What Is LASIK?
LASIK eye surgery is a refractive surgery treatment that corrects refractive errors by reshaping the cornea in order to produce clear vision. LASIK stands for Laser In-Situ Keratomileusis. The procedure can treat myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, and reduce patients’ dependency on contact lenses and corrective lenses. Because refractive errors impede the focusing ability of the eye, patients who suffer from these conditions experience blurred vision. LASIK surgery provides these individuals with an effective treatment option.
How Does The LASIK Procedure Work?
LASIK Procedure Steps: One-by-one
After you have finished preparing for LASIK vision correction, a lasik surgeon will perform another eye exam and answer any lingering questions or concerns you may have. The procedure itself takes less than 15 minutes, although the length of pre- and post-operative examinations varies depending on the doctor and the individual case. The procedure itself is broken down into four simple steps:
1. Refractive Error Measurement
If you choose to undergo custom LASIK vision correction rather than traditional LASIK, the procedure will begin with the mapping of the eyes with Wavefront™ technology. This provides a blueprint of your eyes’ lower and higher order aberrations, allowing for the most accurate correction of visual impairments. The treatment then proceeds in a similar manner to traditional LASIK.
Patients also undergo a pre-LASIK eye exam. The patient’s eyes will be measured and the surgeon will once again review the procedure, making sure all questions and concerns have been addressed. The data gathered in this preliminary eye exam will allow your doctor to customize your treatment, as each procedure is unique.
2. Creating the Corneal Flap for LASIK surgery
To begin the traditional procedure, the eye will be anesthetized with topical eye drops. The patient will be asked to lie on a table with laser equipment mounted above it. The eye will be held open with a special instrument called a speculum. The other eye is protected by a shield. As the patient stares at a small blinking light, the surgeon will use a microkeratome (a precise, computer operated surgical blade) or an Intralase® laser to create a hinged corneal flap on the outer layer of the eye.
What is a Microkeratome?
A microkeratome is a precise, hand-held surgical instrument with an oscillating metal blade. It is used to separate the surface layers of the cornea and create a corneal flap during the first step of laser vision correction surgery. First, the microkeratome is placed over the eye, then suction is applied so that the microkeratome is held perfectly still during the procedure. The microkeratome creates a hinged flap, which is laid back while the excimer laser sculpts the cornea into the optimal shape. Once the cornea is re-sculpted into a shape that improves your vision, the tissue is repositioned and healing begins.
The Modern Microkeratome
In recent years, great advancements have been made in the microkeratome. Laser vision correction is now more accurate and convenient than ever. The newest microkeratomes available on the market offer consistency, precision, and fewer complications.
What Qualities Make a Good Microkeratome?
The factors that determine the quality of a microkeratome are related to its stability and consistency in creating the corneal flap. The newest and best microkeratomes focus on creating corneal flaps that are uniform in thickness, with proper suction maintained throughout the laser vision correction procedure. The following are two of the most state-of-the-art models available today.
The Moria M2 microkeratome has an innovative design that allows your surgeon to view the flap as it is being created, providing greater accuracy. In addition, the quality of the cut and the predictability of flap thickness have been proven in studies to be better and more consistent than with other microkeratomes. The Moria M2 also offers the surgeon greater control over the flap and hinge size.
The Hansatome™ is one of the more advanced microkeratomes available. It has fewer gears, which reduces the potential for creating an incomplete flap as there is less likelihood of the gears jamming. Studies have established that the Hansatome™ has fewer instances of flap complications during laser vision correction surgery, such as partial flaps, free caps (unattached flaps), and buttonholes (improperly formed flaps).
3. Reshaping the Cornea
After the flap has been created, an excimer laser is used to remove the precise amount of corneal tissue needed to correct your refractive error. As the patient continues to stare at the blinking light, the surgeon then will apply very small, rapid bursts of laser energy, reshaping the cornea. This portion of the procedure only takes about 15 seconds per eye. The precision of the laser is such that in mere seconds, the cornea can be finely altered so that it can correctly refract incoming light onto the retina.
4. Replacing the Flap
Once the cornea has been reshaped, the flap is replaced. The eye will heal by itself and no stitches are necessary. The actual surgery usually takes less than 15 minutes, but preoperative preparation may extend surgery time to one hour. Vision improvement is immediate, but the full effect of your surgery may not be evident for several months. Following the post-surgery recovery guidelines outlined by your doctor will help ensure proper healing and superb vision.
After the procedure is complete, many patients experience immediate improved vision, although it can take up to six months for vision to stabilize. Patients can expect a short recovery period but there is usually little to no discomfort following the procedure. Follow-up exams ensure proper healing.
