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LASIK Procedure
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1. Anesthetic drops are applied to the eye.
2. A hinged flap is created by the surgeon and folded back.
3. The inner corneal layer is reshaped with the laser.
4. The surgeon closes the flap.
5. The flap adheres naturally and securely.
| | Q. What is laser vision correction and what problems can it correct? |  | | A. With the advent of laser technology, vision correction has entered a development since the introduction of the contact lens three decades ago. Correction of nearsightedness, farsightedness and astigmatism with the excimer laser is the most technologically advanced method available to reduce your dependence on glasses and contact lenses. This exciting refractive technology uses a cool laser beam of light to gently reshape the front surface of your eye. Over two million laser vision correction procedures have been performed, in 52 countries around the world, for more than a decade. Laser vision correction has been used since the late 1980's to successfully correct nearsightedness (myopia) and astigmatism, and since 1996 to correct hyperopia. Two laser vision correction procedures, LASIK (Laser In Situ Keratomileusis) and PRK (Photo refractive Keratectomy) are available. The LASIK procedure is the most frequently performed procedure at our centers today. Both PRK and LASIK are compared in detail later in this brochure. | |  | | TLC surgeon Dr. Omar Hakim looks at an enhanced picture of a patient's eye through the laser. | |
| Q. How does the excimer laser work? | | | A. The excimer laser was invented to etch microchips more than two decades ago at IBM's Watson Laboratories. Subsequently, the remarkable discovery was made that the excimer can also be used to re-sculpt human tissue, particularly the cornea, with a great degree of precision. Today, the excimer provides accuracy, predictability, and the capability to - correct a wide range of refractive errors. This Argon-Fluoride gas laser emits computer-controlled pulses of cool ultraviolet light with an unparalleled degree of precision. Each pulse of the excimer laser can remove 39 millionths of an inch of tissue in as little as 12 billionths of a second. In fact, the excimer laser can remove as little as 1/40 of a human cell. This precision leaves the integrity of the eye unchanged. The excimer works by breaking molecular bonds. It is the ability of the excimer laser to remove a single cell without damaging the remaining cells that allows doctors to perform laser vision correction with precision. At TLC, we perform two procedures with the excimer laser: LASIK and PRK. Both procedures can achieve the same results, but employ different methods. |
| Q. What is a LASIK procedure like? | | | A. LASIK is a painless, outpatient procedure that usually takes about 10 minutes to perform. During LASIK, the surgeon first creates a protective corneal flap revealing the inner corneal tissue. This protective flap is temporarily folded back, and computer-controlled pulses of cool laser light are applied to the inner layers of your cornea. The inner layers are gently reshaped to duplicate your contact lens or glasses prescription. This allows you to reduce or eliminate your dependence on glasses or contacts. The flap is closed and heals naturally and securely. Surgical skill is a key component in the creation of the corneal flap, and the experience and success of TLC surgeons with this procedure is unsurpassed.Because the surface layer (epithelium) of the cornea is preserved, discomfort following LASIK procedures is much less likely. After the LASIK procedure, your eye may feel irritation or a foreign body sensation for a few hours, but most patients are quite comfortable after taking a short nap. Dryness in your eyes may last for several days. |
| Q. How can monovision delay my need for reading glasses? | | | A. When you have laser vision correction, one eye can be intentionally left slightly nearsighted. This is called monovision, and it allows you to maintain your ability to read after presbyopia begins. Your other eye will be fully corrected for distance vision. Gaining this near vision means giving up some distance sharpness. (Many people have already elected monovision correction with their contacts or glasses.) Monovision is helpful for near-tasks such as reading your watch, opening the mail, scanning a menu or article, butnot for reading fine print or reading for a prolonged time. Almost everyone will require reading glasses at some point. For active individuals, such as those who play golf or tennis, or who drive a great deal at night, monovision may not be suitable. Fully correcting both eyes for optimal distance vision will help avoid the need for driving glasses, but reading glasses may be required. During your consultation, you and your eye doctor can decide which choice is best for you. | |  | | Opting far manavisian may make it easier ta use yaur eyes for close work. |
What's new in refractive surgery? |
