LASIK vs. Other Treatments

There are a wide variety of LASIK eye surgery procedures available, so many in fact that many consumers are unaware of the differences among each technique. Here, was review the key differences between LASIK and these alternative laser vision correction procedures.

Epi-LASIK

The biggest difference between LASIK and Epi-LASIK involves the actual surgical procedure - Epi-LASIK does not require the creation of a corneal flap. When the surgeon is ready to perform surgery, numbing drops are applied to both eyes. Once the drops have taken effect, the surgeon separates the epithelium (the outermost layer of the cornea) from the underlying corneal tissue. An instrument known as an epikeratome serves as an epithelial separator, and is used to isolate a thin corneal sheet called the epithelium to expose the cornea. The surgeon then uses an excimer laser to reshape the cornea and improve vision. After a precise amount of corneal tissue has been removed, the surgeon replaces the epithelial sheet and places special bandage contact lenses in each eye to promote healing. The special contact lenses can usually be removed within three days. Most patients experience improved vision in a few days; however, the best results may not be apparent until up to six months after undergoing the Epi-LASIK procedure.

LASEK

LASEK was developed after PRK surgery had already been in use as way to preserve the epithelial layer of the eye and reduce post-operative discomfort and healing time. In the LASEK technique, the epithelial layer of the eye is not completely removed, but rather folded back using a fine blade called a trephine, and then the cornea is reshaped with the laser. After the cornea has been precisely sculpted, the epithelial flap is placed back over the eye and bandage contact lenses are inserted to promote healing. In this regard, LASEK is in many ways similar to the standard LASIK procedure but because the epithelial layer is preserved, offers benefits over PRK.

PRK

PRK was on the market prior to LASIK and offers similar results. However, the treatment is associated with a longer and more painful recovery period due to the technique used to access the inner corneal tissue. During PRK surgery, the surgeon removes the epithelium, the thin top layer of the cornea. The surgeon then uses an excimer laser to reshape the cornea's inner layers, as is done during the LASIK procedure. After surgery, the patient wears special contact lenses that promote healing and stimulate regeneration of the epithelium.

SBK

The majority of the SBK (sub-Bowman's keratomileusis) procedure is performed in the same manner as LASIK surgery; for example, during both LASIK and SBK surgery, an excimer laser is used to ablate offending corneal tissue to correct for refractive errors. The primary difference between the two procedures is that a thinner corneal flap is created during SBK surgery. An IntraLase® laser is used to create the corneal flap during SBK, while LASIK surgeons will use either the IntraLase® laser or a surgical blade known as a microkeratome. During SBK surgery, the surgeon creates a flap that is even thinner (110 microns thick) than the one made during LASIK surgery (120 to 180 microns thick). This makes the procedure ideal for individuals with thin corneas. Because the IntraLase® laser affords a greater level of precision than is possible with a microkeratome, the procedure involves less risk and can be done on eyes that require extra care. After the extra thin corneal flap is created, the underlying cornea is reshaped to create a more ideal curvature that will properly reflect light.

Custom LASIK

In traditional LASIK surgery, eye measurements are taken in a manual fashion, the way they are taken when patients get an eyeglass prescription. While this method is effective and can produce improved visual results in patients, it does not account for the unique aberrations of the eyes. In custom LASIK surgery, eye measurements are taken using Wavefront^TM mapping equipment. The machine directs light at the eyes, which is then reflected back into the Wavefront^TM system where a three-dimensional map of the eyes is recorded. In addition to recording the degree of nearsightedness, farsightedness, or astigmatism in patients, the Wavefront^TM system also maps out higher order aberrations that cause starbursts, ghosting, halos, and glare. This computerized corneal mapping allows for extremely precise treatment.

IntraLASIK

IntraLASIK is also referred to as all-laser LASIK or LASIK with Intralase®. The procedure is similar to traditional LASIK eye surgery, with one key difference. In IntraLASIK surgery, the surgeon creates the corneal flap using the Intralase® laser. After the incision is made in the cornea, the surgeon lifts up the flap and folds it over the eye so underlying corneal tissue can be accessed with an excimer laser. The surgeon then reshapes the cornea by ablating or removing offending tissue to achieve ideal curvature of the cornea and improve visual clarity. Once this process is complete, the flap is closed and the patient is sent home to recover.

Though extremely similar to LASIK surgery, the IntraLASIK technique is more precise and less risky thanks to the fact that it is blade-free. The all-laser approach affords doctors greater reliability and reduces the already miniscule risk for complications even further. For these reasons and more, many doctors are choosing to offer IntraLASIK surgery, or variations of all-laser LASIK surgery, exclusively at their practice. If you are considering laser vision correction, call your local LASIK providers and find out which techniques they employ.

The iLASIK^TM Technique

The iLASIK^TM procedure involves use of both the IntraLase® laser and custom LASIK technology. It has distinct advantages over traditional LASIK. In addition to wavefront technology and digital eye mapping, the iLASIK^TM technique employs the use of an IntraLase® laser instead of a microkeratome for the creation of the corneal flap. The laser gives the surgeon better control of the flap diameter, depth, centration, and morphology, reducing the incidence of flap complications and side effects post-surgery.

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