileusis (LASIK), though other options like photorefractive keratectomy (PRK) use a similar concept with slightly different techniques depending on your cornea’s thickness and shape.
Refractive errors all stem from the same basic problem: Light isn’t landing where it should inside your eye. The specific cause varies depending on the condition, but all three of the following can be corrected with laser surgery.
Nearsightedness is the most common refractive error in the world, affecting roughly 30% of the U.S. population. If you’re nearsighted, your cornea is too steeply curved, causing light to focus in front of the retina rather than on it. Close objects look clear, but anything in the distance appears blurry.
Refractive surgery flattens the cornea slightly so light bends less aggressively and lands on the retina.
Farsightedness is essentially the opposite problem. Your cornea is too flat, so light focuses behind the retina instead of on it. Nearby objects look blurry, while distant ones may appear clearer.
Refractive surgery steepens the cornea to increase its curvature and bring near objects into focus. Farsightedness can be trickier to correct than nearsightedness, and the degree of correction depends on factors like your age and the severity of your prescription.
Astigmatism happens when your cornea is curved more in one direction than another. This irregular shape causes light to focus at multiple points rather than a singular one, making both near and far objects appear distorted or blurry.
Many people have some degree of astigmatism alongside myopia or hyperopia. Refractive surgery addresses the uneven curvature by reshaping the cornea into a more symmetrical shape. Laser technology has advanced to the point where Dr. Khachikian can typically treat even complex astigmatism cases.
Not everyone qualifies for refractive eye surgery. Dr. Khachikian evaluates your corneal thickness, overall eye health, and prescription stability before recommending a procedure. During your consultation, he looks at several key factors to determine whether you're a good fit.
Candidates generally need to:
Pregnancy and breastfeeding can also affect your prescription, so Dr. Khachikian typically recommends waiting until your vision has stabilized before moving forward.
Most people are good candidates, but a thorough evaluation is the only way to know for sure. Call Stephen Khachikian, MD, at 605-203-4256 to schedule a consultation, or book an appointment online to find out if refractive surgery is the best way to address your vision problem.
