Laser Assisted In-Situ Keratomileusis, is the leading refractive surgical procedure performed worldwide. Lasik is remarkably effective in improving visual errors due to nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. The procedure involves two parts; the creation of a thin surface corneal flap, and then the application of laser energy from an Excimer laser to reshape the underlying corneal bed. The surgery is relatively painless, and it takes only minutes. The results for appropriately screened candidates are extremely gratifying. Virtually all of our Lasik patients drive themselves to the office the next day without their glasses or contact lenses!
Visual or Refractive Errors occur when the focusing mechanism of the eye (the cornea and the lens) is unable to focus light rays from objects in the outside world onto the retina. If the light rays don't focus right onto the retinal plane, a blurry image will result. In nearsightedness, the light rays focus in front of the retina. Nearsightedness is usually the result of a steep cornea, or a large eye. In farsightedness, the light rays focus at a point behind the retinal plane. Farsightedness is usually the result of a flat cornea or a small eye. In astigmatism, light rays focus at two or more planes either in front or in back of the retina. Astigmatism is usually caused by an uneven or irregularly shaped cornea. In each of these conditions, the common experience will be a blurry, out of focus image.
The Excimer Laser
After the corneal flap is made by using either a steel keratome blade or the new Intralase technology, an Excimer laser is used to gently smooth or resurface the cornea. Unlike most medical and industrial lasers, the Excimer laser is not a hot or tissue destroying laser. Instead of burning or melting tissue away, this laser works by gently breaking the bonds that hold tissue together. Also, because it is computer assisted and has a precise focusing mechanism, there is little effect or change to surrounding tissue.
The Lasik Procedure
Lasik is performed as an outpatient procedure at our laser eye center, Laser Eye Associates at Cedars Sinai. Arrival an hour before the procedure is usually required to take pictures of the eye or Wavefront measurements. Dr. Ullman will then examine you and after the application of anesthetic drops, the eye will be gently marked if astigmatism is present. The eyelids will then be cleansed with a disinfectant solution and a plastic drape will be applied to cover the eyelid and lashes.
Next, a thin speculum will be placed to open the eye. At this point, under the microscope, the corneal flap is made with an automated keratome blade. If the "All Laser Lasik" option was chosen, the corneal flap will have been made beforehand with the Intralase laser. The flap is then gently lifted back toward the superior attachment hinge and then the excimer laser is applied for twenty to ninety seconds to resurface the cornea. During this time you will be focusing on a blinking colored light. The flap will then be irrigated back onto the corneal bed and returned to its exact original location using marker alignments which were previously placed.
Eye drops are applied and then protective goggles are fitted which are worn overnight. The whole procedure usually takes around twenty to thirty minutes for both eyes. If the "All Laser Lasik" method is used, the procedure will take a little longer. There is little discomfort or pain involved during or after the procedure. Vision might be blurry immediately after the procedure, similar to what your vision is like without your glasses if you are mildly to moderately nearsighted. Hour by hour the vision will progressively improve. By the next morning most people will obtain vision good enough to drive themselves to the office without their glasses or contacts, i.e. 20/40 or better.
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