Understanding Corrective Laser Eye Surgery

Understanding Corrective Laser Eye SurgeryPatients undergoing corrective laser eye surgery often want to understand the details of what will be occurring, while many other people simply trust their doctors and don’t care to know the details. This is simply a personal decision that every person has to make for themselves. Those who do want to know and understand corrective laser eye surgery can find the procedure explained below to help grasp what will be occurring to their eye during the process.

The Intricate Details

LASIK eye surgeons are trained in a very intricate procedure that uses a very large and complicated piece of machinery that has a computer, microscope and laser attached to it and will be the main tool used during the procedure. On the day of the surgery, the patient is placed in a reclined position and given a medication to help them relax, if they would like it. The level of relaxation that is induced will vary from person to person and from doctor to doctor. If a person is extremely anxious and apprehensive, they may receive more sedation than someone who simply doesn’t want to be nervous. Other people forego the valium or other relaxant as there is no pain involved in the process and they don’t want to be drowsy or unaware of their surroundings during the procedure.

Anesthetic eye drops are placed in the eye that is going to be under the laser. These eye drops not only numb the eyes, they also act as a cleanser to help rid the eyes of dust that could lead to infection during the process. This is vital, as infection is one of the risks that must be avoided in order to ensure a successful procedure and a fast recovery. There is not much pain involved in corrective eye surgery using a laser; however, these eye drops help to ensure that even the slightest hint of pain is avoided.

After the eyes have been numbed and are thoroughly clean, the surgeon will prepare to begin the eye operation by placing a speculum over the eye to hold the eye open during the process. This helps the surgeon by preventing blinking during the procedure; this may sound uncomfortable; however, the eyes have been numbed and there is the option of a relaxant at the beginning of the procedure if this seems like a frightening thought.

The Laser Surgery

The cornea, or front part of the eye, will have a ring fitted over it to prepare it for the laser. Once in place, the cornea will be lifted from the surface of the eye using high pressure. The patient may feel this and think it is painful; however, the numbing agent should keep this from being too painful. Once the cornea is removed off the surface of the eye, it is time for the most important part of the surgery to begin.

Now that the cornea has been prepared, the laser can be allowed to do what it has been prepared to do prior to the visit. If the cornea were not removed, the laser could damage the eye. The computer that controls the laser has been programmed prior to the appointment using the measurements that were taken during the visits leading up to the surgery. These measurements are what make the surgery successful, as every person will have different measurements. These measurements are used to reshape the eye to the correct shape that will eliminate the blurring and astigmatism.

Once the eye has been reshaped to the exact measurents, the surgeon will place an eye patch over the eye and revisit the patient in a few days. Typically, the patient is allowed to go home after a short period of time. There should be someone to drive the patient, as driving is not allowed for the first forty-eight hours. Other than driving, the patient’s activities will be limited for just the first two days. The entire procedure will be completed in a very short period of time and the patient will be home in bed quickly.  After the first forty-eight hours the patient is under no strict guidelines; however, the eye doctor will provide the patient with a list of activities that should be limited for at least one week, such as getting water directly in the eyes such as would occur in the shower. This is one of the main avoidances that the doctor will point out for the first week, keeping foreign material out of the eye.

While this is an intricate procedure, it is quick, painless and the recovery is short and uncomplicated if the instructions are followed. Understanding all of the steps is important for some people and not so much for others.

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Excimer Laser Eye Surgery

Excimer Laser Eye SurgeryWhat is an Excimer Laser?

Originally used in microchip manufacturing, ophthalmologists (eye doctors) saw the possibilities for using an excimer laser in delicate eye surgery. These doctors first envisioned using the laser on biological tissue and eventually discovered how well it could work for surgical procedures on the eye’s cornea. This type of laser sends out a cold beam that breaks done molecular bonds within the corneal tissue, ultimately causing tissue evaporation (technical term for this is ablation).

