Had a thorough eye examination and received a recommendation for cataract surgery within the next three years.
Bob Carpenter
Contoura Vision vs. LASIK: Understanding Your Options for Laser Vision Correction
Who Is a Good Candidate for Each Procedure
Not everyone qualifies for both options, and the right choice depends on your prescription, corneal anatomy, and overall eye health. Our LASIK Surgeons evaluate each of these factors carefully before making a recommendation.
Both procedures treat myopia (nearsightedness) and regular astigmatism within specific ranges. An important distinction is that Contoura topography-guided treatment is FDA-approved only for myopia with or without regular astigmatism in the United States. It is not approved for hyperopia (farsightedness).
Standard LASIK, by contrast, can treat myopia, hyperopia, and astigmatism within the following approximate ranges:
- Myopia up to about -10.00 to -12.00 diopters, depending on corneal thickness
- Hyperopia up to about +4.00 to +6.00 diopters
- Astigmatism up to about 5.00 to 6.00 diopters
- Prescription stable for at least one to two years
For Contoura in the United States, the typical approved range includes myopia up to about -9.00 diopters with up to about -3.00 diopters of regular astigmatism, along with adequate corneal thickness and stable topography.
Our LASIK Surgeons may recommend Contoura when your corneal topography, though regular, shows measurable surface irregularities that a topography-guided profile would likely improve. Patients who have experienced halos, glare, or reduced night vision even while wearing glasses may also benefit from the surface-level precision of Contoura.
It is important to note that Contoura is not appropriate for keratoconus, corneal ectasia, or structurally unstable corneas. In cases involving disease-related irregular astigmatism, topography-guided PRK combined with corneal cross-linking may be considered as an alternative.
Your corneas must have sufficient thickness to safely allow tissue removal and still maintain structural integrity after surgery. We measure corneal thickness precisely during your evaluation to confirm this.
Tear film health is another critical factor. Dry eye can worsen after any laser vision correction procedure, so we assess your baseline tear production carefully. We also screen for early signs of keratoconus using corneal tomography, which provides a three-dimensional picture of your corneal shape and thickness distribution.
Most LASIK Surgeons prefer patients to be at least 18 years old, with many recommending waiting until age 21 or beyond. Prescription stability for at least one to two years before surgery is essential.
- Younger patients may still have prescriptions that change as their eyes mature
- Hormonal changes, pregnancy, and certain medications can cause temporary prescription fluctuations
- A stable prescription helps ensure that results last long-term
Certain eye and health conditions can make LASIK or Contoura unsafe or less predictable. We screen thoroughly to protect your safety and set realistic expectations for outcomes.
- Active eye infections, inflammation, or severe dry eye disease
- Keratoconus, corneal ectasia, or corneas that are too thin
- Uncontrolled diabetes, autoimmune disorders, or immunosuppression
- Pregnancy or nursing, due to hormonal effects on vision
- Visually significant cataracts, poorly controlled glaucoma, or unstable retinal disease
Some of these are relative rather than absolute disqualifiers. A careful risk assessment may still allow surgery in select cases after appropriate evaluation and clearance.
Evaluation and Choosing the Right Approach
Selecting the most appropriate procedure requires a detailed in-person evaluation. Our team uses a combination of tests to build a complete picture of your eyes and identify which option is best suited to your individual anatomy and visual goals.
Your evaluation starts with a thorough eye exam that measures your current prescription and checks the overall health of your eyes. We assess visual acuity, eye alignment, and how your eyes function together.
We also examine both the front and back of each eye using specialized instruments. This helps identify any conditions that may need to be addressed before or instead of surgery.
Corneal topography produces a detailed, color-coded map of your corneal surface. The test is quick and completely painless, and it provides data that is essential for both Contoura planning and keratoconus screening.
