LASIK, or laser in-situ keratomileus, simply means "to shape the cornea from within." LASIK can treat both nearsightedness (myopia) and farsightedness (hyperopia) with or without astigmatism (blurry or distorted vision). While this procedure has been around since the late 1980s, and received Food and Drug Administration approval in 1999, it has undergone many advances leading to faster recovery, minimum discomfort, and exceptional vision benefits.
About Standard LASIK
In LASIK surgery, a femtosecond laser is used to create a flap in the cornea, after which an excimer laser reshapes the cornea in a precise and controlled fashion to change its focusing power. The LASIK procedure offers patients the following benefits and advantages:
- Fast visual recovery
- Minimal discomfort, limited to mild burning or foreign body sensation
- Minimal to no haze, glare, and halos
- Just a week or two of postoperative medications
In the vast majority of LASIK patients, visual outcome is excellent, and the results are nearly immediate.
What Happens During Standard Lasik Surgery?
- Measuring your eye: The treatment during standard LASIK surgery is based on measurements of patient’s vision refractive status. During your consultation, your ophthalmologist will perform a detailed eye exam, corneal mapping, and refraction to measure a person's prescription for eyeglasses or contact lenses. These measurements will guide the surgeon during the procedure. You have to stop wearing your contact lenses for at least two weeks prior to this appointment to ensure your eyes are in best condition for testing.
- Preparing your eye: After numbing the eyes with eye drops, the surgeon creates a very thin flap of corneal tissue using either a blade (microkeratomer) or a femtosecond laser (iLASIK) to prepare the cornea for treatment. Bladeless, or iLASIK (intralase LASIK), technology is the latest ultra-fast medical laser used to create the flap; the cornea specialists at NYEE are adept at using both methods and will advise what is most appropriate for your unique case.
- Delivering your personal treatment: Once this tissue flap is created, the surgeon positions an excimer laser beam over the eye, directing light pulses to achieve the desired correction. An excimer laser (STAR S4 IR Excimer Laser) is an ultra-precise medical laser that creates a highly focused beam of cool ultraviolet (UV) light to gently reshape the cornea. Your refraction measurements will guide the excimer laser reshaping procedure, called photoablation, and it generally takes less than 60 seconds.
About Wavefront-Guided or Custom LASIK
Wavefront-guided LASIK treats common vision irregularities, like nearsightedness, farsightedness, and astigmatism, as well as higher-order abnormalities, in order to achieve better vision than possible with contact lenses, eyeglasses, or conventional LASIK.
The main difference between standard LASIK and wavefront-guided procedures, is that custom LASIK creates a personalized 3D map of a patient’s visual pathway from the front of the cornea to the back of the retina. These measurements are obtained with an instrument called a wavefront aberrometer during your initial preoperative exam. This 3D mapping is extremely detailed, producing more personalization than conventional LASIK, which is based only on the eyes’ refractive error. It allows the surgeon to reshape the cornea based on patient’s unique anatomy. As a result, the procedure can offer superior results, bringing patients closer to 20/20 vision or better.
What Happens During Wavefront-Guided LASIK Procedure?
- Creating your eye map: A detailed 3D map of the visual imperfections of the eye is created using wavefront eye-mapping technology that is 25 times more precise than the measurements used to write standard prescriptions for eyeglasses or contacts. This step takes place during your pre-surgical consultation, when your surgeon will perform a detailed eye exam and mapping. You have to stop wearing your contact lenses for at least two weeks prior to this appointment to ensure your eyes are in best condition for testing.
- Preparing your eye: After numbing the eyes with eye drops, the surgeon uses a blade (microkeratomer) or an ultrafast femtosecond laser (iLASIK) to create a thin flap to prepare your cornea for your personalized wavefront correction. Bladeless or iLASIK (intralase LASIK) technology is the latest ultra-fast medical laser used to create the flap; the cornea specialist at NYEE are adept at using both methods and will advise what is most appropriate for your unique case.
- Delivering your personal treatment: In the final step, the Star S4 IR excimer laser gently reshapes the cornea to the desired curvature, based on the digital information from the personalized eye map measurements (using Wavefront technology). Our Laser Vision Correction Center uses the STAR S4 IR® Excimer Laser System, which features VSS technology (Variable Spot Scanning) and VRR (Variable Repetition Rate) pulse-packing algorithm. This laser lessens the thermal effects on the cornea, which lets the doctor perform wavefront-guided procedures more efficiently with maximum patient safety.
What to Expect After Standard or Custom LASIK Surgery?
The recovery process for patients whether they had standard or custom LASIK is the same, including:
- Once the reshaping is complete, the flap is carefully put back in its original position. The LASIK flap will heal completely over time, from a few weeks to a few months.
- Most patients can resume regular activity within a few days after the procedure.
- There is minimal discomfort during an overnight recovery period.
- Taking postoperative eye drops for 10-14 days after LASIK.
- The results of LASIK are irreversible. In those rare cases when the laser surgical procedure may over- or under-correct, a second LASIK procedure may be required to adjust the first surgery.
A thorough preoperative exam and consultation with a board certified ophthalmologist is the best way to determine if you are a candidate for LASIK. The initial pre-operative eye exam will measure the curvature of the eye, and check corneal thickness, pupil size, tear production, and stability of the refractive error. All of these factors are taken into consideration when determining if a patient is a candidate for laser eye surgery as well as which procedure is best for their individual case. Patients should use this opportunity to ask questions and discuss any lifestyle changes they need to make during their recovery period.
It is likely you are an excellent candidate for the LASIK procedure if you meet the following conditions:
- Being at least 21 years of age and having a refractive error.
- Acceptable refractive errors: near-sighted up to -10.00 or far-sighted up to +6.00. Your level of astigmatism may be as high as 6.00 diopters.
- Having healthy eyes that are free of eye disease or corneal abnormality (scars, infection, abnormal thinning, etc.).
- Having a stable eye prescription (with documented evidence that your refraction did not change by more than 0.50 to 1.0 diopter for two years prior to your preoperative examination).
- Not being pregnant or nursing.
Patients should not get LASIK if they have:
- An unstable (changing) refractive error
- Advanced glaucoma
- Chronically dry eyes or thin corneas
- Autoimmune diseases (such as lupus, HIV, etc.)
- Uncontrolled diabetes
- Been taking certain medications, like steroids, which could prevent proper healing
Your ophthalmologist will be able to advise what procedure may be right for you based on your eye and overall health.