LASIK & Refractive Surgery in San Francisco
Pacific Eye Associates offers LASIK and other refractive procedures for patients who want to rely less on glasses or contact lenses. Our fellowship-trained cornea specialists perform LASIK, PRK, refractive lens exchange (RLE), implantable collamer lens (ICL) surgery, and limbal relaxing incisions (LRI).
Not every procedure is right for every eye. At your consultation, we’ll tell you which ones you qualify for, if any, and why.
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Procedures We Offer
LASIK (Laser-Assisted In Situ Keratomileusis)
LASIK is the most common vision correction procedure. A laser creates a thin flap in the front of the cornea, a second laser reshapes the tissue underneath, and the flap is laid back into place. No blade is used. Most patients notice clearer vision the next day and return to work within a few days.
PRK (Photorefractive Keratectomy)
PRK reshapes the cornea like LASIK, but without a flap. The thin outer layer is removed and grows back over several days. Recovery is slower, with vision sharpening over a few weeks, but long-term results are comparable for most patients. PRK is often the better choice for thinner corneas or for people whose work or sports risk eye impact.
LRI (Limbal Relaxing Incisions)
LRI reduces astigmatism with small incisions near the edge of the cornea, which let it relax into a rounder shape. It takes a few minutes and is often done together with RLE or cataract surgery. Vision can fluctuate for the first few weeks while the cornea settles. It works best for mild to moderate astigmatism. Higher amounts may need a toric lens.
ICL (Implantable Collamer Lens)
An ICL is a thin lens placed inside the eye, between the iris and your natural lens. Nothing is removed from the cornea, which makes ICL an option for high nearsightedness or corneas too thin for LASIK or PRK. Your natural lens stays in place, and the ICL can be removed if needed. Most patients see clearly within a day or two.
RLE (Refractive Lens Exchange)
RLE, also called clear lens exchange (CLE), replaces your natural lens with an intraocular lens (IOL), the same way cataract surgery does. It's most often considered for patients over 40 or with significant farsightedness. Depending on the lens, it can reduce the need for reading and distance glasses, and you won't develop a cataract later.
Am I a Candidate?
Candidacy comes down to a handful of factors. Your surgeon will check all of them at your consultation.
- Corneal thickness and shape. Thin or irregular corneas may rule out LASIK. PRK or ICL may still be options.
- Prescription stability. Your prescription should be stable for at least two years.
- Age after 40. Laser procedures don’t correct presbyopia, the near-vision change that eventually sends most people to reading glasses. That doesn’t rule you out. It means the conversation may include alternative.
- Dry eye. Existing dry eye can worsen after laser procedures and usually needs to be treated first.
- Overall eye health. Conditions like keratoconus, cataracts, or untreated glaucoma affect which options are safe.
- Pregnancy and nursing. Hormonal changes can shift your prescription, so we recommend waiting.
If surgery isn’t the right call, glasses and contacts are still good options, and our optical team can help you find what works.
What to Expect
At your consultation
Before your visit, stop wearing contact lenses for two weeks so we can measure your eyes in their natural shape. Your eyes will also be dilated, so bring sunglasses, and consider having someone drive you home.
At the consultation, a technician will take detailed measurements of your eyes, including the shape and thickness of your cornea. Then one of our surgeons will examine your eyes, go over the results with you, and talk through which options make sense. Plan for about an hour. There’s no obligation to schedule surgery.
On surgery day
Most vision correction procedures are done as outpatient surgery. You’ll be awake, your eyes are numbed with drops, and you may be offered something to help you relax. Most patients describe some pressure and very little pain. Plan to spend a few hours there, and you’ll need someone to drive you home. Our surgery coordinator will walk you through preparation, recovery, and follow-up for your specific procedure.
Risks
Every surgery carries some risk, and the right procedure for you is partly about which risks are lowest for your eyes.
Common, and usually temporary:
- Dry eye. Most common after LASIK and PRK. It typically improves over the first several months and is managed with drops.
- Glare, halos, or starbursts around lights at night. Also common early on, and usually fading as the eye heals. For a small number of patients it lingers.
Less common:
- Under or overcorrection. Your vision may land slightly off target, or drift over time. A follow-up procedure (an enhancement) can sometimes fine-tune the result.
- Flap complications with LASIK, or corneal haze with PRK.
- With RLE and ICL, there are risks similar to other surgery inside the eye, including infection, inflammation, or increased eye pressure. RLE carries a small risk of retinal detachment, especially for very nearsighted patients.
Serious, permanent vision loss is rare. Your surgeon will go through the risks that apply to you specifically at your consultation.
Cost
Refractive surgery is rarely covered by insurance, though some employer benefit programs cover part of the cost. Out of pocket costs can be paid through FSA and HSA accounts.
Pricing depends on your procedure needs. Schedule a consultation with one of our refractive surgeons to learn more!
Am I a candidate?
Find out if LASIK or another vision correction procedure is right for your eyes.
Meet Our Surgeons
Our surgeons combine advanced training with a patient-first approach, taking the time to understand your vision goals and guide you through your options with clarity and care.
