Eye Surgery to Correct Vision Problems

While varying degrees of vision loss is very common—and caused by a variety of factors—surgery can now be used to correct many of these issues. But at the same time, you do need to be cautious whenever you're dealing with your eyes and vision, so be sure to consult an ophthalmologist before making any decisions.

Female patient undergoing laser eye surgery at clinic

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LASIK

LASIK—which is short for laser-assisted in situ keratomileusis—is the most common type of refractive eye surgery to treat a range of vision problems including:

The procedure cannot, however, reverse age-related close-up vision (presbyopia). But, if someone dealing with presbyopia wants to have LASIK, they can opt for a modified version of the surgery called "monovision," in which one eye is corrected for distance, and the other for seeing things that are nearby.

Standard LASIK

Standard LASIK is an outpatient surgical procedure that uses an ultraviolet laser to remove a thin layer of the cornea, reshaping it in the process, enabling light rays to focus more clearly on the retina.

The procedure is done using numbing eye drops while the patient is awake, and takes approximately 10 to 15 minutes to perform on each eye. Although not all patients have 20/20 vision after LASIK, 95% of people report being satisfied with the outcome.

Custom LASIK

Custom LASIK—also referred to as "wavefront-guided LASIK"—uses a more advanced type of laser to get a three-dimensional image of the patient's eye. The aim is then to use that image to ensure that the corrections made to the patient's cornea are as precise as possible.

Lasers Are Used in More Than Just Refractive Surgery

Laser surgery and refractive surgery are often used interchangeably, but they are not the same thing.

  • Refractive surgery is the general term for surgical procedures to correct nearsightedness, farsightedness, and astigmatism.
  • LASIK is a type of refractive surgery that uses lasers, but lasers used for many types of other surgeries as well. Similarly, there are methods of performing refractive surgery that does not involve lasers.

PRK

Photorefractive keratectomy (PRK) is another type of laser surgery used to correct mild nearsightedness, farsightedness, and astigmatism.

Like LASIK, the procedure involves using ultraviolet light to reshape the cornea. The difference is that in PRK the laser reshapes the surface of the cornea while LASIK reshapes the cornea under a flap.

Approximately 90% of people who have had PRK reported having 20/40 vision or better without glasses or contact lenses.

Cataract Surgery

When the lens of a person's eye becomes cloudy, it is likely caused by cataracts. Surgery is often required to treat cataracts.

Cataract surgery involves removing the eye's cloudy lens (located at the front of the eye) and replacing it with an artificial, clear lens.

Approximately 90% of people report experiencing an improvement in their vision after cataract surgery, though that doesn't mean a person's vision will be completely restored. Many people still have to wear glasses or contact lenses after the procedure.

Use of Anesthesia in Ocular Surgery

Because there are several different types of ocular surgery—with varying degrees of invasiveness—different types of anesthesia are used.

Any eye surgery performed on children typically uses general anesthesia (when the whole body is put into medically-induced "sleep").

For adults, it really depends on what is involved with the procedure. For example, while some cataract surgeries can be performed under local or topical anesthesia, others require the patient to receive general anesthesia.

Glaucoma Surgery

If someone has been dealing with glaucoma, and medications or laser treatments aren't helping, their doctor may recommend surgery. While glaucoma surgery doesn't cure glaucoma or undo any vision loss, it can at least stop a person's glaucoma from getting worse and help lower the pressure in their eye(s). If a patient requires glaucoma surgery in both eyes, the doctor will do each procedure separately.

There are three main types of glaucoma surgery:

Trabeculectomy 

This surgical procedure—typically used to treat open-angle glaucoma—involves the surgeon creating a tiny opening in the top of the eye (under the eyelid, so it's pretty well-hidden). The incision allows extra fluid in the patient's eye to drain away, lowering the pressure in their eye.

Though it's done in a hospital, the outpatient procedure usually takes less than an hour.

Glaucoma Implant Surgery

Used to treat:

  • Congenital glaucoma
  • Neovascular glaucoma
  • Glaucoma caused by an injury

This outpatient procedure takes one to two hours and involves the surgeon implanting a tiny tube into the white part of the eye to allow extra fluid to drain out of the eye, lowering eye pressure.  