The procedure is designed around each patient’s individual needs. To ensure the best results possible, doctors employ advanced imaging and laser vision correction technology during the procedure, and in many cases, custom procedures can be tailored around a patient’s needs should it be necessary to deliver improved vision.
Who Is a Candidate For LASIK surgery?
Individuals who suffer from vision impairment can benefit tremendously from LASIK, but the procedure is not for everyone. A good LASIK candidate should meet the general requirements outlined below, as well as have an understanding of the risks and possible side effects of treatment. Ensuring that you meet the recommended conditions of surgery can greatly improve your chances for a positive outcome. Your ophthalmologist can evaluate your vision and determine if you would be a suitable candidate for refractive surgery.
If you are interested in learning more about laser eye surgery or would like to schedule a consultation with an area doctor regarding LASIK, we can help at DocShop. The doctors in our nationwide directory promote safe laser eye surgery and take every precaution to reduce the risk factors associated with the procedure. Your vision is of the utmost importance so you should take great care to ensure you see a qualified and experienced doctor.
General Requirements for LASIK
Your ophthalmologist will follow these guidelines when considering your candidacy for LASIK:
- To ensure that the eye has developed properly and is fully matured, the ideal candidate is at least 18 years old
- Prior to LASIK surgery, vision must be stable for at least one year
- No eye infection or injury within the past year
- Candidates may not be affected by an auto immune disorder, such as Sjogren's Syndrome or Lupus
- No history of herpes infections in the eye, as LASIK may bring on a recurrence of the infection
- No scarring may be present on the cornea to be considered
- Candidates must understand the risks of surgery and have realistic expectations regarding the results that can be achieved
- A LASIK candidate may not be nursing or pregnant on the date of surgery
- Individuals with dry eye syndrome are not good LASIK candidates
- Individuals with pupils that dilate beyond seven millimeters in the dark are not good candidates
To determine whether or not a patient is a good candidate for LASIK surgery, the ophthalmologist will conduct a pre-LASIK eye examination. Once completed, patients should follow certain guidelines in the days and weeks preceding LASIK vision correction.
What are the benefits of LASIK?
Most patients are extremely pleased with their results. The benefits of LASIK eye surgery are many, and include immediate vision improvement, the ability to discontinue using costly and frustrating corrective eyewear and contact lenses, and broadened social, recreational, and career opportunities.
Please read below to learn more about LASIK eye surgery and the many benefits patients enjoy. You may also find our page discussing costs and financing options helpful. If you are interested in undergoing surgery or have specific questions regarding the procedure, we encourage you to contact a refractive surgeon.
Benefit #1: Immediate Results
One of the truly remarkable benefits of LASIK laser eye surgery is that most patients experience dramatically improved vision within mere moments of the procedure. While ideal visual acuity may take up to six months to achieve, it is very common for patients to demonstrate near-perfect vision during their follow-up examinations the very day after surgery, and to immediately discontinue the use of glasses or contact lenses.
Benefit #2: Freedom from Corrective Eyewear
After successfully undergoing surgery, one of the benefits patients are most excited about is their new-found freedom from corrective eyeglasses and contact lenses. In the vast majority of cases, patients enjoy visual acuity that is better than what they formerly experienced with the use of corrective lenses, and are no longer dependent on glasses and contacts. For many patients, gone are the days of worrying over broken glasses or lost contacts, packing cumbersome cleaning and storing solutions for a vacation, or paying for costly replacements each time refractive needs change. With LASIK eye surgery, patients not only enjoy incredibly clear vision, but also enjoy a life free from the daily hassles and expenses of glasses and contact lenses.
Benefit #3: New Activities and Career Opportunities
Patients who have undergone successful surgery find that travel becomes much more enjoyable and convenient because they no longer have to worry about packing a back-up pair of glasses or all the accessories necessary for contact wearers. Furthermore, such activities as swimming, cycling, sky-diving, and even spending a day at the beach become more pleasurable without the worries and hassles associated with corrective eyewear.
In addition to the many leisure-time surgery benefits, patients also find that they have a broadened array of career choices available to them. Some fields, especially law enforcement and aviation, require participants to display excellent vision that is not dependent upon such refractive solutions as glasses or contact lenses. After undergoing LASIK, patients who were not formerly suitable candidates for such occupations find themselves embarking on the careers of their dreams.
Benefit #4: More Self-Confidence
Perhaps the most life-changing of the many benefits is the heightened self-confidence many patients attain. After LASIK surgery, patients no longer feel as though their faces are hidden by glasses. Furthermore, many patients find that the ability to see more clearly than ever before helps them to be more outgoing socially. For instance, patients who were formerly disoriented while trying to navigate in a darkened environment with poor vision now feel more at ease in dimly-lit clubs and restaurants. Increased self-confidence not only enhances the social lives of surgery patients, but can also lead to a more satisfying love life and a dramatically enhanced professional life.
