I tried them and they were awful for me. Didn't last the full day, caused terrible halos while driving (and that was BEFORE 90% of cars drove with LED high beams), were generally too uncomfortable.
the flap size itself keeps the lens in place; the elasticity of the underlying tissue itself, until it heals into an encapsulation.
the surgery videos of that procedure make me squeamish unlike other surgery videos. Watching an eyeball get deflated/inflated with liquid pressure from the surgeon is just un-nerving to me; not as bad as watching a glaucoma surgery -- but up there.
I only have wore glasses, i dont care about trying contacts. Its the glare with or without thats pretty bad driving at night in US
I'm surprised LASIK still can't correct for astigmatism though, I know that was the case when it first came out but in principle I can't see why it wouldn't work.
Contacts (especially the rigid or scleral kind) can sometimes smooth out those imperfections, but if you’re not interested in them, the next step is usually an eye exam to look for things like lens changes or surface dryness. Cataracts, even very early ones, are a common culprit for glare driving at night in the U.S.
Laser surgery can sometimes make halos worse, especially if someone already has them, so you’re right to be cautious. But it’s not the only option. Treating dry eye, using anti-reflective coatings on your glasses, or addressing cataracts (if present) can all help a lot.
In short: it’s not hopeless, but the “fix” depends on what’s causing the scatter in the first place. A detailed eye exam is the best way to pin that down.
Flaps aren't inherently dangerous either (flap detachments are very rare, even more so with modern systems that create essentially a cavity where the flap can rest in), but the difference in healing post OP is a lead cause of heightened dry eye after LASIK. Both PRK and SMILE, due to the way they work, are less likely to suffer from this, but every procedure has trade-offs naturally.
With PRK, the epithelium in the area is removed and has to regrow, a process that takes a few days (to get the initial part done, full regrowth takes far longer but isn't noticeable in general). This regrowth can be both rather painful and also rob you of the "instantly perfect sight"-effect many people desire from their laser eye surgery. As the epithelium does regrow naturally however, it is less likely (both in theory and in medical literature) to lead to dry eye and other side effects in the short and long term, making it the preferred choice by many ophthalmologists when choosing such surgery for themselves.
SMILE, on paper, might be able to offer the best of both worlds, but is severely more expensive than either and there is not a sufficient degree of long term research to make a definitive statement that the side effect amount and severity is comparable to PRK, simply because it is rather new. What research is out there is promising though.
Overall, each option is very well tolerated, leads to major QOL improvements and we need to keep in mind that even the more common side effects one may face with LASIK may not affect everyone and still are comparably small considering other medical fields and their elective procedures.
In this context, I'm very excited to see whether this method might have even fewer short and long term side effects than PRK, but like with SMILE, it may take decades to have a conclusive answer.
Edit: Another thing I missed and which was not covered in the article, is the potential that this new method could be applicable to people who, because of a variety of factors, are not eligible for any ablative eye surgery. I myself was at the upper limit for Trans-PRK in regard to the severity of my Myopia and the thickness (or lack there off) of my Epithelium. In that regard, I see far more potential than just reducing already low side-effect risks further.
My bet is on SMILE evolving but we'll see where it goes
This is exactly opposite to how I understood and experienced healing after Trans-PRK. My eyes are still very dry 6 months post surgery. Being at the upper limit of Trans-PRK yourself, did you actually go through with the surgery? If yes, how was your healing process? I would be very interested in chatting about it, since I am not particularly happy with mine, and wondering what can be done (and whom to blame).
From there on, the pain and foreign object feeling quickly subsided alongside the remaining "haze" and by day five, I neither had any subjective pain, nor any major issues reading text (both typed and digital). Had multiple check-ins of course, both at the clinic which performed the surgery and with my decades long ophthalmologist, no issues were found there either. Subjectively, I do not experience a heightened severity in dry eye symptoms for what that is worth.
Also had a clinical rotation in Ophthalmology just this month (small world, though was why I felt the urge to comment) and the attendings did assess my epithelium as having regrown evenly too.
What could have gone wrong for you and how to go about this, I really can't say and I am sure you have already considered /pursued it, but I can only suggest getting a second opinion from another established ophthalmologist, including looking at the eye drop regiment prior to the surgery and during, as well as post recovery.
In any case, I agree that a second opinion would be most helpful.
[0] https://crstodayeurope.com/wp-content/uploads/sites/5/2019/0... referenced from https://pubmed.ncbi.nlm.nih.gov/26871764/
[1] If you look at the source they are referencing, it compares TransPRK to aaPRK after three months and they were using Schwind machines, though did not clarify whether this was using Smartsurface. Very cursory search engine use tells me that this is toggleable, so an option on these machines. Even if this study did use Smartsurface though, that doesn't answer whether outcomes are different in TransPRK with Smartsurface vs TransPRK without Smartsurface. Additionally, I do not know whether this option was used in my case.
https://www.youtube.com/live/Dw9D7C8CpM0?si=e-KJ8J2u_oVy4RvM
Originally there was a mention of developing a less invasive method of correcting a deviated septum, but I guess they went with the harder problem first.
In any case I'm up for both, because while my vision is not terrible, it's slowly, but consistently getting worse, so max-twice-a-lifetime interventions like laser eye surgery won't cut it for me.
That brings me to one of my personal pet peeves which is selling pensioners that qualify for cataract surgery on an expensive, but in fact identical but privately paid for IOL.
Same with selling some Myopic+Presbyopic person on laser eye surgery of any kind. At best you get a few short years out of the expense before it catches up with you or you tolerate mono, at worst you spend thousands to suddenly need reading glasses you didn't require before.
Course, if you are financially solid and Presbyopia is starting, getting a high quality lens exchange can be a very neat luxury, with the added benefit of not needing Cataract surgery later in life. Do note though that artificial lenses, while incredibly advanced, still cannot accommodate as well as the real deal as of now.
When I heard that LASIK is not a solution to farsightedness, I specifically asked my eye doctor if there are other solutions for this. The only one mentioned was monovision (getting two different prescriptions for different eyes).
> Do note though that artificial lenses, while incredibly advanced, still cannot accommodate as well as the real deal as of now.
Cannot accommodate what as well?
take my money!
jacknews•2h ago
Let's hope it pans out for eyesight, and I'm sure there must be a whole lot of other things this could apply to.