Laser Vision Correction
Short for Laser-Assisted In Situ Keratomileusis, LASIK uses targeted excimer laser beam energy to gently remove, or ablate, corneal tissue in order to correct refractive errors and help patients see clearly. Millions of patients choose to undergo LASIK each year, and achieve clear vision without the need for glasses or contact lenses, while also benefiting from minimal downtimes and little to no post-operative discomfort.
LASIK is performed on an outpatient basis using only numbing eye drops to reduce any potential discomfort during the procedure. The entire surgery takes less than sixty seconds to perform, although patients can expect to spend a few hours at the office.
LASIK can be performed with a microkeratome blade or a femtosecond laser to create the corneal flap, which gently lifts the surface of the cornea so that the excimer laser can reshape the curvature of the cornea.
This customization is determined prior to surgery, with the precise positioning confirmed prior to triggering the laser. The second eye is treated right after the first, after which patients will be given protective shields to keep the eyes safe from bright lights after LASIK.
Custom LASIK, also known as wavefront LASIK, is quickly becoming the new standard in laser vision correction as it offers the most accurate, individualized results for each patient. This FDA-approved procedure uses three-dimensional measurements of the eye to help guide the laser as it reshapes the cornea and corrects your vision.
Custom LASIK lets patients benefit from a higher chance of achieving 20/20 vision, with many patients achieving vision that is better than 20/20, which often unachievable with traditional LASIK, glasses, or contacts. Custom LASIK also reduces the risk of poor night vision and glare, side effects that are common with traditional LASIK.
Like LASIK, it involves making an ultra-thin flap of corneal tissue to reduce pain.
During Epi-LASIK a blunt microkeratome smoothly separates the surface layer, or epithelium, from the cornea. This ultra-thin flap is what gives the procedure its name: "Epi" stands for the Greek word "Epipolis," meaning "superficial." This avoids complications associated with the deep stromal flaps of ordinary LASIK including flap irregularity (photo#13), epithelial ingrowth and corneal ectasia. The flap heals in a few days with very little pain and without stitches. The contact lenses can usually be removed after three days.
Epi-LASIK is best for people with thin corneas who would not be able to sustain a normal LASIK flap.
Photorefractive keratectomy (PRK) is a unique laser vision correction procedure that uses an excimer laser to burn away a small amount (about 5 to 30 percent) of the top of the cornea in order to correct refractive errors. Instead of cutting a flap into the cornea with a blade like the LASIK procedure, this method preserves the strength of the cornea and avoids the risk of perforation of the flap and other flap errors.
Up to 95 percent of patients with a correction of up to -6.00 diopters achieved vision of 20/40 or better after PRK, with up to 70 percent achieving 20/20.
LASEK, or Laser Assisted Subepithelial Keratomileusis, is a modification of the LASIK procedure for patients with very thin or very steep corneas. First, the outer layer of the cornea (the epithelium) is bathed in a special alcohol solution that loosens the edges of the epithelial flap. The flap is lifted so the central cornea may be exposed and treated with an excimer laser.
Many improvements have been made in LASIK procedures since they were first introduced years ago. Among the newest and most advanced is iLASIK, which incorporates IntraLase and CustomVue technologies for the best possible vision enhancement.
IntraLase® has redefined the world of LASIK vision correction. Also known as bladeless LASIK, the IntraLase® all-laser procedure eliminates the need for a metal blade during surgery, helping bring clear vision to many people who feel uneasy about going "under the knife" during LASIK.
The state-of-the-art IntraLase® technology replaces the microkeratome blade that has traditionally been used to cut the necessary corneal flap during laser vision correction procedures. Rather than creating the flap with a blade, IntraLase® uses laser energy to make a quick, painless incision. By replacing the hand-held blade with a computer-controlled laser, the risk of complications is virtually eliminated.
VISXTM's CustomVue procedure combines the technologies of the WaveFront and STAR S4 Excimer Laser systems for high-definition, high-accuracy LASIK vision correction. CustomVue makes it possible to perform customized refractive surgeries using information gathered from your own eyes. This allows for the correction of the very specific refractive errors that obscure each patient's vision so you can enjoy the best post-operative vision quality possible, whether you are nearsighted, farsighted and/or astigmatic. Other benefits of the CustomVue process include faster treatment time and no need to dilate the pupils.
The Benefits of iLASIK
Because of the low risk of complications and high level of precision it provides, bladeless LASIK treatment has become the standard of care among leading LASIK surgeons and ophthalmic teaching institutions worldwide.
Compared to methods that use a microkeratome blade, this minimally invasive and incredibly precise procedure decreases the occurrence of partial flaps, holes in the flap, and other traumatic flap complications. Of the hundreds of thousands of iLASIK procedures that have been performed globally to date, there have been no reports of any serious or sight-threatening complications.
Am I a good candidate for iLASIK?
An eye exam is required to see if you are a candidate for laser vision correction. Candidates must be at least 18 years old to ensure that their eyes have matured. Also, vision must have remained stable without an infection or injury for one year prior to the surgery. Ideal candidates for iLASIK surgery do not suffer from dry eye syndrome or any autoimmune disorder such as lupus or Sjogren's syndrome, and have no scarring on the cornea.
How iLASIK Works
The laser uses quick pulses (a quadrillion per second) of laser energy to create the flap in the cornea needed to correct refractive problems. The computer-guided laser pulses travel through the outer layers of the cornea, moving back and forth across the eye to create microscopic bubbles at a specified depth. The bubbles under the cornea eventually create a perforation. The surgeon is then able to gently separate the perforated tissue to create a flap, allowing him to continue with the laser vision correction procedure.
Because the laser is guided by a computer, the procedure is carried out with extreme precision and creates the optimal depth, position, and diameter for the flap specific to each patient. The entire process of creating the corneal flap takes about 30 seconds.
After the iLASIK Procedure
Discomfort is usually minimal following iLASIK. You can expect to notice a significant improvement in vision the very next day. Most patients are able to resume normal daily activities, including driving and returning to work, at this time. You should, however, avoid using any eye makeup for three days following the procedure and avoid swimming and rubbing your eyes for two weeks.
Some patients experience increased sensitivity to bright light in the weeks following iLASIK. Patients sometimes also report seeing halos around lights at night. On occasion, patients may experience dry eyes and require eye drops to increase moisture. These symptoms typically decrease shortly after the surgery.
Follow-up visits are required to make sure that the procedure went well and your vision remains crisp and clear.
The iLASIK procedure has proven to be extremely safe and effective. Nevertheless, no surgery is entirely free from risks and complications. Some patients experience light sensitivity. This is often temporary and can be successfully treated using steroidal eye drops for a few weeks. Also, inflammation can occur in the cornea. Though microscopic, this swelling can lead to blurred vision. This should correct itself over time. Dry eyes may also be experienced, in which case eye drops may be recommended to lubricate the eyes.
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