Blade-free LASIK with IntraLase® Technology
Blade-free LASIK is 100% blade free approach to creating your corneal flap (step 1), the thin flap of tissue that a surgeon folds back in order to perform your LASIK or Custom LASIK procedure (step 2).
Intralase technology enables the surgeon to customize the corneal flap for every individual patient. This technology may now make it possible to treat patients who were previously dismissed as candidates for LASIK due to thin corneas.
How does it work?
Step 1: The Intralase procedure is a highly sophisticated way of preparing your eye for your LASIK procedure using the tiny, rapid pulses of the Intralase FS laser light. As the laser moves back and forth across your eye, a uniform layer of tiny microscopic bubbles form just below the corneal surface at a specific depth and position determined by the surgeon. The corneal flap is created by gently separating the tissue where these bubbles have formed.
Step 2: The flap is then folded back so the surgeon can perform your LASIK or Custom LASIK, which is correcting your vision utilizing the cool laser beams of the excimer laser. Once the procedure is completed, the corneal flap is positioned back in place.
Custom LASIK
In 2003 the FDA approved an advanced technology called Custom LASIK. Custom LASIK is a laser vision correction procedure that uses the unique visual characteristics of your eye to customize your treatment.
Custom LASIK provides an additional level of precise data about your vision requirements using wavefront technology. A device called a wavefront analyzer measures the way light travels through your eye and compares it to the way light travels through an eye with perfect vision. This device then creates a 3-D wavefront map that is unique in the same way that your DNA is unique to you. Your wavefront map provides a detailed diagram of your vision that allows your doctor to provide you with truly personalized vision correction.
LASIK
LASIK (Laser-In-Situ Keratomileusis) is currently the most common type of laser vision correction procedure. It is an extremely effective outpatient procedure that is suitable for low, moderate, and higher prescriptions. It can be used to correct severe prescriptions, and is currently one of the most commonly performed healthcare procedures in North America.
Although no medical procedure is perfect, the excimer laser allows for an unparalleled degree of precision and predictability. Each pulse of the laser can remove 39-millionths of an inch of tissue in 12-billionths of a second. This enables an experienced surgeon to achieve remarkable accuracy while maintaining excellent control throughout the procedure.
However, the LASIK procedure requires a great deal of technical skill and training to perform properly, so choosing the proper surgeon is critical. LaserVision has a access to a network of surgeons.
Steps to the Procedure:
Prior to the procedure, an extremely detailed map of your eyes’ surface is created by a computer and then used by your surgeon to calibrate the excimer laser to your exact prescription. Before going into the laser room, your technician will put a few anesthetic drops in to numb the eye and prevent pain.
Once the laser has been properly calibrated, your surgeon will place an eyelid holder in your eye to keep it open throughout the procedure. Your surgeon then uses a microkeratome (an automated microsurgical instrument similar in design to a carpenter's plane) to create a corneal flap, that has a thickness of approximately 1/4 of the cornea’s depth. A cool laser beam of light from the excimer laser is then used to precisely and gently reshape the cornea.
When your surgeon is finished, the flap is carefully put back into place and the eyelid holder is removed. Over the next few days, the flap will heal and bond more securely.
The entire procedure only takes about five minutes to complete and the laser is on each eye for less than one minute for an average prescription.
After your procedure is completed, you will relax in the recovery room for about fifteen to twenty minutes, allowing the center staff to ensure that everything is in order before you leave. During this time, additional drops will be placed in your eyes to keep them lubricated. You may also be given protective eye shields to place over your eyes to prevent you from rubbing your eyes while sleeping during the first night, and sunglasses to reduce the discomfort the sunlight may cause. During this early postoperative period it is important to not squeeze or rub the eyes. Antibiotic and anti-inflammatory drops are used to prevent infection and decrease inflammation.
After leaving the center, many patients will feel the need to rest for a few hours. Later that evening, most patients feel very well and are extremely pleased with their results already. Many patients go back to work the next day, while others wait a few days.
You will need to go for a post-operative check up following your procedure to ensure that your eyes are healing as expected. There are a few restrictions for a week or so following your procedure, but as long as you follow your doctors instructions, you should be free to resume all of your normal activities thereafter.
The Excimer Laser
What is the Excimer Laser?
