LASIK (Laser-Assisted-In-Situ Keratomileusis) is currently one of the most frequently
performed elective procedures in North America. It is a highly effective outpatient
procedure that is suitable for most low, moderate and higher prescriptions. (Link to
nearsightedness and other common viusion problems) LASIK uses a cool beam of light
from the excimer laser to gently reshape the front surface (cornea) of your eye.
(insert LASIK animation)
The LASIK Procedure
1. Anesthetic drops are applied to the eye.
2. A protective flap is created and gently lifted by the surgeon, revealing the inner
corneal tissue.
3. Computer-controlled pulses of cool laser light are applied to the inner layers of your
cornea. As the laser pulses, it makes a ticking sound. The inner corneal layer is reshaped
with the laser to mimic your contact lens or glasses prescription.
4. The surgeon gently replaces the flap and aligns it to its original position. It heals
naturally and securely.
5. Some patients may feel slight irritation for a few hours, but most are quite comfortable
after a nap and rest.
Custom LASIK
While conventional LASIK has been a complete revolution in vision correction, the latest
in laser vision correction technology is Custom LASIK. Custom LASIK is a procedure
that enables your surgeon to further customize the conventional LASIK procedure to your
individual eyes. This customized procedure may result in patients seeing clearer and
sharper than ever before. FDA studies show that Custom LASIK may produce better
vision than is possible with contact lenses or glasses.
In clinical studies, Custom LASIK has been able to provide patients with:
1. A greater chance of having 20/20 vision
2. The potential for better vision than is possible with contacts or glasses
3. Less incidence of glare and halos
4. Potentially better overall vision, even at night.
Better Quality Vision
Clinical studies have shown that Custom LASIK may improve not only what you see but
also how well you see it. In the past, all vision was measured using a standard vision
chart. If you could see the letters, the doctor would use that measurement for how well
you could see. But now, with Custom LASIK, doctors are able to focus on the quantity as
well as the quality of your vision. Many patients who have had Custom LASIK are
reporting the ability to see clearer than ever before.
Higher Order Aberrations
Several types of visual imperfections, referred to as lower- and higher-order aberrations,
exist within the eye and may affect your vision (the amount of these aberrations vary
from person to person). Previously, only lower-order aberrations (such as
nearsightedness, farsightedness and astigmatism (link to appropriate page)) could be
measured and treated. Higher-order aberrations may also have a significant impact on
vision and have been linked to glare and halos. Now Custom LASIK may help to further
customize your treatment of these higher-order aberrations that, in the past, could not be
adequately treated with glasses, contacts or conventional LASIK treatments. Your doctor
will recommend the best procedure for you based on your personal aberrations.
For some patients, such as those entering the armed services, those with thinner corneas
or with dry eyes PRK may be a more suitable option. (Link to PRK page). If your
prescription is too high for LASIK the Visian ICL or Refractive Lensectomy may be
appropriate. (Links to these as well)_
The Technology of Custom LASIK
Custom LASIK uses a wavefront analyzer to measure the way light travels through your
eye. The wavefront analyzer creates a customized 3-D map of your eye that looks at your
entire optical system. This map provides information about the unique visual
characteristics of your eye which adds an additional level of data about your vision,
enabling Dr. Arffa to further customize your vision correction.
Wavefront Analyzers
Wavefront analyzers are used to map "aberrations" in the eye. As you may know, several
types of visual imperfections, referred to as lower and higher-order aberrations, exist
within the eye and can affect both visual acuity and the quality of vision.
To date, only lower-order aberrations such as myopia, hyperopia, and astigmatism could
be measured and treated. However, these do not account for all potential vision
imperfections. Higher-order aberrations can also have a significant impact on one's
quality of vision and are often linked to visual glare and halos that may cause night vision
problems.
Higher-order aberrations cannot adequately be corrected with glasses, contact lenses, or
conventional LASIK treatments. In fact, some researchers have found that such
aberrations may actually be increased by laser refractive surgery, while other aberrations
are naturally occurring.
Ophthalmologists are just beginning to understand how these higher-order aberrations
affect vision. The wavefront analyzer software performs complicated measurements and
projects a precise map for the surgeon to evaluate. The data is used to generate a
"treatment table"or an outline of the patient's refractive error and higher-order
aberrations. A perfect wavefront would be completely flat. When light rays enter the eye
and traverse the different refractive indices, the wavefront surface changes taking on a
shape unique to that eye. These variations are called wavefront errors. Treating a patient
with the information taken from the analyzer can result in greater clarity of vision and
less complaints of glare or night halos.
Custom LASIK or Traditional LASIK?
The actual LASIK procedure process is performed the same way in both traditional
LASIK and Custom LASIK. Everyone's eyes are different; your pre-procedure
consultation with your doctor will help determine the range of your probable outcome
based on your particular prescription, healing profile and expectations. Dr. Arffa will
recommend which procedure is best for you based on many factors, including your
refractive error, the size of your pupils, and your visual aberrations. He will help you to
determine if you could benefit from the higher level of customization that Custom
LASIK may provide.
What is Bladeless LASIK?
In the LASIK and CustomLASIK procedures, a flap of corneal tissue must be created and
then folded back. The cornea is the transparent dome-like structure that covers the iris
and pupil of your eye. By creating a flap in the cornea, the surgeon is able to perform the
laser vision correction treatment on the inner layer of the cornea and allows for a rapid
visual recovery.
With Bladeless LASIK, the surgeon uses a laser to create the corneal flap. This
technology enables the surgeon the ability to customize the corneal flap for every
individual patient. Bladeless LASIK with the IntraLase produces flaps of more precise
and uniform thickness. Therefore, this technology may now make it possible to treat
those who were previously dismissed as non candidates due to thin corneas. Intralase
flaps also make some potential complications, such as incomplete flaps, postoperative
dislocation or epithelial ingrowth, less likely.
Studies have also shown the incidence of dry eye symptoms may be reduced with
Bladeless LASIK.
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• Bladeless LASIK has been used in more than one million LASIK procedures
worldwide.