LASIK Surgery

One of the most important factors in achieving a positive outcome with laser eye surgery is determining if you are a good LASIK candidate. 

LASIK

LASIK Options

Since the introduction of LASIK, surgical techniques have continued to develop and improve. The newer options have improved results and increased the amount of people that can benefit from laser eye surgery. While the older techniques are performed less frequently, they may still be a more viable solution for some patients. The following paragraphs will describe the conventional LASIK procedure, new LASIK options, and other laser eye surgery procedures.

The LASIK Procedure

LASIK Procedure

Conventional LASIK

LASIK uses a microkeratome blade to cut a flap into the cornea in order to expose the treatment area and an excimer laser to burn off corneal tissue. Conventional LASIK (the original LASIK procedure) is not customized to a person's eyes, but basically applies a standard treatment to all eyes. Depending on a person's refractive error, conventional LASIK may be an effective choice, but many patients will have better vision correction with more customized treatment (Wavefront LASIK).


Blade-Free LASIK - IntraLase

LASIK using the IntraLase laser was approved by the FDA in 2001. The IntraLase laser replaces the microkeratome blade used for cutting the corneal flap, thus it is often referred to as Blade-Free LASIK. IntraLase can be used with either conventional or custom LASIK eye surgery. This technology allows the surgeon to custom cut the corneal flap for each individual patient and each individual eye. While the microkeratome is an effective technology, many believe the IntraLase method improves both precision and visual results.

Custom LASIK - Wavefront LASIK

Custom Wavefront LASIK was approved in 2003. Custom LASIK is similar to conventional LASIK in that it uses a microkeratome blade to cut the corneal flap and an excimer laser to remove corneal tissue. Unlike conventional LASIK, however, the treatment area and amount of tissue removed is customized to a person's eyes using Wavefront technology.

Wavefront LASIK

The Wavefront Analyzer takes 3-dimensional measurements of the eye and maps the corneal surface using a beam of light.

While many people may have the same eye prescription, a person's Wavefront measurement is unique. The surface of the eye is very irregular, and just like a person's fingerprints, a person's eyes are one of a kind. The Wavefront procedure, which is performed before the LASIK surgery, takes 3-dimensional measurements of the eye and maps the corneal surface using a beam of light. The personalized measurements can then be programmed into the laser for customized treatment.

When the LASIK procedure is combined with Wavefront technology, a patient will usually achieve better vision correction than with conventional LASIK. Wavefront LASIK lessens the chance of experiencing "higher order" aberrations such as visual glare and halos. While most patients will benefit from custom LASIK, it may not be recommended by your doctor if you have thin corneas, high degrees of aberration, or severely dry eyes because it removes more corneal tissue than conventional LASIK.

Epi-LASIK

Epi-LASIK is an option for people with thin corneas, dry eyes, or other conditions that make them ineligible for LASIK. Epi-LASIK does not require the creation of a corneal flap, but uses an epikeratome (plastic instrument) to perform a separation of the epithelium, the outermost layer of cells of the cornea. The procedure avoids the use of alcohol, which kills epithelium cells.

LASEK

LASEK (Laser Epithelial Keratomileusis), a hybrid of PRK and LASIK, is an option for people with corneas too thin for LASIK. It does not use a microkeratome to create a corneal flap as in LASIK or completely remove the epithelium as in PRK. Instead, an alcohol solution is applied to the epithelium (the thin outer layer of the cornea) to loosen it and allow the surgeon to separate it from the stroma (the middle layer of the cornea) to reveal the area to be treated with the laser. The epithelium layer is then rolled back in place after laser treatment.

PRK

PRK, the acronym for photorefractive keratectomy, is the original laser eye surgery and precursor to LASIK. With PRK, a corneal flap is not cut before the laser treatment is performed. Instead, the epithelium (the thin outer layer of the cornea) is completely removed using an alcohol solution. Custom PRK is available using Wavefront technology. PRK is an option for people with corneal conditions who do not qualify for LASIK or for those who must avoid flap complications, such as military pilots or divers.

Presby LASIK

While still experimental, Presby LASIK is a possible type of laser correction for presbyopia, a condition caused by the aging of the eyes.