LASIK

When the eye is nearsighted (myopic), the curvature of the cornea (clear front portion of the eye) is too steep, and this causes light rays entering the eye to be focused in front of the retina. In the farsighted (hyperopic) eye, the point of convergence would be behind the retina. The astigmatic eye is shaped more like a football instead of round like a baseball.This uneven shape causes ghosting and/or double vision. Presbyopia is best described as the loss of elasticity in the fine muscles of the eye making it difficult to focus properly for near. This generally occurs in the early 40s, and many people will notice subtle changes in the vision, difficulty seeing to read or do close work. It is at this time people may begin to depend on reading glasses or bifocals.Laser vision correction CANNOT correct presbyopia; however “monovision” may be performed where one eye is corrected for near vision, and the other corrected for distance.

LASIK is an acronym for Laser-assisted in-situ keratomileusis. In LASIK the surgeon uses an Excimer laser to reshape the corneal surface after creating a thin flap of corneal tissue. The flap remains attached to the cornea on one side and is recessed back so that the laser can remove a very tiny amount of tissue to flatten the cornea. This procedure is used to treat low to high levels of nearsightedness, and by adjusting the pattern of the laser beam; it is possible to treat farsightedness and astigmatism. Following the application of the laser, the flap is repositioned into its original place. The resulting shape of the cornea is corrected under the surface, changing your refractive error.

If you are interested in LASIK Laser Vision Correction, you have probably heard the term, “wavefront” used in connection with the procedure. NSVC offers custom Wavefront LASIK as well as conventional laser surgery. What is “wavefront”, what advantages can this revolutionary technology offer you and how can it impact your vision after surgery? Basically, wavefront refers to the excimer laser’s capability to provide:

• An incredibly detailed map of the eye for diagnostic purposes that is uniquely individual to each patient.
• Highly sophisticated and individualized information that can enable the surgeon to change the shape of the cornea using the more advanced diagnostic mapping system.

The wavefront technology was developed some years ago as a means to refine and sharpen the optics in high-powered the telescopes used by astronomers. It is a technology that has allowed scientists better views of the universe by eliminating aberrations caused by the Earth’s atmosphere. Now, wavefront technology has been applied to produce highly refined corneal “maps” and to use the same information to treat aberrations of the cornea by eliminating carefully selected tissue in an effort to improve vision. Remember, LASIK works by reshaping the cornea (that is too steep or too flat) of the eye to enable light to converge in a clear point of focus on the macula (central portion) of the retina.

There are several instances in which wavefront ablation may not be preferable, i.e., thin corneas, the size of the pupil too small, too nearsighted, too farsighted, too much astigmatism, etc. Based on your complete eye exam and wavefront diagnostics, your NSVC doctor will discuss the advisability of undergoing the wavefront procedure. Custom wavefront LASIK is certainly a high technology option, but there are exceptions and it is not for every patient. Your doctor at NSVC will thoroughly explore your particular options and make recommendations based on years of experience in refractive surgery management.

We know the decision to have LASIK is a big one, so we take great care to determine what’s best for you as our patient. That’s why we offer blade-free LASIK treatment using the IntraLase method.

With the IntraLase method, pulses of laser light create your corneal flap, which is then lifted so the next step of LASIK the reshaping of your cornea can be performed. When your LASIK treatment is over, the flap is securely repositioned into place. This bladeless, computer-guided technology is 100% more accurate than most of the mechanical microkeratomes (hand-held devices with a thin metal blade) that surgeons may also use to create a corneal flap.

The IntraLase method has been used successfully on hundreds of thousands of eyes and we trust this advanced technology to deliver exceptional results. Our commitment is to provide you with the ultimate in comfort, safety, and outstanding vision. LASIK with IntraLase can help you achieve all of this while it delivers the added assurance of knowing you’re being treated with the mostadvanced technology there is.

LASIK performed with IntraLase delivers superior visual results: In a clinical study comparing the IntraLase laser to the leading microkeratome, more patients achieved 20/20 vision or better in standard and custom LASIK surgery when the IntraLase method was used to create the corneal flap.

Unlike mechanical instruments, IntraLase technology is uniquely able to program the dimensions of your flap based on what’s best for your eye. Then the IntraLase laser creates your flap from below the surface of the cornea without ever cutting it. How?

• Ultra fast pulses of laser light position microscopic bubbles at a precise depth determined by your doctor.
• The laser light passes harmlessly through your cornea. Then the laser creates rows of these bubbles just beneath your corneal surface as it moves back and forth across your eye in a uniform plane.
• Next, the IntraLase laser stacks bubbles around your corneal diameter to create the edges of your flap. These bubbles are stacked at an angle that is determined by your doctor and is individualized to the way your eye is shaped.
• The process takes only about 30 seconds from start to finish, it’s quiet and it’s comfortable.
• Your doctor then gently lifts the flap to allow for the second step of your LASIK treatment. When treatment is complete, the flap easily “locks” back into position and rapidly begins to heal.

As an increasing number of people are taking advantage of technology to correct vision, LASIK has, by far, received the most notice. But there is another laser procedure, one that, although not for everyone, has distinct advantages, and can offer the opportunity to see well without glasses or contact lenses. It is called Photorefractive Keratectomy, or PRK.

PRK was invented in the 1980s, and widely practiced worldwide before receiving FDA approval in the US in 1995. PRK cannot correct presbyopia, the age-related loss of flexibility of the eye¹s focusing muscles that ultimately cause the need for reading glasses or bifocals. Like LASIK Laser Vision Correction, PRK uses the excimer laser’s cool, ultraviolet light beam. Now the difference between LASIK and PRK begins. While a microkeratome is used to gently create a corneal “flap” that is left attached and folded back for LASIK, PRK does not require the creation of a flap. Simply, based on previous testing, microscopic amounts of corneal tissue are removed, or ablated, by the excimer laser in an effort to restructure the cornea and thus better control the focusing of light on the retina. Due to the extreme accuracy of the excimer laser, a single cell of microscopic corneal tissue can be removed without damage to adjacent cells.

PRK and the excimer laser can benefit both nearsighted (flatten a too-steep cornea) and farsighted (make the cornea steeper) patients. In some cases, the excimer laser may also be used to smooth the irregular curvature of a cornea, the cause of astigmatism.

What are the advantages of PRK? Typically your NSVC doctor may recommend PRK in order to retain the integrity and strength of the eye. The doctor may also recommend PRK for patients with very dry eyes or thinner corneas — individuals who are not LASIK candidates. Because the excimer laser can “sculpt”, advanced technology can reliably treat nearsightedness, farsighted, and astigmatic eyes.

People who should not be considered for PRK are pregnant, have a pacemaker, are under 21 years old, have active eye, collagen or vascular disease, or whose glasses prescription changes several times in one year. Prior to PRK surgery, testing will be done in order to accurately establish a treatment pattern for the laser to ensure an optimal outcome.

All testing is pain-free. If you are a contact lens wearer, you will be asked to return to wearing glasses. If you wear hard or gas permeable contacts, leave them out for at least 4 weeks; or soft contact lenses, leave them out for 2 weeks.

After surgery, your eye will be fit with a special bandage contact lens to promote healing, and you will rest for a few minutes before returning home. Most people experience some discomfort following PRK for the first day or so following surgery as the eye heals. The discomfort is minimized by the use of the bandage contact lens and medications prescribed by our doctor. Some people return to work the next day, but we prefer you rest at least three days before resuming an active schedule. We also recommend patients refrain from strenuous activities or exercise for one week. During this time it will be necessary to refrain from rubbing the eye, and to guard against water, soap, shampoo or make-up from getting in the eye.