LASIK (Laser Assisted in-Situ Keratomileusis) and PRK (Photo-Refractive Keratectomy) are the two most common forms of laser vision correction (LVC). Both procedures use the excimer laser to reshape the corneal curvature. Reshaping the corneal surface allows the light to properly focus on the retina (as with glasses and contacts), providing clear vision. Laser eye surgery is becoming increasingly popular as people discover how much it can change their lives.
The goal of surgery is to reduce the need for glasses and contact lenses, allowing you to go about your daily routine without needing corrective lenses. Our surgeons personally discuss with each patient their individual needs and expectations. LVC may also be used to treat residual amounts of nearsightedness (myopia), or farsightedness (hyperopia) following other forms of refractive and cataract surgery.
With LASIK, the cornea is treated by first using an instrument called a microkeratome to create a corneal flap. Next, the laser is used to reshape the central cornea underneath the flap. With PRK, the laser is used to directly treat the front surface of the eye. Both procedures can be used to correct nearsightedness, farsightedness, and astigmatism. PRK has been performed in this country since 1988, and LASIK since 1991. During your consultation, our surgeons will discuss the advantages and disadvantages of each procedure which may vary depending on the individual.
The eyes are first anesthetized with drops and the surrounding area cleaned. Inadvertent blinking is prevented by using a comfortable lid speculum. The patient is asked to focus on a red blinking light. The corneal flap is created with the microkeratome and folded back. The laser is then used to vaporize a very thin layer of corneal tissue (0.2 microns per pulse) in a pattern customized to the patient's prescription. The corneal flap is then reflected back into position and medicated drops are applied. Surgery takes only a few minutes. Typically a protective eye shield is worn over the eye for the first day.
Visx LASIKDuring your examination, we gather important information regarding the health of your eye. The surgeon expertly measures your prescription as well as the shape and thickness of your cornea. Our goal is to help you select the procedure that will have the highest chance of achieving clear vision, while minimizing risks. Some patients have corneas that are thinner than average, and may not allow enough tissue to fully and safely treat their full prescription with LASIK. Patients with thinner corneas can often be treated with PRK. This procedure does not require a corneal flap, providing more corneal tissue for treatment.
Your eye is anesthetized with eye drops. The outermost layer of the cornea is removed with the laser, or mechanically with a special instrument. The laser is then used to remove a thin layer of corneal tissue similar to LASIK. Following the procedure, a special contact lens is applied, and is worn for 2-5 days as the eye heals.
The surgery itself is generally painless. After LASIK surgery, there may be some mild foreign-body sensation and light-sensitivity for a couple days. Following PRK, patients usually experience moderate discomfort for 3-5 days. Symptoms may be treated with oral medications and eye drops.
Usually both eyes are treated at the same time. In some cases the surgeon or patient may elect to treat the eyes at different times.
In the U.S., the excimer laser procedure is approved for the treatment of nearsightedness up to -14.00 diopters, with astigmatism from 0.50 to 5.00 diopters. Farsightedness of +0.50 to +5.00, with up to 4.00 diopters of astigmatism may be treated.
The excimer laser is approved to treat nearsightedness, farsightedness, and astigmatism. Both LASIK and PRK are able to treat astigmatism right along with any nearsightedness or farsightedness. No additional procedures are necessary - it is all done at once.
With LASIK you may generally to return to work the next day. Although the vision is significantly improved the day after surgery, the vision will fluctuate as it heals. With PRK it may take several days for the vision to become clear enough to drive. With both procedures, individual healing times may vary.
Some patients experience a regression of the surgery depending on their individual healing response. Enhancement surgery may be done to "fine-tune" the result if a significant prescription remains 3-6 months after the original procedure. This is accomplished by lifting the original LASIK flap with a special instrument and applying more laser treatment.
The most common side effects are light-sensitivity, halos/glare, and dryness. Undercorrection or overcorrection may occur. Glasses may be needed after surgery to provide the best possible vision. In rare instances, irregular corneal curvatures and/or haze may result, and glasses may not restore perfect vision. A more detailed discussion of these issues will take place during your comprehensive eye examination.
Patients should be at least 18 years old, with a stable prescription for at least 6 months. There is no upper age limit as long as the eyes are otherwise healthy.
When you schedule your comprehensive eye examination, hard or gas permeable contacts should be out of your eyes 2-3 weeks prior to your exam. Soft lenses must be out for five days. Also, bring in your glasses if available.
A few insurance companies have plans that may cover PRK and LASIK. We will be happy to check coverage for you. If there is no coverage, we have a medical finance company that will help you obtain financing should you need it. We also accept VISA, MasterCard, AMEX and personal checks.
You may call any of our five offices to schedule your complimentary evaluation. If you are a good candidate and wish to proceed, we will schedule a comprehensive examination including dilation. This exam will take approximately one and a half hours, and give you the opportunity to interact with your doctor and have your questions answered.
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