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.
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 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 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.
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.
ICL – Implantable Contact Lenses
Patients who are not suitable candidates for LASIK but who are still looking for a way to permanently improve their vision should know that there are alternatives to LASIK surgery. 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.
Patients who choose to undergo ICL surgery can enjoy a variety of benefits. One of the biggest benefits of this LASIK alternative is that it allows patients who used to depend on burdensome glasses and contacts to enjoy activities they were not previously able to. ICL surgery also has benefits that LASIK does not offer patients. ICLs are safe and effective alternatives to LASIK surgery for people who are not good candidates for LASIK, including patients with dry eyes, large pupils, and thin corneas. ICL surgery can also correct high refractive errors like severe nearsightedness, something LASIK surgery cannot accomplish. ICL surgery also does not permanently change the shape of your cornea as with LASIK. And unlike LASIK surgery, the results of ICL surgery are reversible; if the patient’s eyesight changes dramatically, the ICLs can be removed or replaced with new ones. Patients can feel more at ease undergoing ICL surgery knowing that the outcome is not permanent.
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