The surgical correction of vision is a rapidly-evolving science that has led to amazing advances in technology over the past 20 years. In both of these procedures, laser energy is used to reshape the clear surface of the eye, the cornea, so that it focuses light crisply on the retina. The excimer laser utilized in LASIK is so precise that it can cut notches in a single strand of human hair. Laser vision correction was first approved by the FDA in 1995. Since then, there have been over 12 million laser vision correction surgeries performed throughout the world.
The first step when you are considering laser vision correction is a comprehensive refractive evaluation. Measurements will be taken to quantify your uncorrected (without glasses or contacts) and best-corrected vision. Your refractive error will be determined; this is the additional power that your eye needs to see its best. Fortunately, with newer technologies and lasers, the range of refractive error that can be safely treated has increased significantly over recent years. A thorough examination of your eyes, from the cornea to the retina and all the structures in between, is performed to be sure that your eyes are healthy for an elective procedure such as LASIK. Our surgeons will review these measurements with you and recommend the treatment that is best suited for you. In addition to the actual surgical procedure, our surgeons perform all pre-operative and post-operative care.
Blade-free iLASIK with IntraLase®
The first step in LASIK surgery is creating a thin corneal flap. The corneal flap is then lifted and the excimer laser applies the appropriate amount of energy to the cornea to reshape it. Our surgeons use the VISX Star 4 Active Trak® Excimer Laser. This highly sophisticated machine actively tracks the eye in real time and guides the laser appropriately. In addition, the VISX Star 4® has iris recognition software that further improves the accuracy of the procedure. Once the excimer laser is complete, the flap is returned to original position and the corneal tissue heals without the need for sutures.
When LASIK first became FDA-approved, the corneal flap was created by a small blade called a microkeratome. Today, most eye surgeons have evolved to use the latest technology of bladeless LASIK or iLASIK. In this procedure, a femtosecond laser called the IntraLase,® is used to create the initial corneal flap. Using this highly precise instrument has significantly decreased the complication rate for LASIK procedures.
Custom LASIK with CustomVue™
Custom LASIK with VISX’s CustomVue™ system is the most advanced technology available in the field of laser vision correction. As the name implies, custom LASIK tailors the laser treatment to each individual’s eye. The cornerstone of CustomVue™ is wavefront technology, which was originally designed for high-powered telescopes to reduce distortions when viewing distant objects in space. The wavefront analyzer sends light into the eye and then evaluates the light as it exits the eye. With this data, it creates a precise 3-D wavefront map of the cornea that is unique to every individual, a “fingerprint” of your vision. This unique map then guides the laser treatment to the eye.
Wavefront technology has revolutionized laser vision correction because it not only improves how much you see (measured by the standard 20/20 eye chart) but also how well you see (decreased glare, halos and trouble with night vision). How well you can read the eye chart is based on visual imperfections known as lower-order aberrations. These include myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism. Lower order aberrations can be treated by conventional LASIK. The quality of your vision (contrast-sensitivity and fine detail) is dependent on the amount of higher-order aberrations in your eye. Unlike standard LASIK, custom LASIK treats both lower- and higher-order aberrations. This technology is especially beneficial to patients who have had prior refractive surgery and have lost best-corrected vision; while these patients may not have been good candidates for standard LASIK, they may qualify for custom LASIK.
With the advanced technology of custom LASIK, you have a greater chance of attaining 20/20 vision, a greater chance of attaining better than 20/20 vision, a reduced chance of losing contrast sensitivity or fine detail, and a reduced chance of night-vision problems and glare.
Alternatives to LASIK
For a variety of reasons, not everyone will be a candidate for LASIK. Some people have corneas that are too thin to create a flap. Others have irregular scars on the cornea that preclude flap creation. For some of the patients, PRK (photorefractive keratectomy) may be an option. PRK is similar to LASIK except a corneal flap is not created. To learn more about PRK, click on the link below.