- The device projects rings of light onto your cornea and photographs the reflection
- Computer analysis identifies areas that are steeper or flatter than the surrounding tissue
- The map reveals patterns of regular or irregular astigmatism
- This information directly informs whether Contoura topography-guided treatment is appropriate
We measure your pupil size under both bright and dim lighting because larger pupils in low light can increase the likelihood of seeing halos or starbursts around lights after surgery. Wavefront analysis measures how light travels through your entire optical system and identifies higher-order aberrations that a standard prescription cannot capture.
Modern lasers use larger optical zones and aspheric treatment profiles, which reduce but do not eliminate the risk of night vision symptoms. These measurements help us predict your likely outcomes and discuss any visual quality concerns before surgery.
After reviewing all test results, our LASIK Surgeons analyze your corneal shape, prescription, lifestyle needs, and visual goals together. If your corneas are smooth and regular, wavefront-optimized LASIK may deliver excellent results.
If topography reveals surface irregularities or you have significant higher-order aberrations, Contoura may offer a more personalized treatment outcome. In some cases, neither LASIK nor Contoura is the best option, and a surface-based procedure such as PRK may be recommended instead.
What to Expect on Surgery Day
Understanding what happens before, during, and immediately after surgery helps reduce anxiety and supports a smooth experience. Our team walks you through every step so you feel prepared and comfortable.
You will need to stop wearing contact lenses before your final measurements and on surgery day. Contacts alter the natural shape of the cornea, and removal time varies by lens type.
- Soft spherical lenses: stop at least one week before final measurements
- Soft toric lenses: stop at least two weeks before final measurements
- Rigid gas-permeable or hybrid lenses: stop two to four weeks or longer, until topography is stable
- Orthokeratology lenses: may require several weeks or more until corneal shape fully returns to baseline
On surgery day, arrange for a driver, avoid eye makeup and lotions, eat a light meal beforehand, and bring sunglasses since your eyes will likely be light-sensitive after the procedure.
Anesthetic drops numb your eyes before surgery begins, so you will not feel pain. A gentle device holds your eyelids open while you focus on a small light target overhead.
The LASIK Surgeon creates a thin corneal flap using a femtosecond laser, lifts it carefully, and applies the excimer laser to reshape the tissue beneath. With Contoura, the laser follows the topography-guided map rather than prescription data alone, making thousands of small adjustments that smooth surface irregularities as it corrects your vision. The flap is then repositioned and adheres naturally without sutures.
Most patients feel only mild pressure when the flap is created, lasting just a few seconds. The laser treatment itself is painless.
After the anesthetic drops wear off, some patients notice a mild burning or scratchy feeling for several hours. This typically resolves quickly with rest and the eye drops we provide, and most people describe it as similar to having an eyelash in their eye.
The laser treatment for each eye typically takes under one minute. The full procedure for both eyes, including preparation, usually takes between 15 and 30 minutes.
- Positioning and numbing drops: approximately 5 minutes
- Flap creation: 10 to 30 seconds per eye
- Laser reshaping: 10 to 60 seconds per eye, depending on your prescription
- Post-procedure instructions and recovery: approximately 10 minutes
Plan to be at our center for one to two hours total to allow for check-in, preparation, the procedure, and post-operative instructions before you leave.
Risks, Side Effects, and What to Watch For
Both procedures are well-established and considered safe, but like any surgery, they carry potential risks. Understanding these helps you make an informed decision and know when to seek prompt care.
Most patients experience some degree of temporary side effects during the healing period. These are a normal part of recovery and typically resolve on their own.
- Dryness, burning, or a foreign body sensation for several weeks
- Fluctuating or hazy vision during early healing
- Glare, halos, and starbursts around lights at night, which usually improve over time
- Light sensitivity in the first few days
- Mild discomfort during the first 24 hours
Although serious complications are uncommon, they can occur. Our team screens carefully to minimize risk and monitors your healing closely at each follow-up visit.
