LASIK Laser Eye Surgery

For some patients, Laser Assisted In-Situ Keratomileusis (LASIK) is the best way to achieve natural vision. LASIK was first performed in 1989 by an ophthalmologist in Greece and was introduced to American LASIK surgeons in 1990.

Prior to the LASIK procedure, some drops are placed on the eye to numb the cornea. The entire treatment takes only about 15 minutes.

	The surgeon utilizes a special instrument (called a microkeratome) to make a very fine layer through about one third of the front surface of the cornea. This makes a "flap" of clear tissue on the central part of the eye. The resulting "flap" is approximately 160 microns thick (about 1/3 the thickness of human hair) and about 9 millimeters in diameter (much wider than the pupil).
	Once this flap is created, the physician removes the microkeratome and gently folds the flap back, exposing the underlying cornea. It is the area upon which the laser treatment is actually applied. Prior to your treatment, the surgeon will have carefully reviewed the detailed measurements and prepared a treatment plan from which the staff members will be fully able to accurately program the laser to achieve the desired correction of your vision.
	The excimer laser is then utilized, as in PRK, to even out the curvature of the cornea to achieve the desired correction.
	After laser treatment of myopia, the profile of the treated layer of the cornea shows flattening
	Upon completion of the laser aspect of the treatment, the flap is gently laid back into its original position over the treated corneal tissue. Because the cornea has unique bonding qualities, the flap will simply adhere to the underlying surface without the need for stitches.
	After the flap is gently laid back, the cross-section view of the cornea, treated for myopia, shows the reduced (flatter) corneal curvature (exaggerated for clarity).

Upon completion of the treatment, an eye shield may be applied. The patient goes home with a mild "something in the eye" feeling, comes back the next day to have the shield removed, and might have excellent vision immediately.

Laser Epithelial Keratomileusis (LASEK)

LASEK is an abbreviation for Laser Epithelial Keratomileusis. This procedure is the merging of the desirable features of LASIK and PRK. In this procedure, there is no microkeratome used to create a corneal flap. Instead a dilute solution of alcohol is applied to loosen and remove only the very surface of the epithelium. In this way, it is similar to PRK and can be used for patients who have thin corneas. Once the epithelial layer has been removed, an excimer laser is then used to reshape the cornea, as in both LASIK and PRK. Upon completion of the excimer laser treatment, the epithelial layer is then returned to its original position.

LASEK has the relative advantage in that it avoids any of the potential complications encountered while making the flap and during the flap healing process. The relative disadvantage is that, as with PRK, vision recovery is slower than LASIK and there is often moderate, but temporary discomfort for a few days after the procedure.

Generally, a thin soft bandage contact lens will be worn for several days after treatment to help with healing and minimize discomfort. Good functional vision is usually achieved within 7 days after treatment. For patients with thin corneas and sometimes for farsighted, or hyperopic patients, LASEK may be recommended as the best treatment option.

Photorefractive Keratectomy (PRK)

PRK or Photorefractive Keratectomy has demonstrated over a long period of time that it is a safe, effective and predictable method of Laser Vision Correction.

The PRK procedure is similar to that of LASIK in the way the laser is applied to the eye. The main difference is that there is no flap created by the surgeon using a microkeratome. Instead, the laser is used to produce your optical correction by reshaping the outermost surface of the cornea, rather than the tissue beneath a flap, as in LASIK. This requires the removal of a thin layer of the corneal epithelium, which may produce varying degrees of temporary discomfort for up to a few days after your treatment. In general PRK provides a slower visual recovery than LASIK.

The surgeon will often prescribe additional medications and a thin, soft bandage contact lens to make you more comfortable for a few days after your treatment. While PRK is only occasionally recommended, it has a distinct place for some patients. PRK is recommended for those patients: A) whose corneas are too thin to have LASIK safely, B) whose corneas display evidence of scarring from infection or trauma, or C) who are active or reserve military personnel.