Laser Refractive Surgery Consultation and Co-Management
LASIK is "hybrid" procedure, combining the ALK technique with the accuracy of the Excimer Laser. First the doctor will use an instrument called a Hansatome Microkeratome to create a thin surface-flap under a microscope this will only take a few seconds. Then the Excimer Laser, which has been pre-programmed with your exact correction, applies a rapid, cool ultraviolet light that precisely sculpts a very small amount of the sub-surface of the cornea. These short laser pulses correct the curvature of the cornea, allowing images to be focused clearly on the retina. The flap is then smoothed back down where it quickly bonds back in place, restoring a smooth, intact surface.
Intralase ("All Laser" LASIK or "Bladeless" LASIK):
Intralase utilizes a laser that gives the surgeon maximum control and accuracy during the creation of the corneal flap. No blades are used whatsoever. This technology is less invasive and more precise, which adds a very important level of safety to the LASIK procedure.
Custom LASIK ("Wavefront" LASIK):
While traditional LASIK corrects only lower order aberrations such as Myopia, Hyperopia and astigmatism. Custom LASIK or Wavefront-Guided LASIK can correct higher order aberrations that were not detectable before. The wavefront device uses the same "aberrometer" technology used in specialized telescopes to detect distortions in light waves from space allowing researchers to accurately view images of the stars and plants. The wavefront device measures hundreds of individual points of light that are reflected from the eye and treats each point to maximize your vision.
This recent technology creates a detailed map of the patient's iris before surgery. During surgery, the camera scans the iris and perfectly matches the wavefront data to the eye's exact position. Since the eye can rotate during surgery, this new technology provides a significant benefit, especially when treating high degrees of astigmatism.
The LASIK consultation process involves a comprehensive eye exam with dilation. Additional tests include measuring the corneal thickness and an additional refraction through the dilated pupils called a cycloplegic refraction. If you wear soft or hard contact lenses, they should be out for a minimum of 3 days prior to the exam. If you wear astigmatism contact lenses then you should have them out for one week prior to the exam. There are three basic criteria that need to be met for most patients in determining LASIK candidacy.
-Stable prescription the last few exams
-Adequate corneal thickness
-Adequate corneal thickness
When all three criteria are met, you may be considered an ideal candidate for LASIK refractive surgery.
The measurements that were determined during the LASIK consultation are sent to the office of a well respected and skilled LASIK surgeon. Their office will contact you to schedule a pre-operative exam where your prescription and other important data points will be verified. Once LASIK candidacy is established, a surgery date is scheduled. The day after surgery, you will return to our office for a post-operative follow up. Additional follow ups will be scheduled, typically 1 week, 1 month, 3 months and 6 months after the surgery to evaluate your vision and eye health. Throughout the entire process of the post-operative care, there will be constant contact with the surgeon.
Not a candidate for LASIK surgery?
For those patients who are not candidates for LASIK, an alternative procedure is PRK/LASEK. Here, there is no flap created. The epithelium (the skin of the cornea) is removed allowing the laser to treat the underlying corneal tissue in the exact same fashion as in the LASIK procedure. The major difference between the LASIK and PRK/LASEK is the longer healing time and some discomfort.
Implantable Contact Lens (ICL):
An approved procedure by the FDA, An implant with your prescription is inserted in the space between the iris and lens through a small corneal incision. The procedure is done under local anesthesia and takes about 30-60 minutes. The implant is made of the same material that is used in cataract surgery so the lens is well accepted by the eye.
Is the LASIK procedure approved by the FDA?
The FDA does not approve procedures they approve the technology. They consider LASIK to be a "Practice of medicine issue," meaning that it is up to the doctor to decide what procedure is best suited for the patient. A laser that has been fully approved by the FDA, along with the Hansatome Microkeratome or Intralase laser is used.