Minimally Invasive Glaucoma Surgery (MIGS) 

There are several different types of MIGS, though they all use microscopic-sized equipment and tiny incisions. While that can mean that a patient heals more quickly after surgery, it may also mean the surgery is not as effective as one using traditional methods.

Overall, glaucoma surgery is typically 70 to 90% effective in older patients.

Macular Degeneration Surgery

There are two types of macular degeneration: dry and wet. Approximately 80% of people with macular degeneration have the dry variety, which unfortunately has no effective treatments at present. But the 20% of those with wet macular degeneration—which is the more severe type—treatment options include an injectable drug or laser surgery.

During the laser surgery, the doctor shines a laser light beam on the abnormal blood vessels in a patient's eye, reducing the number of vessels and slowing their leaking.

While the specific success rate of this procedure is unavailable, a 2015 study did demonstrate that in some cases, laser surgery limits the progression of macular degeneration.

Corneal Surgery

While some issues with the cornea can be fixed using LASIK or other procedures, in some cases, a person's front and inner corneal layers are damaged, meaning that they need a corneal transplant. This is called penetrating keratoplasty (PK), or full-thickness corneal transplant.

This involves removing a patient's diseased or damaged cornea, then sewing a clear donor cornea is sewn into place.

Given factors like the potential rejection of the donor cornea, the success rate for PK varies widely, so it's best for a patient to discuss their specific situation with their doctor.

Diabetic Retinopathy Surgery

People will diabetes may be diagnosed with an eye disease called diabetic retinopathy. This condition—which can cause vision loss—occurs when high blood sugar levels cause damage to blood vessels in the retina. While there are some non-surgical options for diabetic retinopathy (like medication), two types of surgery are used to treat the condition:

  • Laser surgery: Used to help shrink or seal off leaking blood vessels, which can reduce swelling of the retina. In some cases, more than one treatment is needed.
  • Vitrectomy: A surgical procedure that involves removing vitreous gel and blood from leaking vessels in the back of the eye, allowing light rays to focus properly on the retina again. It may also include the removal of scar tissue from the retina.

While the outcomes of the surgeries vary depending on the extent of a patient's eye damage, between 75 to 98% of patients report significant improvements in their visual activity after recovering from the procedures.

Vitreoretinal Surgery

In addition to treating diabetic retinopathy, vitreoretinal surgery can also be used for the following conditions:

  • Floaters and flashes
  • Macular degeneration
  • Macular holes
  • Retinal detachments or tears
  • Retinitis pigmentosa
  • Retinal vein occlusion
  • Retinopathy of prematurity
  • Retinoblastoma

There are a few different procedures that are considered vitreoretinal surgery, though they typically involve a surgeon making three tiny incisions in the patient's eye and using them to making any necessary adjustments in the eye.

Again, because there are different procedures considered vitreoretinal surgeries, the success rates depend on the procedure—though they typically range from approximately 90 to 98%.

Eye Muscle Surgery

Eye muscle surgery is used to correct the eye muscle issues that cause strabismus (also known as crossed eyes). Though it's most often performed on children, eye muscle surgery can be done on adults as well.

The procedure involves the surgeon making a small incision in the clear tissue covering the white of the eye called the conjunctiva.

From there, the surgeon will pinpoint the eye muscles that require surgery, and then either strengthen or weaken the muscle, depending on the patient's specific needs. The earlier eye muscle surgery is done, the more effective it is.

Approximately 10 to 20% of adult patients return for a follow-up surgery to fix any remaining eye alignment issues.

A Word From Verywell

It's completely normal to be nervous before any type of surgery—especially one involving your eyes. If the risks of a procedure outweighed its benefits, the doctor would not have even brought it up as an option in the first place.

On the day of your surgery, make yourself as comfortable as possible. That could include wearing loose-fitting or soft clothing (you'll likely be changing into a gown, but you might as well travel to and from the hospital in comfort) or bringing a trusted friend with you (you'll also need them to bring you home).

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19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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