The LASIK Procedure
LASIK procedures performed at our Phoenix and Sun City practices represent the latest technology in refractive surgery to correct refractive errors. LASIK utilizes the precision of the computerized excimer laser delivery system to customize change in corneal curvature to bring light into proper focus. By reshaping the cornea under a precision made flap, the comfort level and return to normal activities generally happens very quickly.
- LASIK lifts a corneal flap.
- The bed under the corneal flap is flattened precisely with an excimer laser beam.
- The corneal flap is placed back over the flattened cornea; with the flap in place, the eye is more comfortable much more rapidly than in PRK (Photorefractive Keratectomy).
In the LASIK procedure, a corneal cap is fashioned by the Microkeratome as described above. This technique has been refined with today's technology to the point where it produces beautiful smooth surfaces dependably with the best in speed and efficiency. Cornea reshaping is accomplished with the excimer laser by virtue of the bed of the cornea under the cap being flattened or remolded to correct for errors of short-sightedness, far-sightedness and astigmatism.
After the central cornea is remolded by the high energy ultra-violet pulses of the excimer laser, the cap is folded back over the central cornea and allowed to heal in place without the need for any sutures. The patient does have a 4 to 5 hour period of time when there is discomfort that feels like sandiness in the eyes, which is tolerated better by simply keeping the eyes closed for this period of time. After this 4-5 hours, the eyes are expected to be comfortable, and we can expect a return to normal activities by the next day. By the next day, we expect the patient to be seeing quite well, though fluctuations of vision are normal over the expected healing time of 3-4 months.
The PRK (EPILASIK) Procedure
There are some individuals who may have higher amounts of myopia combined with corneal thicknesses that are a little thinner than average. These parameters are determined in the consultation by measuring the corneal thickness with ultrasound pachymetry. In order to preserve stability of the cornea, these occasional patients are safer having treatment with the PRK technique. With this technique, no flap is fashioned. Only the very superficial layer of epithelium is removed (with a delicate brush in PRK or with the specialized Epilasik Microkeratome) and the cornea is then reshaped with the laser. Because there is no flap to keep the eye comfortable post-operatively, a delicate bandage contact lens is utilized to encourage healing of the epithelium; a process that generally takes 3-5 days. Although the patient is more blurred in the first few days, the ultimate visual result is every bit as excellent as with Lasik.
- Appears to have more precise results than the old and outdated techniques of radial keratotomy (RK)
- Results appear equivalent to PRK , but the eyes become comfortable more quickly.
- Has been shown to produce good results in high myopia, and has also shown encouraging results around the world for low hyperopia as well as astigmatism
- No pain aside from some irritation for 4-5 hours
- Can return to normal activities by the following day
- The visual effect is seen quickly – usually within 24 hours
- No need for a bandage contact lens to promote healing as in PRK
- Generally no haze seen, as noted for the first 2 months in PRK for moderate myopia
- Generally no need for cortisone eye drops for the 2 months as with PRK
Although the LASIK procedure, when performed on an individual that is an appropriate candidate, is very successful, some symptoms, such as glare at night, are common early on in the healing period. In addition, dry eye symptoms are also common during the healing period, but can be successfully managed with the use of artificial tears. We expect that these symptoms settle in most individuals over the 3 - 4 month healing time.. Other issues, such as infections or flap problems, are uncommon, and often can be successfully managed. For a more complete discussion of risks and benefits, it is best to come in for a consultation so that a relevant discussion of factors as related to your particular circumstances can be discussed.
LASIK or PRK?
For refractive surgery problems, the age of the Excimer laser has brought significant benefits to the expected results. What is the best type of refractive surgical procedure for you? At Walman Eye Center, we pride ourselves in treating individuals as individuals – not parts in an assembly line. The appropriate course of action needs to be specified for each individual. This is one of the many reasons our Scottsdale, Sun City, and Phoenix patients choose us for LASIK surgery.
In general terms, the Excimer Laser procedures have lead to the extinction of the older RK procedures, primarily because of the accuracy and dependability. Lasik or PRK now leads to excellent results.
There are, however, some instances of patients in whom the PRK procedure is safer - particularly those individuals whose corneas are too thin for the amount of myopia to be treated.
We have, in the past few years, consulted with many patients who felt that they wished to hold off from refractive surgery until our confidence level in the technology has improved. That time appears to be here. Your vision without glasses or contacts can likely be improved.
Will I have pain with a Laser Treatment?
This question is certainly one of the most common that is asked in association with any eye surgical procedure. To the surprise of most patients, a significant amount of discomfort is not encountered. There is no need to put an individual to sleep for a procedure and, generally, a few numbing eye drops work very effectively when performing the laser procedures. In this way, the patient is alert, but generally speaking, not uncomfortable. Usually, Dr. Walman and the patient are chatting about a diversity of subjects - and the entire procedure is generally over in 10 to 15 minutes.
Will I see anything during the procedure?
A common worry and among many is the thought that they will see what is happening or be staring at instruments in front of them. During the procedure, it is impossible to focus on any instruments. The only visible sensation will be a bright light from the microscope.
What happens if I move my eyes during the procedure?
Patients often are concerned that they may mess things up if they move their eyes during the procedure. As assurance, it is important for you to realize that our Excimer laser has a sophisticated "Tracker" technology that optically locks on to the position of your eyes without touching them. If your eyes move slightly, the head of the laser responds instantly by moving in the same direction. So, not to worry if you move your eyes. You may slow things up a bit, but you won't mess things up.
How fast will I heal? How fast can I return to work?
When the procedure is over, the patient returns home within about ½ hour. Usually, no patch is necessary. One can return to most types of work by the following day. Improvement in vision is often noticeable on the same day of treatment, but continued improvement is expected over the following 2 – 4 weeks in LASIK, and over the following 2 months in PRK.
What is the cost of Laser Refractive Surgery?
The costs of the procedure can only be discussed after you and Dr. Walman have determined the extent of treatment. Financing is available through Care Credit patient financing.
LASIK2020 / Walman Eye Center offers patients the option to finance their procedure, through Care Credit Financing. Patient financing was created for people who don’t want to tie up their traditional credit sources with medical debt or those who simply can’t afford to pay out-of-pocket healthcare charges atone time. It’s no longer necessary to delay a surgical procedure that you really want, nor worry about the inability to pay for treatment. Care Credit allows you to make low monthly payments over an extended period of time. Contact either our Sun City or Phoenix laser vision center to learn more about LASIK and patient financing.