- Infection or significant inflammation, including diffuse lamellar keratitis (inflammation beneath the flap)
- Flap-related issues such as microscopic folds or tissue growing under the flap
- Overcorrection or undercorrection, sometimes requiring an enhancement procedure
- Irregular astigmatism or off-center treatment
- Corneal ectasia (progressive corneal thinning) in predisposed eyes, despite thorough screening
- Persistent dry eye symptoms beyond the typical healing period
Both LASIK and Contoura deliver lasting results, but your eyes will continue to change naturally with age. Setting realistic expectations before surgery leads to greater long-term satisfaction.
- Presbyopia, the age-related loss of near-focusing ability, develops around age 40 and is not corrected by either procedure
- Regression of correction is possible, particularly with higher preoperative prescriptions
- Enhancement (touch-up) surgery may be needed in some cases; most practices see low single-digit rates within the first year
Recovery and Aftercare
How you care for your eyes in the days and weeks after surgery plays a significant role in achieving the best possible outcome. Following our aftercare instructions carefully protects the corneal flap and supports smooth healing.
Vision may be blurry or hazy right after the procedure, but many patients notice improvement within a few hours. Resting with your eyes closed as much as possible during the first day is strongly encouraged.
We provide protective eye shields to wear while sleeping to prevent accidental rubbing. Avoid touching or rubbing your eyes at all, even if they feel itchy, until the flap has had time to heal securely. Do not drive until you have been examined and cleared at your first post-operative visit.
We will prescribe several types of eye drops to support healing and prevent complications. Using them exactly as directed is important for your recovery.
- Antibiotic drops to prevent infection, typically used four times daily for about one week
- Anti-inflammatory or steroid drops, used for one to four weeks with frequency tapering over time
- Preservative-free artificial tears, used frequently throughout the day to keep your eyes comfortable and moist
Do not adjust, skip, or discontinue any drops without guidance from our team. The exact schedule may be tailored based on your individual healing.
Most patients can return to light work and daily activities within one to three days. More strenuous activities require additional healing time before they are safe to resume.
- Avoid direct shower spray to the eyes for the first 24 to 48 hours
- No eye makeup for at least one week
- Avoid dusty, dirty, or smoky environments for at least one week
- No rubbing or pressing on the eyes for at least one month
- Non-contact sports can generally resume in one to two weeks
- Contact or high-impact sports typically require at least four weeks, with protective eyewear
- Pools and hot tubs: avoid for at least two weeks; lakes and ocean swimming: three to four weeks
Your first follow-up visit is typically scheduled for the day after surgery. At this visit, we check your vision, examine the flap, and confirm that healing is progressing as expected.
Additional appointments are usually scheduled at one week, one month, three months, and six months after surgery. These visits allow us to track your vision improvement and respond promptly to any changes or concerns. We adjust the schedule based on how your healing progresses.
Complications after LASIK are rare, but certain symptoms should never be ignored. Contact our office right away if you experience any of the following.
- Sudden or significant vision loss
- Severe eye pain that does not improve with rest or prescribed drops
- Increasing redness, discharge, or signs of infection
- New flashes of light, sudden new floaters, or a curtain or shadow in your visual field
- A sensation that the corneal flap has shifted or wrinkled
Comparing Results and Visual Quality
Both procedures deliver excellent visual outcomes for appropriately selected patients, but there are some differences worth understanding when making your decision. Our LASIK Surgeons will explain what results are realistic based on your individual evaluation.
Most patients notice clearer vision within the first 24 hours after either LASIK or Contoura. Vision may fluctuate during the first few weeks as the cornea heals and stabilizes.
Significant improvement typically occurs within the first week, with continued refinement over one to three months. Final visual results are generally stable by three to six months after surgery.
Clinical studies show that both standard LASIK and Contoura achieve excellent results for most properly selected patients. The majority of people reach 20/20 vision or better after either procedure.
