KS EyeWorks | Laser Surgery of the Eye

Laser Surgery of the Eye The word "laser" is an acronym for Light Amplification by Stimulated Emission of Radiation. A laser is a concentrated beam of light, created when an electrical current passes through a special material. Used in eye surgery since the 1970's, the laser is popular for its unparalleled degree of precision and predictability. Lasers are being used for an increasing variety of eye diseases. A laser's specific wavelength allows energy to be absorbed in selected tissues without damaging surrounding tissues. The laser beam is so precise it can cut notches in a strand of human hair without breaking it. Thermal lasers convert light to heat. This type of laser seals blood vessels and destroys abnormal tissues. Photoablative lasers cut or sculpt tissue and are used to remove tissue, changing the shape and surface of the eye. Lasers can preserve vision, sometimes for many years, for diabetics with diabetic retinopathy. In treating diabetic retinopathy, the laser light seals leaking blood vessels in the retina, the light-sensitive layer of cells lining the back of the eye. Lasers also treat more unusual retinal disorders, including blood vessel problems and tumors. Also used to treat glaucoma, lasers can create a new passage through the iris to relieve eye pressure or open the eye's blocked drainage canals. More recently, the excimer laser has received a great deal of attention as a tool for permanently correcting refractive errors such as nearsightedness, farsightedness and astigmatism. Refractive laser surgery can decrease or eliminate the need for glasses and contact lenses by reshaping the cornea.

The word "laser" is an acronym for Light Amplification by Stimulated Emission of Radiation. A laser is a concentrated beam of light, created when an electrical current passes through a special material. Used in eye surgery since the 1970's, the laser is popular for its unparalleled degree of precision and predictability. Lasers are being used for an increasing variety of eye diseases. A laser's specific wavelength allows energy to be absorbed in selected tissues without damaging surrounding tissues. The laser beam is so precise it can cut notches in a strand of human hair without breaking it. Thermal lasers convert light to heat. This type of laser seals blood vessels and destroys abnormal tissues. Photoablative lasers cut or sculpt tissue and are used to remove tissue, changing the shape and surface of the eye. Lasers can preserve vision, sometimes for many years, for diabetics with diabetic retinopathy. In treating diabetic retinopathy, the laser light seals leaking blood vessels in the retina, the light-sensitive layer of cells lining the back of the eye. Lasers also treat more unusual retinal disorders, including blood vessel problems and tumors. Also used to treat glaucoma, lasers can create a new passage through the iris to relieve eye pressure or open the eye's blocked drainage canals. More recently, the excimer laser has received a great deal of attention as a tool for permanently correcting refractive errors such as nearsightedness, farsightedness and astigmatism. Refractive laser surgery can decrease or eliminate the need for glasses and contact lenses by reshaping the cornea.

The flap is lifted and the laser reshapes the cornea	Following the procedure the flap is repositioned in its normal position

LASIK Until recently, if you were one of the millions of people with a refractive error, eyeglasses and contact lenses were the only options for correcting vision. But with the arrival of refractive surgery, some people with myopia (nearsightedness), hyperopia (farsightedness) or astigmatism (a cornea with unequal curves), may have their vision improved through surgery.

Here are some frequently asked questions regarding LASIK:
Q. What is LASIK?
A. LASIK is a refractive procedure that uses an automated blade and a laser to permanently reshape the cornea. The reshaped cornea helps focus light directly onto the retina to produce clearer vision.
Q. Who can have LASIK?
A. Anyone 18 or older who wears glasses or contact lenses to correct nearsightedness, farsightedness and/or astigmatism may benefit from LASIK.
Q. What happens during the procedure?
A. LASIK is usually performed as an outpatient procedure using topical anesthesia with drops. The procedure itself generally takes about fifteen minutes. Dr. Smith creates a flap in the cornea with a microkeratome. The flap is lifted to the side and the cool beam of the excimer laser is used to remove a layer of corneal tissue. The flap is folded back to its normal position and sealed without sutures. The removal of corneal tissue permanently reshapes the cornea.
Q. How long after the procedure does it take to see the effects of LASIK?
A. Vision should be clear by the next day. During the first few months after surgery, your vision may fluctuate. It may take up to three to six months for your vision to stabilize after surgery. Glare, haloes, difficulty driving at night and other visual symptoms may also persist during the stabilization period.

Custom Wavefront LASIK The new Custom Wavefront procedure takes LASIK to an entirely new, personalized level with the addition of wavefront technology which is 25 times more accurate than the traditional method of measurement.
Wavefront technology provides Dr. Smith with a unique map of your vision, as unique as your DNA or your fingerprint, allowing Dr. Smith to custom tailor your LASIK procedure to the unique characteristics of your vision. Wavefront technology is groundbreaking because it has the potential to improve not only how much you see, but also how well you can see, in terms of contrast sensitivity and fine detail. In an FDA clinical study, here’s what Custom Wavefront patients experienced one year after their procedure:
100% of the clinical study participants could pass a driving test without glasses or contacts
98 % of the participants could see 20/20 or better without glasses or contacts
70% of the participants could see better than 20/16 without glasses or contacts
The process begins with the Orbscan and Zywave Maps, which provides a more detailed analysis of the way your entire personal optical system operates. This information is then transferred to the excimer laser, therefore customizing your LASIK procedure. Custom Wavefront Lasik has been FDA approved for myopia (nearsightedness), astigmatism and most recently for hyperopia (far-sightedness).

Photorefractive Keratectomy (PRK) Photorefractive keratectomy (PRK) is one of several refractive surgery procedures used by Dr. Smith to permanently change the shape of the cornea to improve the way it focuses light on the retina. PRK is an outpatient procedure, done under topical anesthetic eyedrops. It takes about fifteen minutes. The epithelium, the outer cell layer of the cornea, is removed with a blade, alcohol or a laser. An excimer laser, which produces ultraviolet light and emits high-energy pulses, is used to remove a thin layer of corneal tissue. Dr. Smith enters your vision correction information in a computer and the laser beam vaporizes the surface of the cornea up to that precise depth. By breaking the bonds that hold the tissue molecules together, your cornea is reshaped, correcting the refractive error. Because no incisions are made, the procedure does not weaken the structure of the cornea.

The outer lining of the eye is removed with a spatula	Next the laser reshapes the cornea on the surface

Immediately following surgery the eye is patched or a bandage contact lens is placed on the eye. After PRK vision is blurry for three days to one week. It may take a month or longer to achieve one's best vision. Patients may need to use eyedrops for up to three months. The healing process with PRK is longer than it is with LASIK, but allows certain persons who are not good LASIK candidates to receive refractive surgery and improved vision. Possible complications of PRK surgery include undercorrection, overcorrection, poor night vision and corneal scarring. Permanent vision loss is very rare. In recent studies monitored by the FDA, 95% of eyes were corrected to 20/40, the legal limit for driving without corrective lenses in most states. The ideal candidate for PRK has a stable and appropriate refractive error, is free of eye disease, is at least eighteen years old and is willing to accept the potential risks, complications and side effects of PRK.