| Q.What is Custom LASIK? | | A.Custom LASIK is a procedure that uses a wavefront analyzer to provide the surgeon with a precise map of the eye. By doing so, higher-order aberrations that may contribute to night glare and halos will be reduced. For many patients, this results in enhanced quality of vision. |
| Q.Can people with reading glasses benefit from refractive surgeries? | | A.In January, the FDA approved Refractive Lensectomy, the latest surgery for people with presbyopia. A new flexible crystalline lens is implanted into the eye allowing the eye better focusing ability. This is a great alternative for people that are tired of using reading glasses. This procedure is also good for people who have very high prescription and thin corneas and were not able to do LASIK surgery before. People who have had this surgery tend to have less dry eyes. There is another procedure call Conductive Keratopathy, "CK", which uses radio frequency energy to reshape the cornea, front layer of the eye. "CK" got FDA approval December 2002 and is the first procedure approved to correct presbyopia. This procedure takes only a few minutes and is generally done at the clinic. There is no blade or laser involved. This procedure is ideal for patients who have dry eyes. However, there is a small possibility that one may need a touch up as the presbyopia changes. |
| Q.What is Intralase? | | A.In the LASIK and CustomLASIK procedures, a flap of corneal tissue must be created and then folded back. The cornea is the transparent dome-like structure that covers the iris and pupil of your eye. By creating a flap in the cornea, the surgeon is able to perform the laser vision correction treatment on the inner layer of the cornea and allows for a rapid visual recovery. With the IntraLase laser, the surgeon uses the precision of a laser to create the corneal flap. This technology allows the surgeon control during the procedure and allows customization of the corneal flap for every individual patient. Because of its consistent accuracy as demonstrated in studies, IntraLase may now make it possible to treat many patients who were previously dismissed as candidates for laser vision correction due to thin corneas. A truly customized procedure
Our doctors can offer customization for you in all parts of the procedure: custom diagnosis (before the procedure), custom flap (IntraLase), and custom treatment (to complete the procedure). confidence in your decision...
The potential to see even better than you did with glasses or contact lenses has never been greater. According to IntraLase, the IntraLase FS laser enables surgeons to provide remarkable predictability and precision and has given many patients more confidence when considering laser vision correction. IntraLase may help minimize risks and optimize results, providing better vision.
• Many IntraLase surgeons report that the need to do a touch-up procedure, commonly known as an "enhancement," may be reduced.
• IntraLase studies have shown the incidence of dry eye symptoms may be reduced with the IntraLase laser.
• With IntraLase and its customization components, surgeons can treat a wider variety of patients, including patients with thin corneas.
| If you are over the age of 40
and depend on reading glasses, you may
be a candidate for CK. | | Q.How CK works? | | | A.Conductive KeratoplastySM (CK) changes how light is focused on your eye by reshaping the surface of your eye (cornea). When the shape is changed, light can be refocused on the correct part of your eye (retina). CK uses the controlled release of RF energy to shrink corneal tissue. This reshaping steepens the cornea and allows light to properly focus on the retina again, improving near vision.
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 | CK is performed using a small probe, thinner than a strand of human hair, that releases radiofrequency (RF) energy. |
| | The probe is applied in a circular pattern on the outer cornea to shrink small areas of corneal tissue. This circular shrinkage pattern creates a constrictive band (like the tightening of a belt), increasing the overall curvature of the cornea. The procedure, which takes less than three minutes, is done in-office with only topical anesthesia (eye drops). CK is the first alternative to laser for hyperopia. |  |
| Q.Is CK right for you? | | A.CK is for people over age 40 who want to improve their near vision. If you are over the age of 40 and depend on reading glasses, you may be a candidate for CK. Other criteria include: • No significant changes in your vision for one year
• No chronic eye disorders
• Not pregnant or nursing
• No chronic illness or disease |
| Q.What's ICL ? |
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A.Implantable Contact Lenses (ICL) may be an option for people who find their prescriptions fall outside the accepted range for laser refractive procedures, have extreme near or farsightedness, or who may otherwise not be an ideal candidate for vision correction procedures. Similar to an external contact lens, ICLs are able to correct visual problems from inside the eye without removing the eye's natural lens.