What Are the Risks of LASIK Surgery?
A small number of patients - one to five percent - experience complications. LASIK risks include sensitivity to light, haloed or glared vision, irregular astigmatism, dry eyes, loss of visual clarity, and sensitivity. Fortunately, advances in technology have dramatically reduced complications and many problems can be easily corrected with additional treatment.
What Results Can a LASIK Patient Expect?
LASIK eye surgery has become the most popular vision surgery in the country. More than one million Americans undergo LASIK each year. LASIK surgery statistics gathered by the FDA indicate that complications occur in just 1 to 5 percent of patients. In most cases, treatment provides patients with exceptional results, with many patients experiencing 20/20 vision or better following surgery. When comparing LASIK to other eye care treatments, the advantages become evident.
What Is the Cost of LASIK?
The cost of LASIK eye surgery continues to drop as the surgery is further refined, more patients are seeking treatment, and technology continues to advance. Cost can vary based on the patient's degree of refractive error and the area of the country the procedure is performed. On average, surgery can cost in the neighborhood of $1,000 - $2,000 per eye. What many patients don't know, however, is that there are numerous financing options available that can help decrease or disperse the fee.
Types of LASIK
Advances in LASIK technology have led to the development of several variations of the procedure, each of which offers unique advantages over LASIK as it existed at its inception.
Custom LASIK Procedure
Custom LASIK surgery uses advanced Wavefront technology to correct visual flaws not addressed by traditional LASIK. This provides patients with vision correction tailored to address their own unique needs, often leading to better vision after the procedure has been completed. Custom LASIK eye surgery has the same mechanical components of traditional LASIK, but is fully personalized and guided by a detailed Wavefront map of your eyes.
Custom LASIK surgery allows surgeons to correct visual aberrations that previously could not be addressed with traditional LASIK surgery. Custom LASIK offers patients a chance to achieve visual acuity superior to that possible with contacts or glasses.
LASIK vs. Custom LASIK
In the past, LASIK eye surgery was based simply on your prescription: whether you were nearsighted, farsighted, or astigmatic, and your degrees of each. However, vision can also be compromised by higher-order aberrations - more complicated and personalized visual imperfections that affect the crispness and clarity of your vision. New custom LASIK technology is able to diagnose and treat these visual imperfections like never before. Custom LASIK eye surgery has the same mechanical components of traditional LASIK, but is fully personalized and guided by a detailed Wavefront map of your eyes.
Custom LASIK surgery uses advanced Wavefront technology to correct visual flaws not addressed by traditional LASIK. This provides patients with vision correction tailored to address their own unique needs, often leading to better vision after the procedure has been completed. On this page, learn more about the custom LASIK procedure and what you can expect during your surgery.
Wavefront LASIK Technology
Wavefront mapping for LASIK eye surgery is able to detect and measure optical imperfections 25 times more precisely than standard methods.
This mapping takes advantage of the properties of light. Specifically, light travels in flat sheets, called wavefronts. To generate a Wavefront map of a person's eye in preparation for laser eye surgery, a safe beam of light is passed through the patient's eye. This beam of light passes through the eye's optical system (the cornea, lens, and retina), and reflects it back, at which point the Wavefront diagnostic machine captures and measures it. If the eye's system was perfect, the ray of light would exit just as it entered the eye - as flat sheets. However, in an eye with lower- and higher-order aberrations, the ray will become distorted. Translating this distorted light into a Wavefront map of the eye's imperfections is the basis of custom LASIK.
- Three-Dimensional Mapping: Over 60 patterns of higher-order aberrations exist alongside the common problems of nearsightedness, farsightedness, and astigmatism. These various imperfections exist to different degrees, and often vary between a person's two eyes. It is no surprise, then, that the more detail and realism a WavefrontTM map is able to convey, the better. Today's WavefrontTM laser eye surgery sensors are able to map both lower- and higher-order aberrations on a highly detailed, three-dimensional diagram of the eye.
- Transfer Map to Computer-Controlled Laser: Once a WavefrontTM LASIK sensor has identified, measured, and mapped the eye's specific irregularities, special software converts these data points into a mathematical algorithm. This algorithm acts as treatment instructions for the excimer laser that carries out the actual LASIK procedure. Today's best WavefrontTM sensors are seamlessly integrated with excimer laser eye surgery systems. Such integrated technology ensures that your unique visual challenges are diagnosed, measured, and treated, with no information lost en route.
