Lasik/PRK: Laser Vision Correction (or Refractive) Surgery

 "Refractive surgery" refers to any surgical procedure designed to reduce an eye's refractive error. The surgery usually involves altering the shape of the cornea, the clear focusing surface at the front of the eye, and changing how much it focuses (refracts) light.
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LASIK

        If you have a refractive error, such as myopia (nearsightedness), hyperopia (farsightedness) or astigmatism, you may be considering LASIK as a way to reduce your dependence on glasses or contact lenses. LASIK is an acronym for "laser assisted in situ keratomileusis" (in situ means "in place" and keratomileusis means "shaping the cornea"). The surgery uses an excimer laser to change the curvature of the cornea.

LASIK is different from PRK, another laser procedure, in that with PRK, the laser reshapes the outer surface of the cornea, and with LASIK, it reshapes the exposed corneal surface after a thin flap of corneal tissue is gently folded back.

Examination

       You will be carefully evaluated to see if you are a suitable candidate for refractive surgery. Your vision and refractive error will be carefully measured, and your eye examined for any conditions that might lessen the chance of a good result. The corneal surface will be mapped by a computerized topographic analyzer to determine if its shape is appropriate for the surgery.

        You must be at least 18 years of age and have a stable refractive error. You cannot be pregnant or nursing.

What Happens During LASIK Treatment

        LASIK is an outpatient procedure, performed under local anesthesia. The excimer laser is controlled by a computer that has been programmed to create an optical correction specifically for your eye.

 As you recline under the laser instrument, your eye is anesthetized with drops and calculations are re-checked. A speculum holds your eyelids apart, and a suction ring is placed on the eye. A corneal flap is then created with a microkeratome, a specialized instrument that works like a tiny carpenter's plane. You won't feel any pain but you may feel a pressure sensation from the suction ring and your vision may black out for a few seconds, until the ring is removed.

        The corneal flap is lifted, exposing the tissue to be reshaped. A beam of intense laser light sweeps in a circular pattern over the cornea for about 10 to 60 seconds, depending on how much refractive error you have. The laser reshapes the cornea by precisely vaporizing microscopically thin layers, not by burning it.

 You may be aware of a slight odor, and you will hear a loud tapping sound as the laser pulses. To keep your eye from moving, you will stare at a tiny light. But if you should inadvertently move, the laser shuts off instantly. When the eye stops moving, treatment picks up exactly where it left off.

 As soon as the reshaping is accomplished, the corneal flap is returned to its original position. It will spontaneously "stick" in place in about 3 to 5 minutes without sutures. You are likely to see better right away. Most people have very little discomfort.

        The full healing process takes time. For the next 4 to 6 weeks, your vision will continue improving, though it may fluctuate somewhat and you may see halos around lights. But results are not perfectly predictable -- the lower your refractive error, the more predictable the result. If your final result turns out to provide less (or more) correction than you had hoped for, the flap can be lifted and the cornea re-lasered.  This is called an enhancement. Dr. Aflleck's enhancement rates are much lower than the national average. This could be due to Dr. Affleck personally calculating your measurements. In fact, Dr. Affleck takes part in every step of your treatment from the Lasik evaluation, surgery to all your post surgery care.

What Are the Risks? 

        The excimer laser is extremely precise: it removes tissue by breaking chemical bonds at a molecular level. But surgery of any kind involves some risk. Temporary side effects may include corneal haze, decreased night vision, increased light sensitivity, ghost images, and glare. More serious possibilities, though unlikely, include wrinkling of the corneal flap, infection, and even corneal opacification and loss of vision.

        Still, serious risk is slight. The fact is, most people who have had LASIK are delighted with their resulting vision.  You may learn more by visiting the FDA risk information by clicking here

To learn more about Lasik and the health care we can provide,

please call us at 208-523-6868

 PRK

       If you have a refractive error, such as myopia (nearsightedness), hyperopia (farsightedness) or astigmatism, you may be considering PRK as a way to reduce your dependence on glasses or contact lenses.

        PRK, which stands for photorefractive keratectomy (photo means "light," kerato- means "cornea," -ectomy means "cutting out") is one way to permanently correct refractive errors. An excimer laser is used to change the curvature of the cornea. PRK is different from LASIK in that with PRK, the laser reshapes the outer surface of the cornea, and with LASIK, the laser procedure is done after a thin flap of corneal tissue is gently folded back.

Examination

        You will be carefully evaluated to see if you are a suitable candidate for refractive surgery. Your vision and refractive error will be measured, and the eye examined to determine if you have any conditions that might lessen the chance of a good result. The corneal surface will be mapped by a computerized topographic analyzer to determine if its shape is appropriate for the surgery.

        You must be at least 18 years of age and have a stable refractive error. You cannot be pregnant or nursing.

What Happens During Laser Treatment

        PRK is an outpatient procedure, performed under local anesthesia. The excimer laser is controlled by a computer that has been programmed to create an optical correction specifically for your eye.

        As you recline under the laser instrument, your eye is anesthetized with drops and calculations are re-checked. The very thin outer surface of the cornea (epithelium) is gently removed. A beam of laser light sweeps across the cornea for about 10 to 60 seconds, depending on how much refractive error you have. The laser does not burn the tissue, but vaporizes microscopically thin layers, to sculpt the corneal surface.

        You may be aware of a slight odor, and you will hear a tapping sound as the laser pulses. To keep your eye from moving, you will stare at a tiny light. But if you should inadvertently move, the laser shuts off instantly. When the eye stops moving, treatment picks up exactly where it left off.

        After surgery, a "bandage" contact lens is placed on your eye, and the eye covered with a clear protective eye shield. You will need to wear the contact lens until the corneal surface heals, usually three or four days.

        At that point, you should notice an improvement in vision, which should get even better over the following weeks. During these first few days you may have some moderate discomfort or eye pain, which can be reduced with pain medication. You will receive eye drop medications to use at home; it is essential that you adhere carefully to the instructions for using them.

        Over the following several months, your vision should gradually stabilize. You should see clearly, possibly without any glasses or contacts, or with a minimal correction for distance vision.  If your final result turns out to provide less (or more) correction than you had hoped for, surgery can usually be repeated.  This is called an enhancement. Dr. Aflleck's enhancement rates are much lower than the national average. This could be due to Dr. Affleck personally calculating your measurements. In fact, Dr. Affleck takes part in every step of your treatment from the Lasik evaluation, surgery to all your post surgery care.

What Are the Risks?  

        The excimer laser is extremely precise: it removes tissue by breaking chemical bonds at a molecular level. But surgery of any kind involves some risk. Temporary side effects may include corneal haze, decreased night vision, increased light sensitivity, ghost images, and glare. More serious possibilities, though unlikely, include infection, corneal opacification and loss of vision. Still, serious risks are slight. The fact is, most people who have had PRK are delighted with their resulting vision.

To learn more about PRK and the health care we can provide,

please call us at 208-523-6868

 
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