Dr Samir Melki MD - Leading Boston Lasik Surgeon

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Refractive errors in the eye could cause vision problems among people from different age group. To address refractive problems like nearsightedness or myopia, farsightedness or hyperopia and completely blurred vision or astigmatism, some people use corrective eyeglasses, while others use contact lenses.

In the past few years, laser surgery has also been employed to fix refractive errors of the eye. The procedure works on reshaping the cornea or natural outside lens of the eye so that the patient gets the ideal visual acuity.

Over time, developments in the field of medical science has brought varying techniques used for laser eye surgery. Each of these techniques uses different equipment designed to perform the procedures on the eye with utmost precision.

LASIK versus Photorefractive Keratectomy

Both LASIK and PRK use laser to reshape the cornea of the eye to achieve ideal contour and help the eye see clearer. PRK removes the epithelium or the membrane covering the cornea in the process of reshaping the cornea. LASIK, on the other hand, keeps the epithelium by creating a flap that is folded away from the treatment zone before actually reshaping the cornea. This approach helps speed up the recovery as the epithelium serves as a natural bandage to the eye.

It has been observed that patients undergoing LASIK has faster recovery period with lesser irritation compared to those who had PRK. However, these patients appear to experience dryness of the eye more than those who went through PRK surgery.

Risks Associated To Flap Creation

While creating and keeping the epithelial membrane seems ideal to promote faster healing, there are associated risks that are unique only to LASIK. The following are examples of flap-related complications.

Epithelial ingrowth. The epithelial membrane that is placed back after the corneal ablation is allowed to heal completely through natural processes. However, there are reported cases of epithelial ingrowth wherein the cells from the surface layer grows underneath the corneal flap.

Slipped flap. In some cases the flap detaches from the rest of the cornea. The risk of dislodged flap is greatest immediately after the procedure. To avoid this, patients are advised to get a good rest and wear protective gears like goggles when sleeping to avoid touching and moving the flap while it reattaches itself to the cornea through natural healing processes.

Diffuse lamellar keratitis. There are reported cases of diffuse lamellar keratitis or eye allergy after laser eye surgery. This complication is not exclusive to LASIK and could happen on other types of laser eye surgeries. However, chances of inflammation is higher in LASIK due to the creation of the flap as this process makes room for cells between the cornea and the epithelial membrane.

Displaced flap or fold. The flap must be properly placed after corneal ablation to avoid instances of displaced flap or fold. It is also important not to touch or move the flap to avoid the said complication. Although instances or occurrence of displaced flap are small and decreases with the surgeon’s experience, it can affect the vision of the patient. As such, correction might be necessary.

Flap interface particle. Surgeons must carefully and skillfully put the flap back in place after ensuring that there are no particle or air bubble on the flap that might be trapped. These interface particles does not have clinical significance determined yet but are observable.

LASIK Procedures

LASIK surgery starts by applying alcohol on the epithelial membrane to weaken the cells. A flap is then created and is folded away from the cornea or the range of the laser. The creation of the flap might be done through mechanical blade or microkeratome or through femtosecond laser depending on the technique used.

After the flap is folded, actual reshaping of the cornea takes place through the use of excimer laser that ablated corneal tissues causing them to evaporate. The laser ablates tissues that are few micrometers thick until the desired shape and contour of the cornea is achieved.

Reshaping the cornea usually takes just a few minutes on each eye. After the said procedure, the flap is carefully placed. There are instances wherein re-placing the flap is not ideal, such as when the flap dislodges. The process therefore becomes more of an alcohol-treated PRK than that of LASIK. Healing process becomes much like of PRK.

Further Developments

The idea of keeping the flap in LASIK surgery comes with both advantages and disadvantages. Developments in the field of eye medicine tries to get the best of LASIK with lesser complication that comes with keeping the epithelial membrane.

Although it is still in the stage of advanced testing and evaluation and therefore not yet available for the general public, the idea of an all-laser, flapless LASIK is being considered. This means that the patients gets the benefit of keeping the epithelial membrane to provide continuous nourishment for the eye to fasten recovery with much lesser flap-related complications.

The procedure includes the reshaping of the cornea through laser and the lenticule that is created inside the cornea is extracted through a small incision which is about three millimeters long. The procedure is still being tested and is in its advanced stages but so far, results collected over a year interval appears promising.

Positive observation include the minimal occurrence of dry eyes and faster healing. Complication associated with the creation of the flap is also eliminated.

While LASIK has been observed to be of high success rate, developments in the field like flapless LASIK is surely something every patient is very glad to welcome. This should help future generations perform laser surgeries to correct refractive issues affecting clarity of vision.

Thanks to the people who tirelessly work on developing new techniques that are useful in the field of medicine and those surgeons who are willing to test the processes together with their expertise for actual application, and the researchers who keep track of the developments, we have something exciting to look forward to. This development brings LASIK a little bit closer to perfection, with lesser risks and complications with better chance of success.

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Laser eye surgery has improved the vision of millions of people around the world who are suffering from eye conditions since it was used by medical practitioners a few years back. This helped them live better quality of life due to improved visual acuity. This breakthrough is one perfect example of how advances in technology could help people with medical or visual conditions live a healthier and better life.

LASIK surgery has been the choice of many people to correct refractive errors in vision. Its tried and tested method and ongoing developments help patients build confidence that the surgery on one of the body’s most important organs would be successful. Let us take a look at what happens during LASIK surgery and how it differs from other laser eye surgeries.

How It Works

LASIK or Laser-Assisted in situ Keratomileusis is a type of refractive surgery that uses laser to reshape the cornea of the eye. Reshaping the cornea gives the patient with impaired vision better image clarity. The way the cornea is shaped depends on the specific eye condition that the patient is suffering from. The result of the operation should be comparable to that of using corrective eyeglasses or contact lenses but with permanent effect.

