Refractive eye surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.The Excimer Laser uses a rare gas mixture to emit laser light with a wavelength of 193nm that is capable of removing molecules of tissue without producing heat or burns. This correction process is called "photoablation," signifying, in essence, the vaporization of tissue by LASER light.
With its ability to safely deliver to a wide range of patients the opportunity to return to work the following day without glasses or contact lenses, LASIK remains our most commonly performed refractive procedure. LASIK combines 2 refractive surgery techniques: keratomileusis and LASER photoablation. The procedure consists, in essence, of raising a thin flap of the superficial anterior part of the cornea followed by corneal sculpting with the EXCIMER LASER according to the desired vision correction.
The Excimer Laser uses a rare gas mixture to emit laser light with a wavelength of 193nm that is capable of removing molecules of tissue without producing heat or burns. This correction process is called "photoablation," signifying, in essence, the vaporization of tissue by LASER light
The Lasik procedure is performed under topical anesthesia (drops only). When finished, the patient returns home with the eye unpatched. With laser vision correction, both eyes may be operated on the same day, if the patient desires. The vast majority of laser vision patients can see well enough to drive the day after their procedure, and pain is usually minimal. The best vision correction candidates have less than 10 diopters of myopia, less than 4 diopters of hyperopia, and less than 4 diopters of astigmatism. Under some circumstances higher lasik eye corrections may be corrected, but the predictability, efficacy, and safety begin to diminish. Serious complications with long-term adverse sequelae are rare.
Custom ablations or wavefront treatments may be performed with either lasik or surface ablation. These treatments are designed to correct optical abnormalities (known as “higher order aberrations”) in addition to myopia, hyperopia and astigmatism. While customized treatments may be used on most laser refractive surgery patients, they are of particular benefit for patients who have higher levels of higher order aberrations or larger pupil sizes preoperatively.
Surface ablation is the term used to refer to classic photorefractive keratectomy (PRK), laser subepithelial keratomileusis (LASEK), and Epi-Lasik, depending on whether or not the epithelium is removed and discarded (PRK) or removed and reposited (Lasek and Epi-Lasik). The surface ablation procedures have sometimes been referred to as “Flapless Lasik.” With surface ablation, the same EXCIMER laser used in LASIK is employed to sculpt the cornea and the visual results are equivalent.
In order to apply laser energy to the permanent portion of the surface of the cornea, the very top layer of temporary cells, the corneal epithelium, must be removed. The corneal epithelium, will heal in approximately 3 days after surgery. A clear, prescription free contact lens is placed on the eye for the few days that it takes the epithelium to regenerate. While the surface ablation procedures, like LASIK, are essentially painless, it is common for surface ablation patients to experience 24 to 36 hours of tearing, light sensitivity, and discomfort following their procedure. Special eyedrops and medications are given to help keep patients as comfortable as possible.
While custom ablation confers incremental gains in safety compared to LASIK, most patients who are good laser vision correction candidates for LASIK prefer its quicker recovery. Surface ablation is most commonly reserved for situations in which a patient’s cornea is too thin or irregularly shaped for LASIK. Surface ablation is able to correct the same levels of nearsightedness, farsightedness, and astigmatism as LASIK.
The ultimate visual outcomes with the surface ablation techniques (PRK, LASEK, and Epi-LASIK) mirror those with LASIK, but it takes longer for the results to be realized. Most surface ablation patients are able to return to work 4 to 5 days after their vision procedure, but will likely still experience some blurring and visual fluctuations during the subsequent three weeks. While the military is beginning to allow laser refractive procedures for its recruits, there have been some situations where certain divisions (ie: Special Forces) may only undergo surface ablation and not LASIK.
Lasik Imagine seeing clearly from the moment you open your eyes in the morning! Once you have vision correction you will see and experience all freedom that life has to offer. Laser refractive eye surgery will truly change your life. Whether you are farsighted, near sighted or have astigmatism, Laser eye surgery can eliminate your dependence on glasses or contact lenses. Once you have a vision correction procedure your natural vision will be restored.Gaining the freedom and security you want is actually quite easy. Laser vision correction is a pain free procedure that takes only few minutes and is approximately 60 seconds of laser time per eye in most cases.
The procedure takes 20 to 30 minutes. After, you’ll be taken to a recovery room where you’ll be closely monitored for a few hours. Your doctor might prescribe eye drops or oral medication for the pain. You can go home the same day, but you’ll need to have a ride. You’ll have a follow-up appointment the next day. Your surgeon will examine the eye and check on your progress. Within the next year, you’ll have follow-up visits 1 week, 1 month, and 3 months after surgery. Your doctor will also have you return for regular checkups once a year.
Refractive surgeries are one of the safest elective surgical procedures available today and various research estimate the rate of complications from refractive surgery to be less than 1 percent.
Over 80% of people who undergo refractive surgery no longer need to use glasses or contact lens post the surgery for most of their activities.
After a thorough examination and discussion with your ophthalmologist, you can decide on the procedure or surgery best suited for your eyes and vision needs. There is no universally-accepted, best method for correcting refractive errors.
