LASIK (Laser Assisted In-Situ Keratomileusis)
LASIK (Laser assisted in-situ keratomileusis) is an
elective eye "re-shaping" surgical procedure used to
improve the refractive state of the eye and decrease the
dependency on contact lenses or glasses. It is
used on
nearsighted,
farsighted
and
astigmatic eyes. LASIK
surgery typically results in rapid
recovery of vision. It is the most commonly
performed refractive eye surgery.
The Procedure
Potential LASIK candidates will receive a complete and
thorough eye exam. Very careful refraction tests
will be performed to determine the precise refractive
error of the operative eye.
In order to rule out possible irregular corneal defects,
a detailed surface map of the cornea will be performed.
Prior to the surgery, an Excimer laser instrument is
customized and pre-programmed to treat the specific
refractive error of the patient.
During the LASIK procedure, anesthetic eye drops will be
used to numb the eyeball and corneal surface. The
patient should experience no discomfort.
An instrument called a speculum is placed on the eyelids
to prevent blinking and eye movement. A ring will
be placed on the eye to hold it steady.
A
thin surface flap of the cornea is made using a microkeratome
-- a precision surgical blade. The flap is lifted
like a hinged door exposing the underlying corneal
tissue.
The surgeon then
applies the Excimer laser beam to the exposed corneal
layer. This laser "ablation", which usually
takes less than one minute, removes targeted
inner-corneal tissue, reshaping its surface and giving
it a more normal curvature. The thin, outer flap
is then replaced. The surgeon observes the eye
under a microscope for a few minutes to make sure the
flap is securely in its place. The speculum is
removed and the patient usually leaves the eye center
within an hour after surgery.
Visual Results with LASIK
Surgical results are often dramatic, with most patients
noticing a very rapid increase in visual acuity.
Same or next day improvements in vision are common.
Vision usually continues to improve for3-4 weeks as the
cornea heals.
In some cases, it may take a few months to realize final
visual acuity gains.
The overwhelming majority of cases result in vision
improvements good enough to eliminate distance glasses.
Although technology continues to improve LASIK's
success, it should be stated that not all patients can
expect to see well without glasses or contact lenses
postoperatively. Patients with large amounts of
myopia,
hyperopia or
astigmatism should avoid
expectations of "perfect" vision.
LASIK Candidates
LASIK is used to treat refractive errors
like myopia (nearsightedness),
hyperopia
(farsightedness) and
astigmatism. LASIK candidates
are those patients with moderate levels of refractive
error. The candidate should be one who no longer
wishes to wear glasses or contact lenses. LASIK is
an elective procedure that carries, like any surgical
procedure, a certain amount of risk and benefits.
The patient should be counseled regarding outcome
expectations and be willing to accept these the
potential risks.
Possible Complications
The most common complications include
postoperative glare, halos or starbursts around lights
at night, corneal infection. Complications that
threaten the vision and eye itself are very rare.
PRK (Photorefractive Keratectomy)
Like LASIK,
Photorefractive keratectomy (PRK) is a corneal
"re-shaping" surgical procedure intended to reduce the
patients need for glasses or contact lenses. The PRK
procedure also employs an Excimer laser. PRK may be used
to treat myopia (nearsightedness),
hyperopia
(farsightedness), or
astigmatism.
Unlike LASIK, PRK does not involve creation of a corneal
flap. The laser is applied directly to the top,
outer surface of the cornea. PRK does not involve
a cutting blade and therefore does not carry the
postoperative risks of corneal flap complications.
However, there is a greater risk of postoperative
scarring, infection (rare) and unpredictable healing of
the cornea with PRK.
The Procedure
Anesthetic
eye drops are applied to the eye to numb the eye and
prevent discomfort during the procedure. An
instrument called a speculum is placed on the eyelids to
prevent blinking and eye movement.
The surgeon then gently removes the surface corneal
cells.
Prior to the surgery, an Excimer laser instrument is
customized and pre-programmed to treat the specific
refractive error of the patient. This laser is
focused on the cornea and activated for less than one
minute. The laser re-shapes the outer surface of
the cornea to the desired refractive correction.
Medication to prevent corneal hazing may be applied.
The surgeon will then place a bandage contact lens on
the eye to decrease postoperative discomfort. The
patient is given anti-inflammatory eye drops to use for
several weeks to months. Patients can typically
leave the eye surgery center within an hour of the
procedure.
PRK Recovery
Unlike LASIK, patients can experience some discomfort
and irritation in the eye after surgery. Multiple
follow-up visits to the eye surgeon will be required to
monitor the condition and healing of the cornea.
The bandage contact lens will remain on the eye for 1 to
3 days, on average.
Visual Results with PRK
Surgical results are very good -- with most patients
noticing an increase in visual acuity. However, unlike
LASIK, same or next day improvements in vision are not
common. Vision will recover at a somewhat slower pace
than with LASIK.PRK Candidates
PRK is used to treat refractive errors
like myopia (nearsightedness),
hyperopia
(farsightedness) and
astigmatism. PRK candidates
are those patients with moderate levels of refractive
error. The candidate should be one who no longer
wishes to wear glasses or contact lenses. The PRK
candidate should understand that enhancement procedures
may be required during the first year after surgery.
PRK is
an elective procedure that carries, like any surgical
procedure, a certain amount of risk and benefits.
The patient should be counseled regarding outcome
expectations and be willing to accept these the
potential risks.
Possible Complications
PRK is an elective procedure which, like any procedure,
has risks and benefits. The potential patient
should understand this. The possible complications
of PRK surgery are: postoperative glare, halos or
starbursts around lights at night, corneal infection,
pain, long healing periods, over-under refractive
correction, reduced visual acuity.
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