LASIK is a more complex
procedure than PRK. It is performed for all degrees of nearsightedness.
The surgeon uses a knife called a microkeratome to cut a flap
of corneal tissue, removes the targeted tissue beneath it with
the laser, and then replaces the flap.
"With LASIK, the
skill of the surgeon is important because he'll be making an
incision," says Stephen Crawford, O.D., an optometrist practicing
in Virginia, "compared to the PRK method where the machine
does more of the work." Crawford urges people to find qualified,
experienced doctors to perform this surgery. "You'll want
someone who's done a number of LASIK procedures since this is
a surgeon-dependent operation," he said.
According to Ken Taylor,
O.D., vice president of Arthur D. Little, Inc., a technology
and management consultant firm in Cambridge, Mass., "Last
year, across the country, 40 to 45 percent of refractive surgeries
performed by physicians were LASIK, which equates to approximately
80,000 procedures." Doctors not participating in clinical
trials may choose to use the approved laser to perform LASIK
procedures at their discretion, says Morris Waxler, Ph.D., chief
of FDA's diagnostic and surgical devices section. But most uses
are considered "off label" and are not regulated by
FDA. Ralph A. Rosenthal, M.D., director of FDA's division of
ophthalmic devices, says, "The agency has ruled that individual
physicians can perform LASIK under the general 'practice of medicine,'
if it's in the patient's best interest."
