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Custom LASIK
There’s a new wave in LASIK/LASEK. The Food and Drug Administration approved a new technology that will change how we view your vision problems. It’s called custom LASIK/LASEK: the laser eye treatment is based upon the very unique visual characteristics of you eye. Up until now, with glasses, contacts and covential LASIK surgery, correction were quite similar for each type of prescription – myopia, hyperopia and astigmatism.
Custom LASIK/LASEK involves measuring the eye from front to back, using what’s called “wavefront” technology, to create dimensional (3-D) corneal map. The information contained in the map guides the laser in customizing the treatment to your individual visual irregularities. Prior to the advent of wavefront technology no two people with the same prescription would receive the same glasses, contacts or LASIK procedure.
Potential Benefits of Custom LASIK/LASEK
Wavefront technology is groundbreaking because it has the potential to improve not only how much you can see, visual acuity measured by the standard 20/20 eye chart, but also how well you can see, in terms of contrast sensitivity and fine details. This translates into a reduced rish of post-LASIK/LASEK complications, such as glare, halos and difficulty with night vision.
Custom LASIK’S/LASEK’S Advantage lies in the area of quality vision:
- Greater chance of achieving 20/20 vision
- Greater chance of achieving better than 20/20 vision
- Reduced chance of losing best corrected vision
- Reduced chance of losing visual quality or contrast sensitivity
- Reduced chance of night-vision disturbances and glare
Wavefront Guided LASIK
Wavefront Guided LASIK is a variation of LASIK surgery which uses “wavefront” technology to custom sculpt the cornea to correct vision. Wavefront Guided LASIK may, in certain situations, provide better results than traditional LASIK.
Over the last few years, much research has been done in the area of “adaptive optics” which is the technique of removing blurring in images caused by distorations in optical systems. The field of astronomy has benefited greatly in this manner-new telescopes use microscopically adjusting mirrors and lenses to compensate for optical irregularities, enhancing the quality of the image received.
Ophthamologist have looked at using this technology to improve laser vision correction techniques. The eye is basically an optical system with lenses (the cornea and the actual lens inside the eye both function as lenses).
Wavefront technology measures optical aberrations or distortions in the eye’s optical system, and mathematically describes and quantifies these aberrations. Linking this information to a small-spot scanning laser allows us to custom-sculpt the cornea and potentially correct these distorations.
LASEK
In the interest of long-term safety, we may recommend to patients with thinner corneas or irregularly shaped corneas, an advanced surface ablation procedure also known as PRK or LASEK. This procedure, which does not create a flap, can give us more cornea to work with enabling a more complete correction or a larger treatment zone diameter. The procedure involves removing the very thin surface layer of the cornea known as epithelium (usually about 50 microns thick) then reshaping the exposed cornea with a laser. The laser treatment is the same as in a LASIK procedure; the only difference is that the placement of the treatment is not as deep in the cornea as with LASEK, the risk of ectasia or instability is lowered. The vision outcome or percentage of patients achieving 20/20 or better vision, is the same as with LASIK in our experience and in published studies. When the procedure is completed, usually after 15-20 minutes, a thin soft contact lens without prescription is placed on each cornea to act as a clear bandage. The vision is immediately better upon standing up from laser, but will fluctuate for several days to several weeks until the surface healing is complete and stabilized. The soft contact lenses are left in place without removing them for 5 days. The contact lenses will minimize the postoperative discomfort, however, some mild pain can occur usually on the second or third day after surgery. We will prescribe a painkiller for you so that it is available to you in the event that you experience discomfort. Once we remove the contact lenses, usually after 5 days, the vision progressively stabilizes and improves. Patients are usually able to return to work after 3-5 days; however, there may be some blurriness that persists for 1-2 weeks further until the cornea is stabilized. Improvement of sharpness in vision is usually noted over a several week period. Antibiotic and nonsteroidal anti-inflammatory drops are used postoperatively for one week and topical steriod drops are used in a tapering dose for 3 months. Haze can develop in the cornea as it heals; however, with modern lasers and techniques, this is quite rare. In some cases, we will treat the cornea in the laser suite with a drop called Mitomycin-C to minimize the risk of haze in high risk cases.
The difference between LASIK and advanced surface ablation LASEK/PRK can be summarized as follows:
- Less intrusive surgical procedure.
- Slower recovery of vision with LASEK. Mild discomfort may occur in the first few days after LASEK.
- Eyedrops used in tapering dose for 3 months.
- Haze affecting vision can rarely occur necessitating re-treatment.
- Enhancement can be done after 6-12 month
CK (Conductive Keratoplasty)
Conductive Keratoplasty (CK) is a non-laser surgical procedure available to treat farsightedness. CK uses radiofrequency energy delivered with a needle-like probe to the cornea. The electrical resistance of the collagen causes heat to build up in the cornea, shrinking the collagen and causing the central cornea to steepen.
CK is FDA-approved for patients with farsightedness between +0.75 and 3.00D, with less than or equal to 0.75D of astigmatism.
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