The excimer laser is an ultraviolet laser, which utilizes Argon and Fluorine gas to create a non-thermal, or cool beam, of laser light, which can break molecular bonds in a process commonly referred to as "photoablation". A simple way to imagine how the laser works is to think of it as placing the curvature from your glasses or contact lenses onto the front surface of your eye, allowing you to see without corrective eyewear.
The most important aspect of the excimer laser is its remarkable precision. It is able to remove 0.25 microns of tissue in a single pulse; that is, 1/200th of a human hair, 1/40th of a human cell, or 39 millionths of an inch in 12 billionths of a second!
Laser Systems & Software
The laser delivery system and laser software program determines basic predictability of the procedure and quality of the pattern lasered.
For low to moderate myopia, most results between programs and lasers are comparable; for severe degrees of myopia correction, there are important differences. That is, 20/20 vision after the LASIK procedure with one program may not be the same as 20/20 with another program, even with the same laser. Differences may lie in the size of the lasered area (which determines risk of night glare and quality of night vision), the amount of tissue removed (which may affect risk of long-term corneal stability) or the quality of vision (which may be affected by central islands). Furthermore, overcorrected or farsighted patients may still read 20/20 but their need for reading glasses is increased.
LASEK
LASEK (laser epithelial keratomileusis) is a laser refractive procedure to correct nearsightedness, farsightedness and astigmatism. LASEK is sometimes referred to as “Epi-LASEK.” It involves removing the top layer of the cornea as a flap-like sheet before re-sculpting the cornea with the excimer laser. The epithelial sheet is then replaced on the surface of the eye and a soft contact lens is inserted for a few days following the surgery.
What is the difference between LASIK and LASEK?
In the LASIK procedure, an instrument called a microkeratome is used to create a protective flap of tissue. LASEK also involves the creation of a protective epithelial flap, but there is no microkeratome used. Instead, the tissue is loosened with a medical solution and then is carefully moved to the side for the laser portion of the procedure. After the laser procedure, the tissue is then repositioned and healing begins.
Why would I have LASEK over LASIK?
LASEK is a great option for patients previously turned down for LASIK because of thin or unusually shaped corneas. It is also a nice option for those patients who are uncomfortable with the microkeratome.
PRK
PRK(photorefractive keratectomy) used to be the most common laser vision correction procedure. LASIK has since surpassed PRK due to its ability to correct more severe visual acuity with less recovery time and with decreased risks of infection, haze and scarring.
Steps to the Procedure
For the PRK procedure, no scalpels are used and no incisions are made. Prior to the procedure, an extremely detailed map of your eyes’ surface is created by a computer and then used by your surgeon to calibrate the excimer laser to your exact prescription.
Once the laser has been properly calibrated, the technician will place an eyelid holder in your eye to keep it open throughout the procedure.
The technician will put a few anesthetic drops in to numb the eye and prevent pain.
Your surgeon prepares the eye by gently removing the eye’s protective first layer of cells, or epithelium (this will naturally regenerate itself in a few days), with the laser, to reveal the next layer of corneal tissue known as Bowman's layer. He/she will then smooth the area and proceed with applying computer-controlled pulses of cool laser light to precisely and delicately reshape the curvature of the eye. Deeper cell layers remain virtually untouched.
The whole PRK procedure itself is usually completed in less than five minutes and is painless. Since a layer about as slender as a human hair is typically removed, the cornea maintains its original strength.
Post-operatively, PRK patients are placed on antibiotic drops, along with anti-inflammatory agents to promote comfort and reduce swelling. Patients are also fitted with a bandage contact lens to improve their comfort while their eye is healing. Once the epithelium is healed, usually on the second or third post-operative day, the bandage contact lens is removed by your doctor. Daily eye examinations are required during this initial healing process to ensure an infection does not develop.
To complete the healing process, PRK patients use steroid anti-inflammatory drops for typically around 2 months under the direct supervision of your eye doctor.
Conductive KeratoplastySM
Conductive KeratoplastySM (CK) uses the controlled release of radiofrequency (RF) energy, instead of a laser, to reshape the cornea. CK is performed using a small probe, thinner than a strand of human hair, that releases radiofrequency (RF) energy. The probe is applied in a circular pattern on the outer cornea to shrink small areas of corneal tissue. This circular shrinkage pattern creates a constrictive band (like the tightening of a belt), increasing the overall curvature of the cornea. The procedure, which takes less than three minutes, is done in-office with only topical anesthesia (eye drops). CK is the first alternative to laser for hyperopia.