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Overview

What is LASIK?

LASIK (laser in-situ keratomileusis) has become one of the most successful procedures to correct refractive errors, replacing glasses and contact lenses. There are no precedents for the number of procedures that are being performed Worldwide. Over one million eyes are being treated this year alone. The rapid return of functional vision, lack of discomfort, and the overall stability and accuracy of the treatment have led to this astounding success. The risk/benefit ratio for most patients exceeds that of contact lenses. Although the FDA has determined the excimer laser vision correction procedure as "safe and effective", there are still many critical factors that must be considered in order for each patient to achieve the best possible result. In LASIK, a thin flap of corneal tissue is created and folded back to allow access to the underlying stromal tissue (bed). With the stroma exposed, multiple 2mm pulses of cool ultraviolet light are applied in a computer-controlled pattern causing a photochemical reaction that evaporates a precise amount of the tissue. This results in the front surface of the cornea being reshaped similar to having a contact lens inside the cornea. With the correction now in your cornea, the light rays entering your eye are bent to focus correctly on the retina, improving vision.

LASIK is performed at our Center as an outpatient procedure, typically, on both eyes on the same day.

The LASIK Procedure

Upon arrival at our facility, you will be asked to thoroughly read and sign the surgical consent form. After completion of the necessary paperwork, you will be taken to our Pre-operative waiting room where you can relax and be "prepped" for surgery. You'll be given drops and a Valium if you wish to calm you and to help you sleep after the procedure. From here you will be directed to the laser suite. Anesthetic eye drops are used immediately prior to surgery to numb the eye. Using a special instrument, the eyelid is held open so you cannot blink during the laser procedure. The first step of the procedure involves creating the corneal flap. A ring is positioned around the colored part of your eye and a vacuum is applied to secure this ring. This pressure will dim the vision temporarily as blood flow is slowed to the retina for the few seconds it takes to make your flap. This brief dimming means you will not see the device come over your eye. The ring is removed and the flap is folded back to expose the stroma. The flap is then measured by the DGH Ultrasound machine to confirm its thickness. Based on these measurements, being within the safe and expected limits, we can now proceed to treat your eye with confidence that we will not be over-thinning your cornea. This step is left out of most center's care and is in our estimate critical in many cases. Read Dr. Foulkes article regarding this topic on the Ocular Surgary News site (article is from May 1, 2002). Once the bed has been shown to be smooth and the flap out of the way, a pupil tracking system is turned on to follow any movement of your eye during the brief time you are being lasered. You will be asked to look up at a red light. It is important to note that the Bausch and Lomb laser with it's large treatment zones achieved better results than other lasers without the tracker system and is simply reassuring to know it is working on our current version of this wonderful laser.

When ultraviolet laser energy is applied to the stroma, a cloud-like plume of ablated tissue and water vapor is created. The Bausch and Lomb laser uses 2 mm spots that are scattered 50 times a second in two locations to create a precision shape on your cornea in seconds. It treats with 100% power usually out to the edge of your pupil size then 80% power for 2 mm further then blend out an additional several millimeters. The result is the largest sized treatments currently available but require a surgeon who is especially diligent about understanding tissue requirements. After the laser stops, the bed is then measured for thickness again, and saline water is used to float the flap back into place. The flap is gently pushed down by a special instrument in all directions for a few moments to insure that the two surfaces bind to each other. Finally, the eye is given steroid and antibiotic drops and then closed. The stroma tissue sticks to itself like Velcro, eliminating the need for stitches. The same procedure is then carried out on the other eye. You will sit up able to see a clock at the end of the room!

The vision is already altered but foggy from the fluid in the flap. This clears significantly after you take your nap at home. Immediately after the procedure, your eye feels "scratchy," but without pain. Because the outer corneal tissue of your eye is among the fastest healing in the body, recovery time is minimal. Nearly all patients achieve functional vision within 24 hours. You will learn a great deal about your vision and the LASIK experience at this web site. We are with you every step of the way and are committed to achieving your visual goals and to do our utmost to protecting your visual future. You can further increase your knowledge by calling or visiting us at Future Vision Laser Center. Because of our commitment to your visual health, Dr. Foulkes and his staff are always available to address any questions or concerns that you may have.