Safety and Effectiveness

Since 1987, the excimer laser has an international track record for safety and effectiveness. Millions of procedures using the laser in eye surgery have been completed successfully.

First Patient

The first patient to have photorefractive keratectomy was treated in Germany in 1988.

Photorefractive Keratectomy

PRK – Photorefractive Keratectomy was the one of the first procedures using this type of laser in eye surgery. RK (refractive keratectomy) was invented in the early 1980s. In 1995, the FDA granted approval of a laser for PRK, but the procedure was practiced in other countries for years. Many Americans crossed the border into Canada to have the surgery performed, before it was available in the United States.

How it Works

Using an Exicmer laser, with PRK is surgeons use and ultraviolet beam of cool light to remove (“ablate”) with precision very small tissue layers in order to change the cornea’s shape in order to focus light on the retina better, increasing vision.

Who Can Benefit from PRK?

People with myopia (nearsightedness) and hyperopia (farsightedness) can choose PRK as a possible treatment. With nearsighted people reducing the slope of the cornea can increase vision. Those who are farsighted need a cornea that has a steeper slope. Excimer lasers can be used to fix astigmatism, taking an irregular cornea and smoothing it into a standard form.

PRK Surgery

PRK is performed on an outpatient basis, usually in a surgical center for ophthalmologists. The actual surgery usually takes only ten minutes per eye from start to finish, using an anesthetic eye drop to numb the eye, so you are awake during the procedure. Occasionally, the doctor will give you a mild oral sedative if you are feeling anxious about the surgery.

The surgeon will have you lie down in a special chair, positioning your eye directly under the laser. (One eye is operated on at a time.) A holding device is placed under your eyelids to keep them open — normally, patients do not think this is uncomfortable.

Keep Your Eye on the Target

Now comes your part. After a computer is used to adjust the laser for your particular prescription, you will be asked to look at a target light for a short time while the surgeon looks through a microscope at the eye, making sure it stays in place while the laser is used to reshape the cornea by painlessly evaporating tiny layers of tissue. It’s important to keep your gaze on that target light in order to get the best results.

The surgeon has full control of the laser and can turn it off at any time. After the procedure is finished, you will rest for a little while. Typically there will be at least a short rest period between surgeries on the left and right eye, even if you are scheduled to have them done the same day. Both doctors and patients may choose to schedule the surgeries a week or two apart.

LASIK Surgery

One type of refractive surgery is LASIK. This option changes the cornea’s contour by using a laser. Using a blade or laser device, a flap is cut in the cornea, with part of the flap attached like a hinge it is folded back to reveal the stroma or middle of the cornea. The changes are made to the cornea and then the flap is reattached.

The surgeon uses pulses that come from a computer and are used to evaporate parts of the stroma before the flap is put back. Be assured the surgeon is always in control of the computer generated laser and can turn it off immediately.

Lasik surgery is also used to correct nearsightedness, farsightedness and astigmatisms to a certain degree. Most patients experience less discomfort and a faster healing time with LASIK than with PRK. It is also a very quick outpatient procedure.

Post-Surgery

As with any kind of surgery, be sure to follow your doctor’s instructions and call immediately if you have any concerns. Get plenty of rest, avoid all activities prohibited by your doctor, and if you are given a prescription for medicine you need to take them as directed.

For several days and even weeks after the surgery you will have regularly scheduled visits with the surgeon to allow the doctor to check your healing process. Often you will be given a special contact lens that serves as a bandage. You may need to use antibiotic drops for a few days, and anti-inflammatory drops for a number of weeks.

Summary

Typically there is no difference in outcome percentages between PRK and LASIK. For the most part after surgery the patients will enjoy 20/20 vision, a few will have only 20/40, and a small percentage will have results that aren’t as good. While often the goal is to be freed of the need for glasses or contact lenses, you may still have to wear them, however the prescription for these corrective lenses will be much lower.

