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By utilizing the accuracy
and precision of the Excimer laser, this computer
controlled procedure ( LASIK ) changes the shape
of the cornea thereby allowing images to be more
sharply focused on the retina. By adjusting the
pattern of the laser beam through its computer,
it is possible to treat high levels of nearsightedness,
farsightedness and astigmatism.
LASIK surgery is performed as an outpatient procedure,
the entire procedure takes less than 30 minutes
and both eyes are done the same day. The procedure
is performed using topical anesthesia (eye drops).
Some patients report a slight, post-operative discomfort
that can usually be alleviated with medications.
Patients see a dramatic improvement in their vision
within hours and almost 90% recovery in 24hrs. Most
patients return to their normal activities within
a day or two.
Step by Step
The LASIK procedure takes a few minutes to complete,
and the procedure is relatively painless. Patients
are always amazed at the ease of this procedure
because of speed and comfort. Only topical anesthetic
drops are used to numb the eye for the procedure.
An eyelid holder is inserted to prevent blinking
while the drops eliminate the reflex to blink.
With LASIK, the surface epithelial layer is left
intact, allowing for not only faster visual recovery
but improved comfort and safety.
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A
suction ring is placed on the eye to secure
the eye and maintain pressure within the
eye while the corneal flap is created. A
microkeratome, an automated microsurgical
instrument is used to create a thin corneal
flap which remains hinged beneath the upper
eyelid. The corneal flap is 160 to 180 microns
thick, about 30% the corneal thickness which
is typically about 550 microns. Patients
do not feel or see the cutting of the corneal
flap, which takes only a few seconds.
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The
corneal flap is then laid back and the inner
stromal layers of the cornea is treated
with a cool gentle beam of Excimer laser
as per the patient's prescription. This
changes the refractive power of the cornea
thus eliminating the refractive error of
the eye.
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The
corneal flap is then repositioned and the
flap and interface rinsed.
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Once the procedure is completed, the surgeon will
wait 2 to 3 minutes to ensure the corneal flap has
fully re-adhered. At this point, patients can blink
normally and the corneal flap remains secured in
position by the natural adherence within the cornea.
While it is possible to dislodge the corneal flap
during the first day or two by physically rubbing
the eye, this event is actually quite rare. After
the first week, LASIK patients can resume their
full exercise activities.
Since the protective layer remains intact with LASIK,
no bandage or contact lens is required. However,
a protective eye shield is normally recommended
for a day. LASIK patients are placed on an antibiotic
and anti-inflammatory drop regimen for about 2-3
weeks. They also need to instill artificial tears
for a few months. Patients are able to travel by
air immediately and exercise after 1 week.
LASIK is generally considered the method of choice
for using the Excimer Laser for correcting refractive
errors. Another popular technique is Photo Refractive
Keratectomy or PRK. LASIK is generally the method
of choice because it allows faster post-operative
recovery of vision, requires less follow-up, and
allows the patient to be more comfortable faster.
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