Some studies have shown a slightly higher percentage of patients achieving 20/15 vision or better with Contoura compared to standard LASIK. However, individual results vary based on your original prescription, corneal characteristics, and healing response. The group-level differences between the two approaches are generally modest and may not be noticeable to every individual patient.
One area where Contoura may offer an advantage is overall visual quality, particularly in low-light conditions. By correcting corneal surface irregularities in addition to your prescription, topography-guided treatment can reduce higher-order aberrations, which are the subtle distortions that cause halos, glare, and starbursts around lights at night.
Some patients report sharper contrast and improved vision after dark with Contoura compared to standard LASIK. That said, both procedures have been refined over the years to minimize night vision symptoms, and modern laser platforms use aspheric profiles and larger optical zones to further reduce these effects.
An enhancement procedure, sometimes called a touch-up, may be needed if your vision is not fully corrected or if your prescription shifts over time. Most practices see low single-digit enhancement rates within the first year, with somewhat higher lifetime rates in older patients and those with higher preoperative prescriptions.
Long-term stability is excellent for both procedures when patients are carefully selected. While the correction itself typically remains stable for many years, natural age-related changes such as presbyopia after age 40 will still occur independently of the surgery.
Frequently Asked Questions
These answers address common questions we hear from patients who are comparing their options and deciding whether to move forward with a consultation.
Contoura typically costs more than standard LASIK because of the advanced corneal mapping technology and the specialized WaveLight platform used for treatment. The price difference can vary by practice and prescription complexity. When weighing cost, consider whether the additional customization is expected to provide meaningful benefit for your specific corneal anatomy. Our team can discuss pricing and available financing options, including CareCredit, FSA, and HSA plans, during your consultation.
Most health insurance plans classify both LASIK and Contoura as elective refractive procedures and do not provide coverage. However, flexible spending accounts and health savings accounts can be used to pay with pre-tax dollars, which can reduce your out-of-pocket cost meaningfully. Some vision plans offer discounts rather than full coverage. Our team can help you understand what benefits you may have access to before your procedure.
There are effective alternatives if LASIK or Contoura are not appropriate for your eyes. PRK (photorefractive keratectomy) removes surface tissue instead of creating a flap, making it a better option for thinner corneas or certain surface conditions. For high myopia or thin corneas, a phakic implantable collamer lens may be considered. Patients with early lens changes may be better suited to refractive lens exchange. Our LASIK Surgeons will review all relevant options based on your exam results and goals.
If you are over 40, you will very likely still need reading glasses for close-up tasks after LASIK or Contoura. These procedures correct distance vision but do not reverse presbyopia, the age-related change in near-focusing ability that typically begins in the mid-forties. Monovision, a technique where one eye is intentionally left slightly nearsighted for reading tasks, is one option some patients choose to reduce reading glass dependence. We can discuss whether monovision would be appropriate for you during your consultation.
LASIK may be considered for patients with well-controlled glaucoma, but it requires careful evaluation and ongoing monitoring afterward. Glaucoma that is poorly controlled or that has caused significant optic nerve damage is generally a contraindication. It is also worth noting that LASIK alters corneal thickness and curvature, which can affect the accuracy of future intraocular pressure readings. Our team coordinates with glaucoma specialists as needed to ensure safe surgical planning.
If you have visually significant cataracts (clouding of the natural lens), cataract surgery with a premium intraocular lens is usually the more appropriate solution rather than LASIK or Contoura. Modern cataract surgery can simultaneously correct refractive error and, in many cases, reduce dependence on glasses. Our LASIK Surgeons can evaluate both conditions and help you understand which path best addresses your vision needs.
Schedule a Consultation at NewView Eye Center
Choosing between Contoura and standard LASIK is a decision that deserves personalized guidance from an experienced LASIK Surgeon who has evaluated your specific eyes. At NewView Eye Center, our team combines advanced diagnostic technology with individualized care to help you understand exactly which option is right for you. We proudly serve patients across Northern Virginia and look forward to helping you see your world more clearly.
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