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Understanding Blade Free (bladeless) Lasik Eye Surgery

Understanding Blade Free (bladeless) Lasik Eye SurgeryBlade free LASIK eye surgery is the most up-to-date method of correcting many vision problems without the need for incisions and long healing times. Everyone in the vision correction profession and practically anyone who has watched television and seen ads knows what LASIK is; however, there are not as many people who know or understand what Blade free laser eye surgery is or how it can help them.

The use of laser surgery for vision problems began in the mid-1980’s with the development of PRK. Photorefractive keratectomy or PRK was the first cool beam laser surgery that used lasers to reshape the cornea in the eye and thus correct astigmatism and other vision defects. It wasn’t many years after that LASIK eye surgery was developed and would become the preferred eye surgery for people with astigmatism, near sightedness and far sightedness.

From PRK to LASIK

The invention of PRK only opened the door to more and better improvements in the arena of laser eye surgery. Up until the invention of laser surgery for vision correction, surgeons had to use much more invasive techniques to correct vision, if there was even a corrective option.

LASIK eye surgery followed PRK with FDA approval in the late 1990’s. Laser assisted in situ keratomileusis or LASIK is a surgical procedure that is permanent and results in the correction of refractive eye defects such as near sightedness, far sightedness, and astigmatism. The end result is clear vision with no dependence on corrective vision appliances such as glasses and contact lenses.

During LASIK, the surgeon creates a flap before reshaping the cornea. This flap is located above the cornea and aides in speeding the recovery process. This makes LASIK recovery faster than recovery from PRK surgery. Typically, patients return to their normal routines in 48 hours and have 20/20 vision after the surgery.

Comparing PRK to LASIK

In many ways, PRK and LASIK are very much alike. They are both short surgeries that are complete in about fifteen minutes per eye. PRK and LASIK both treat the same vision problems and both are outpatient procedures. However, LASIK heals faster than PRK and the end result in improved vision is much quicker than with PRK. PRK also tends to be more uncomfortable for the patient than LASIK. PRK patients tend to report that they have a scratchy, uncomfortable feeling in the eye that has had PRK. At one time both LASIK and PRK were not options for patients who have thin cornea’s due to the flap that needs to be created; however, the recent advances in LASIK that have brought about Bladeless LASIK and custom LASIK have made it possible for practically anyone to have the surgery. The elimination of the cut that creates the flap has allowed people who can benefit from the surgery to be able to get vision that allows them to see more clearly.

Custom LASIK and Bladeless LASIK

Since the invention of LASIK in the 1990’s, many advances have been made that have increased how effective the surgery is and has increased the number of people who are candidates to have the surgery. Bladeless LASIK eliminates the need to have an incision create the flap above the cornea. During this type of LASIK, the flap is created using a secondary laser and the microkeratome is eliminated.

Eliminating the incision has made it possible for people who were not candidates for LASIK to have the surgery. Traditionally, if a person had thin eyelids they would not be eligible for LASIK, due to the incision that had to be made. However, Blade-free LASIK has changed this and now practically anyone can have the surgery regardless of the thickness of the eyelid.

Wavefront technology is used in Custom LASIK and creates a 3D map of the eye that reveals all of the defects and deformities that are in the eye and need to be corrected. Custom LASIK often results in vision that is beyond 20/20 perfect. Additionally, Custom LASIK is a highly personalized procedure that practically removes the chances for many of the complications that are sometimes a result of using traditional LASIK.

Both Custom LASIK and Bladeless LASIK offer results that are far superior to the results of traditional LASIK. These two specialized versions of LASIK surgery allow a larger section of the population to be eligible for LASIK surgery and thus get their vision corrected when they were not previously eligible for traditional laser surgery. People with astigmatism, near sightedness, far sightedness and some other eye disorders should contact an eye doctor to determine if they are eligible for blade free LASIK eye surgery or Customized LASIK eye surgery to correct their vision.

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