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Refractive Surgery

Refractive eye surgery refers to a group of procedures designed to reduce your dependence on glasses and contact lenses. There are many types of refractive eye surgery, the most popular of which is LASIK. For many people, wearing glasses and contacts is a hassle and can interfere with an active lifestyle. Patients who have undergone LASIK enjoy the sense of freedom that comes from not having to worry about wearing glasses or contacts. In many cases, patients have better than 20/20 vision after the procedure. Please read the information below to learn more about our refractive surgery procedures:


LASIK (laser-assisted in situ keratomileusis) is a reliable and painless way to improve vision and reduce or eliminate the need to wear glasses or contact lenses. LASIK changes the way light is bent, or refracted, as it passes through the cornea so that it focuses properly on the retina and objects can be seen clearly. LASIK has been approved by the Food and Drug Administration for a wide range of nearsightedness, farsightedness, and astigmatism.

During a traditional LASIK procedure, a device called a microkeratome cuts a thin flap in the surface of the cornea. Patients are given anesthesia so they can't feel the instruments. Next, the flap is then lifted and an excimer laser is used to reshape the cornea's curvature to improve vision. The flap is then replaced and allowed to seal without stitches.

The entire procedure takes only ten minutes per eye, but patients should plan on spending about an hour at the laser center. You will go home and rest following the procedure but will need to return for follow up appointments the next day and at scheduled intervals thereafter.

LASIK Procedure

Antibiotic and steroid eye drops will be prescribed for a few days, along with any other post-operative instructions. Full recovery takes a few weeks.


IntraLase®, sometimes referred to as "all-laser LASIK" or "bladeless LASIK," is a revolutionary method for creating the corneal flap during the first step of the LASIK procedure. The IntraLase® system utilizes laser energy, rather than an actual cutting tool, to create a thin flap in the cornea. The use of the IntraLase® laser allows for greater control and accuracy than ever before. Using a computer software program to guide the laser, our doctors can control the exact dimensions of the corneal flap, including size, shape, and depth. The ability to customize and precisely carry out the creation of the flap means there are fewer flap complications than LASIK performed with the microkeratome. Patients who would not typically be considered good candidates for LASIK, including those with thinner corneas, may benefit from the IntraLase® system. Dr. Wexler was the first LASIK surgeon in the St. Louis area to perform the Intralase procedure. He has performed more bladeless LASIK procedures than any other St. Louis surgeon.


PRK stands for photorefractive keratectomy. It was the original laser refractive surgery procedure first approved by the FDA in 1997. About 15% of the refractive surgery procedures at Eye Care Associates are done as a PRK surgery. Your doctor will advise you whether PRK or LASIK is right for you.

PRK utilizes the same excimer laser that is used in LASIK surgery. The difference is that instead of reshaping the cornea under a flap, the procedure is performed on the top surface on the cornea. Because of this, the patient is left with an abrasion on the cornea that takes longer to heal than in LASIK surgery. To promote comfort and healing following the procedure, a "bandage contact lens" is placed on the eye for four to five days. Patients notice a gradual improvement in vision over the first week to ten days following PRK, and it may take several months to achieve final results.

PRK works just as well as LASIK for correcting a variety of refractive errors, but is not as convenient for the patient. For many patients however, it is the best refractive surgery option.

PRK Procedure

Phakic IOL

"Phakic" means that the natural lens of the eye is still intact. The phakic IOL, or intraocular lens, is another alternative for patients who have higher degrees of myopia or who are not well suited for LASIK. This intraocular lens is placed inside the eye, in front of the eye’s natural lens. An advantage of this type of refractive surgery is that the intraocular lens can be removed later if desired.

If you are interested in learning more about our Refractive Surgery procedures, call 314-863-4200 today to schedule an appointment.


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