IntraLASIK (All-Laser Bladeless LASIK)
The IntraLase® laser is the first and only laser technology approved for use in the first step of the LASIK procedure, creating the corneal flap. The level of safety and precision this bladeless LASIK delivers is revolutionizing LASIK. During traditional LASIK surgery, the surgeon first creates a flap in the cornea with a microkeratome blade, and then reshapes the cornea in a way that improves the patient's vision. IntraLASIK is an innovative new method in which the surgeon programs the desired depth and position of the corneal flap into a computer system prior to actual surgery, making the creation of the flap an incredibly safe and accurate procedure.
The IntraLase® Laser
The introduction of the IntraLase® laser has redefined the landscape of LASIK laser vision correction. The all-laser approach eliminates the need for a metal blade known as a microkeratome, and hence appeals to those who may have felt uneasy about going under the blade during LASIK surgery. This allows even more people to experience better vision.
The IntraLase® laser is a technology used to replace the metal mechanical blade microkeratome traditionally used to cut the necessary corneal flap during a laser vision correction procedure. Rather than creating a flap with a blade, the IntraLase® laser uses laser energy to make a quick, painless incision.
Laser vision correction using the IntraLase® laser was approved by the Food and Drug Administration in 2001. Though it is a relatively new procedure, it has already been used on more than 250,000 eyes. Since 2001, surgeons have gained invaluable experience in the use of the IntraLase® laser and have adjusted their methods accordingly to fully benefit their myopic, hyperopic, and astigmastic patients.
How the IntraLase® Laser Works
The IntraLase® laser uses quick pulses of laser energy to create the flap in the cornea needed to correct refractive errors. The computer-guided Intralase® laser quickly pulses light through the outer layers of the cornea as it moves back and forth across the eye to create microscopic bubbles at a specified depth in the eye. The bubbles under the cornea eventually create a perforation. The computer-guided laser allows the doctor to program the exact flap diameter, depth, hinge location and width, and side-cut architecture - factors that can be varied to meet patients' individual needs.
After the IntraLase® laser has finished forming the microscopic bubbles beneath the outer cornea, the surgeon is able to gently separate the perforated tissue to create a flap, allowing him or her to continue with the laser vision correction procedure.
- Reduced Complications: The use of the microkeratome is associated with the majority of LASIK complications, which occur in up to 10 percent of all LASIK surgery procedures. The most common complications include buttonhole cuts, partial or improperly formed flaps, free caps, invasive corneal incisions, corneal abrasions, and subsequently blurred vision.
- Can Treat a Wider Range of Patients: Bladeless LASIK is particularly beneficial for patients with thin or thick corneas, factors that might otherwise disqualify them for traditional LASIK surgery.
- Quick: The entire process of creating the corneal flap with all-laser LASIK takes about 30 seconds. Once the corneal flap is created, the surgeon lifts the flap to reveal a pristine corneal surface and proceeds with the laser vision correction portion of the LASIK surgery.
- All-laser approach: Only procedures that use the IntraLase® laser for creating the corneal flap can be considered all-laser LASIK.
Advances in LASIK technology, including custom WavefrontTM LASIK, afford patients options that provide a higher level of safety and accuracy than was possible in the past. With the debut of the IntraLase® laser, patients can undergo a bladeless form of LASIK, while custom LASIK technology offers patients an even more personalized form of vision correction. With custom LASIK systems, both lower and higher-order aberrations can be corrected, allowing patients to achieve better visual results than they would with traditional LASIK surgery. These new technologies are designed with one goal in mind: a more rewarding patient experience and superior results. If you suffer from vision impairment, you may be interested in undergoing a LASIK treatment plan that involves the use of both Intralase and custom LASIK technology, in a procedure that is now known as iLASIK.
Alternatives to LASIK
Patients who are not suitable candidates for LASIK but who are still looking for a way to permanently improve their vision have alternatives to LASIK surgery. There are several different types of LASIK eye surgery procedures available, so many in fact that many consumers are unaware of the differences among each technique. Alternative laser vision correction procedures include Epi-LASIK, LASEK, PRK and SBK. In addition, one of the most promising of these alternatives is implantable contact lens (ICL) surgery. An ICL functions the same way regular contact lenses do, except they are surgically placed behind the iris to complement the eye's natural lens for vision improvement. Patients will not be able to feel the implantable contact lens or ICL once it is in place.
What Should You Consider When Choosing A LASIK Surgeon?
Selecting a qualified LASIK surgeon is perhaps the most important step to ensuring positive results. When choosing a surgeon, your decision should not be based solely on the cost of surgery or office location. Selecting an experienced, reputable, and qualified physician is an important factor in your outcome. Patients should choose their surgeon based on thorough research and individual concerns.
The information provided through DocShop is intended to offer prospective patients an overview of the LASIK laser eye surgery treatment. It is recommended that you contact a qualified surgeon for more details. Find a LASIK surgeon near you using DocShop's online directory.