How Implantable Contact Lenses Work
The Implantable Contact lens corrects refractive errors by focusing light properly on the retina, the sensory tissue on the back of the eye. Because people with refractive errors have difficulty focusing light and images properly, objects come to focus in front of or behind the retina instead of on it, making them appear blurred or out of focus. Implantable Contact Lenses correct this by bending and focusing light directly on the retina reducing the need for contacts and glasses.
Implantable Contact Lens Surgery
As with any vision correction procedure, a comprehensive examination with your eye care professional is necessary to determine if you are a candidate. Patients may be asked to discontinue wearing contacts several weeks before the examination so an accurate reading of your prescription can be taken. Others may need to schedule a procedure prior to surgery which will help manage the pressure within the eye after the IOL has been implanted.
Implantable Contact Lens surgery is an outpatient procedure and is relatively brief. Special drops are placed in the eye to reduce pupil size and a local anesthetic is used to numb the procedure area. A tiny incision is made and the lens is slipped between the iris (colored part of the eye) and the natural lens. The procedure offers permanent vision correction. However, if the patient develops a problem, the ICL can be safely removed.
After The Procedure
Visual recovery with Implantable Contact Lenses is rapid, with noticeable improvement within a day or two. Because the incision used to insert the IOL is so small, sutures are often not required and post operative discomfort is minimal. Following surgery, you will need to visit your doctor for several months and may need to use eye drops. Recovery time varies by patient.
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| Q.What's IOL ? |
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Phakic IOL
The Food and Drug Administration (FDA) recently approved an implantable lens that helps correct moderate to severe nearsightedness and allows the patient to return to normal daily activities relatively quickly. The Phakic Intraocular Lens (IOL) reduces the need for glasses or contact lenses by correcting your vision inside the eye, without removing the eye's natural lens.
Clear Lensectomy (Refractive Lensectomy or clear lens extraction) may be an appropriate option for people who find their prescription falls outside the accepted range for laser refractive procedures, have extreme near or farsightedness, or who may otherwise not be an ideal candidate for vision correction procedures. Clear Lensectomy involves the removal of the natural lens in your eye and replacing it with an Intraocular Lens (IOL), resulting in improved near and distance vision.
How Phakic IOLs Work
Phakic IOLs are inserted in the eye and correct refractive errors by focusing light properly on the retina, the sensory tissue on the back of the eye. Because people who are nearsighted have difficulty focusing light and images properly, distant objects come to focus in front of the retina instead of on it, making them appear blurred or out of focus. When a Phakic IOL is implanted, it corrects this by bending and focusing light directly on the retina reducing the need for contacts and glasses. The procedure is also fully reversible.
Phakic IOL Surgery
As with any vision correction surgery, a comprehensive examination with your eye care professional is necessary to determine if you are a candidate. Patients may be asked to discontinue wearing contacts several weeks before the examination so an accurate reading of your prescription can be taken. Others may need to schedule a procedure prior to surgery which will help manage the pressure within the eye after the IOL has been implanted.
Phakic IOL surgery is an outpatient procedure. During the surgery, your doctor may use eye drops or injections to numb or prevent movement of the eye. A precise incision will allow the doctor to insert the Phakic IOL in front of or just behind the colored part of the eye (iris). A bandage contact lens and a clear eye patch will be used to cover and protect the eye until your doctor feels it is ok to remove.
After The Procedure
Phakic IOL surgery, although minimally invasive and relatively brief, is a serious procedure. Because the incision used to insert the IOL is so small, sutures are often not required and post operative discomfort is minimal. Your vision may also be somewhat hazy or blurry immediately following the surgery and you may notice an increased amount of sensitivity to light. Your scheduled, post-operative visits with your doctor will determine if you will require any additional follow up care.
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