LASIK – Laser Vision Correction
LASIK and alternatives to the LASIK Procedure
LASIK is purely an elective procedure, and you may decide not to have this operation at all. Among the alternatives are:
- EPI-LASIK
- Eyeglasses /Spectacles
- Contact Lenses
- Photorefractive Keratectomy (PRK)
- ADVANCED SURFACE ABLATION (ASA)
- Radial Keratotomy (RK)
- Automated Lamellar Keratoplasty (ALK)
- Orthokeratology, Hexagonal Keratotomy
- Corneal Relaxing Incisions, Intracorneal Ring Segments
- PHAKIC LENS IMPLANTS
- CLEAR and NEAR CLEAR LENSECTOMY
- WAVEFRONT-GUIDED CUSTOM CORNEA TREATMENT
You can discuss these options with Our Staff.
epi-LASIK
The latest innovation in correcting vision is epi-LASIK (Laser assisted epithelial keratomileusis). This procedure represents an improvement over older techniques of simple PRK. In the original form of PRK the outer layer of the cornea, the epithelium, was removed and discarded. The laser ablation was performed and the patient was left with a large abrasion. The epithelium took 4-5 days to heal. Needless to say, this left the patient uncomfortable and blurry. For these reasons LASIK has become the procedure of choice. However, there are patients who have dry eyes or corneas that are too thin to perform LASIK safely. For these patients epi-LASIK becomes a great alternative.
In epi-LASIK, the surgeon carefully removes the outer epithelial covering of the cornea using a special epithelial microkeratome, then uses the excimer laser to reshape the corneal surface. The epithelial flap is replaced and a contact lens is placed to hold the epithelium. The contact lens is removed 3-4 days later. Patients see better, faster, and with greater comfort than with simple PRK.
ADVANCED SURFACE ABLATION (ASA)
ASA is nothing more than PRK or epi-LASIK using the newer more advanced excimer laser CustomCornea treatment. Every cornea has it’s own fingerprint that makes it different than any other cornea in the world. With CustomCornea treatment using the LADARvision excimer laser, we can treat each corneal fingerprint differently. Results with ASA are usually much better than standard excimer laser treatments, giving better uncorrected vision postoperatively. CustomCornea treatments can also be done using LASIK
PHAKIC LENS IMPLANTS
This is exciting new technology that has been used around the world for many years and has been recently been approved by the FDA for use in the United States. Eye surgeons from around the world have implanted over 100,000 since 1986. This represents 2% of the refractive surgery done worldwide during this time. Phakic lens implants are appropriate for those patients between the ages of 21 and 41 years of age who are not corneal-based refractive surgery candidates (LASIK Miami, Advanced Surface Ablation, PRK or epi- LASIK) because they have very high myopia or corneas that are too thin to do corneal refractive surgery.
CLEAR and NEAR-CLEAR LENSECTOMY
This technology has been used around the world for many years and has recently become more accepted in the United States. It is a great treatment for patients who require not only distance glasses but near glasses as well. It’s popularity in the United States has been boosted because of the FDA’s recent approval of high technology intra-ocular lens implants that enable patients to see both at distance and at near without glasses. Lensectomy means the removal of the eye’s natural crystalline lens that focuses the incoming and outgoing light rays. This crystalline lens is replaced with an acrylic high technology intra-ocular lens that can improve the unaided distance as well as the unaided near vision of the patient. FDA studies on the REZOOM implant have shown that over 93% of patients will not need to wear distance or computer glasses and that over 83% of patients will not need reading glasses, whereas 100% of these patients needed distance and reading glasses preoperatively. We also use these high technology implants in upgraded cataract surgery.
WAVEFRONT-GUIDED CUSTOM CORNEA TREATMENT
Wavefront-guided Lasik represents a tremendous advance in laser technology. Up until now, we have only been able to measure the eye as a whole, and then give one overall prescription for glasses or contact lenses for each eye. Traditional Lasik attempts to replicate the vision obtainable with the best glasses and contact lenses, treating each eye with one overall prescription. But we know that the eye is not perfectly regular and that each spot on the eye actually requires its own particular prescription. This is clearly impossible with glasses or contact lenses, because they are constantly moving in relation to the eye. However, wavefront-guided custom treatment makes this possible. With wavefront-guided Lasik, hundreds of individual locations on the cornea are each treated with their own individual prescriptions. The result is vision that typically surpasses traditional Lasik, and frequently is better than the best vision with glasses or contact lenses.
A complete eye examination is performed, including special measurements of the thickness and curvature of the cornea. The patient then sits down in front of the wavefront-measuring instrument, which is known as LADARWave. This device shines an invisible light into the eye and, without touching the eye and without any discomfort, performs wavefront measurements over hundreds of spots in just a few seconds. The wavefront data from the LADARWave is then transferred into the computer of the LADARVision treatment laser, which calculates the exact pattern of laser spots. The patient then undergoes the Lasik procedure: the flap is made, the laser treatment is applied under the flap, and the flap is placed back into its original position.
With wavefront-guided custom Lasik (which also goes by the name of "custom cornea or "custom ablation"), we measure and treat the vision at 200 separate locations on the eye. Because the treatment is much more customized than with glasses, contact lenses, or traditional Lasik methods, the level of vision obtained is more precise. Although results vary from patient to patient, with wavefront-guided custom Lasik it is frequently possible to achieve 20/15 vision, which is typically better than the best vision available with glasses or contact lenses.
