Doctors use an excimer laser to perform this kind of surgery. A small knife, called a microkeratome, is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middle section of the cornea. The pulses from a computer controlled laser vaporize a portion of the stroma and the flap is replaced. Other techniques are also in use.
The cornea is a part of the eye that helps focus light to create an image on the retina. The bending and focusing of light is also known as refraction. The shape of the cornea and the eye are usually not perfect and the image on the retina is out-of-focus (blurred) or distorted.
These imperfections in the focusing power of the eye are called refractive errors. There are three primary types of refractive errors: myopia, hyperopia and astigmatism. Persons with myopia, or nearsightedness, have more difficulty seeing distant objects as clearly as near objects. Persons with hyperopia, or farsightedness, have more difficulty seeing near objects as clearly as distant objects. Astigmatism is a distortion of the image on the retina caused by irregularities in the cornea or lens of the eye. Combinations of myopia and astigmatism or hyperopia and astigmatism are common.
Glasses or contact lenses are designed to compensate for the imperfections of the eye. Surgical procedures aimed at improving the focusing power of the eye are called refractive surgery. With Lasik surgery, precise and controlled removal of corneal tissue by a special laser reshapes the cornea and changes its focusing power.
Before Lasik there were other techniques developed to reshape the cornea for example Photorefractive Keratectomy. Often the exact same laser is used for the two types of surgery. The major difference between the two surgeries is the way that the stroma, the middle layer of the cornea, is exposed before it is vaporized with the laser. In PRK, the top layer of the cornea, called the epithelium, is scraped away to expose the stromal layer underneath. In LASIK, a flap is cut in the stromal layer and the flap is folded back.
Can anyone have a Lasik surgery? Most but not everyone and certain complications are unavoidable in a percentage of patients, and there are no long term data available for current procedures. Also, some jobs prohibit certain refractive procedures so be sure to check with your employer/professional society/military service before undergoing any procedure.
Most medical insurance will not pay for refractive surgery and the cost is still significant. If you have what is called refractive instability, like young people, you can not have this kind of surgery. If you are pregnant or have certain diseases like diabetes or are taking medications you should not have Lasik surgery. In these cases you should discuss the possible additional risks with your doctor.
Eye Surgery For Cataracts
In fact, "miraculous" would not be too strong a term to describe its effectiveness. If you're considering whether to have it done, but you've read or heard some negative stories about it, please put them on hold for a minute and read this article.
What is LASIK?
It's a type of eye surgery that uses an extremely precise laser to modify the surface of the cornea (the front part of the eyeball, the white part).
Facts about lasers
&bullThere are many types of lasers, all man-made for specific purposes.
&bullLasers are divided into 4 classes according to their potential for causing biological damage. All lasers come labeled as to their class. Class I lasers pose no hazard and class IV lasers are a fire hazard and skin hazard and must be carefully controlled.
&bullLasers used in eye surgery are called excimer lasers
&bullExcimer lasers are cool. They emit no heat; just a highly focused ray of ultraviolet light that penetrates only a microscopic depth into the outer layer of corneal tissue
&bullExcimer lasers are so precise they can focus a beam that's only 0.25 microns wide. Compare that to a human hair, which is typically 50 microns wide! The laser could chip away at the width of the hair in half-a-percent increments.
&bullEye surgeons buy or lease complex units that contain a specific laser along with a computer, patient bed, microscope, and other components for the surgeon to use
How is LASIK done?
&bullOnly on good candidates
&bullFirst there's a detailed eye examination to see if you'd be a good candidate. A good eye surgeon performs LASIK only on good candidates, as opposed to some eye facilities that make money on their sheer numbers of patients, and work on a "low cost, minimal service, cheap equipment, no follow-up" basis.
If you're considering a LASIK treatment, check out several eye surgeons and choose one who's selective in choosing LASIK patients.
What makes a good candidate
&bullYour present vision must be within a certain range of clarity
&bullYour corneas must have a certain minimum thickness
&bullYour pupil diameter should be under a certain width
&bullYou're not pregnant or trying to become so
&bullYou have no severe heart problems, no auto-immune disease, and no eye disease
&bullYou're not diabetic
The LASIK surgeon will use a number of sophisticated tools to exactly measure your vision and calculate exactly what correction it needs.
The procedure itself
&bullYour eyes will be numbed with anesthetic eye drops
&bullYou'll lie down on a comfortable bed that will be rotated to place your head beneath the laser. An eye speculum is placed against the eyelids of the eye to be worked on, to keep it open. You don't have to struggle with keeping your own open
&bullYour eye surgeon will treat one eye at a time, placing a shield over the other one. He'll calibrate the laser for each eye because our two eyes are not necessarily identical in shape
&bullUsing a hand-held device called a microkeratome, in combination with a small suction cup, the surgeon will make a small round flap on the outer surface of your cornea, and gently fold it back out of the way.
&bullWhile you look at a red light, the laser is directed at the tissue exposed by the flap being folded back, for somewhere between 10 and 20 seconds. The laser vaporizes tiny amounts of excess corneal tissue that have been impairing your eyesight.
&bullThe surgeon replaces that little flap and applies a bit of antibiotic ointment to its edges. Immediately, it starts healing itself with no stitches or bandages required.
There's no pain at all during this procedure. The worst you might feel is the urge to close your eyes against having somebody touch them. So a little self-control is needed to hold yourself still, but the eye speculum does the work of keeping your eyes open.
Recovery period
&bullAs soon as you're back in the preparation room, you'll notice that you can see more clearly. There might be some temporary blurriness from the antibiotic.
&bullYou'll be given an eye shield and asked to keep it on until the following day.
&bullYou'll be given some things to put in your eyes over the next few days:
&bullMoisturizing drops for day time
&bullAntibiotic drops
&bullMoisturizing gel for night time
&bullThere's no pain, itching, or swelling
&bullThere might be a small amount of temporary redness and sensitivity to light
&bullThere'll be a follow-up appointment the next day and at progressively lengthening intervals for a year.
Within a month, most people are completely healed and their vision stabilized. You'll notice a dramatic improvement in your eyesight after LASIK.
Interview some eye surgeons
If you're apprehensive about having LASIK, you should interview several different eye surgeons. Any good eye surgeon will be glad to take some time with you and listen to your concerns. You could write down all your questions and check them off as the surgeon answers them satisfactorily.
Don't be shy about doing this because all good LASIK surgeons know that the idea of having a laser focused on your eyes can be alarming at first. If you find that the surgeon you're consulting with isn't really listening to you, move on. Find a LASIK surgeon you feel you can trust.
Both Keith George & Patricia Woloch are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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