Nearsighted people need the cornea to be shaped flatter to allow the light waves that enters the eye reach focus exactly at the retina so they could see distant images clearer. Farsighted people on the other hand needs a rounder cornea to achieve normal sight.

Some people might experience blurry vision when viewing either distant or close objects. This usually happens when the cornea is irregularly shaped which causes the image not to reach focus on the retina. This condition is called astigmatism. Although it has several types, most are easily corrected through laser surgery by making the shape of the cornea more even.

The cornea is covered with a thin membrane that provides natural nourishment to the eye. Since LASER eye surgery involves reshaping only the cornea, the membrane is removed or placed away from the laser ‘s treatment zone. LASIK surgery involves keeping the membrane by creating a flap instead of removing it completely so it can be placed back after the procedure, thereby promoting faster healing compared to the other types of refractive eye operations.

What Happens During the Procedure

The surgical equipment is computer-aided to ensure precision. A soft suction ring is applied to the eye to hold the eye in place. The computer system keeps track of the position of the eye with utmost accuracy that could go as much as 4000 times per second. In the event that the eye is moved, the laser is redirected to the treatment zone automatically.

After the eye is positioned, alcohol is applied to the epithelial membrane to weaken the cells. A flap is then made and folded away from the treatment zone. Earlier versions of LASIK equipment use microkeratome or mechanical blade to create the flap, however, newer models use femtosecond laser to create the flap.

After the flap is folded, an excimer laser is used to reshape the cornea. The laser is applied to predetermined treatment zone to achieve the ideal shape. The laser causes small layer of the tissue to evaporate without burning with heat.

Once reshaping is completed, the flap is placed back to serve as a natural bandage. The surgeon ensures that the flap is correctly placed and has no debris or air bubbles when placed.

The process is performed on one eye at a time and would take only a few minutes on each eye. The surgery is an out patient procedure and the patient is left to take care of the eyes as it undergoes natural healing process.

Technology Used

A number of technologies are used to achieve precise results of a safe operation. Over the years, several changes were made in the surgical process as well as equipment used. One major difference is the use of laser to create the flap instead of small mechanical blade. This does not signify that microkeratome would be permanently replaced by laser through as there are advantages and disadvantages in using laser to create the flap.

Excimer lasers used to reshape the cornea is a development in laser technology used in the field of medicine. The technology involves the use of a halide molecule which, under appropriate condition of electrical simulation and high pressure, emits laser light. The properties of this type of laser is ideal for eye surgery because the laser can ablate but a thin piece of tissue with pinpoint accuracy without affecting the surrounding tissues making it possible to reshape the cornea with utmost precision.

Further developments have brought about different types of LASIK surgery, each offering new possibilities and new level of safety and precision. Several techniques are being tested to achieve the best result of the operation as much as possible.

The idea of Thin Flap LASIK is already in its testing stage to hopefully address and minimize risks that appears after a surgery which are usually due to improperly cut or shaped flap.

Developments are also ongoing regarding the use of all-femtosecond correction that uses femtosecod laser during the operation – from creating the flap to the ablation process.

Another exciting development is the wavefront-guided PRK. This technique would allow surgeons to do surgical operation on rather complicated cases of astigmatism with the aid of equipment with wavefront sensors.

The field of medicine has drastically changed over the past years thanks to scientific research and technological developments. These changes have cause unprecedented improvements in out lives and health as well. And with ongoing effects to improve if not perfect the technology, we can expect more. However, these technologies could not stand alone and still needs expertise to achieve optimal effect and result. So no matter what type of laser eye surgery of what technology one wishes to take advantage of, there is no denying that the surgeon’s skill and experience still remains a top priority.

reducing-risks-of-lasik-surgery-what-you-can-do

Surgery almost always comes bundled with risks. This is true with any forms of surgery. Understanding these risks, including the factors affecting them and how to reduce them, could help a prospective patient deal with, decide about and prepare for the procedure better.

How to Reduce Risks

The use of top-of-the-line surgical equipment and cutting-edge features coupled with the service of a skilled and experienced surgeon almost guarantees a very successful operation. However, in the field of medicine, the result would be also dependent on how the patient prepares for the procedure and how he takes care of himself after the procedure.

The patient plays a very vital role in the success of the operation. The task of minimizing the risks starts with the preparation before the operation and continues even after the eye fully recovers.

Although there are known risks associated with LASIK surgery, it can be significantly minimized with proper preoperative consultation and appropriate postoperative care. Understanding the risks and how to eliminate them could absolutely help make the patient feel better and be more confident about the operation. Hence, it is essential to take time to read through the guidelines.

Red Eyes, Irritation and Discomfort

Some common side effects experienced by nearly everyone who has undergone LASIK surgery are irritation, redness of the eye and mild discomfort. It is also common to experience sensitivity to bright light. These things tend to appear almost immediately after the procedure, but are oftentimes temporary. Such complications typically disappear after a few days or weeks as the eye slowly recovers.

To help speed up the recovery process, patients could use prescribed medicines along with proper care of the eyes. Moreover, a prospective LASIK surgery patient needs to undergo thorough check up with the ophthalmologist to ensure that the eye is at its best condition prior to the operation, which is critical to help it recover faster.

To optimize the eye’s health, people who have been wearing contact lenses for a few months or years have to use special gas-permeable lenses. Better yet, they should stop using contact lenses altogether weeks or months before the scheduled operation. This is because the use of artificial lenses could affect the natural membranes of the eye, which is generally responsible for the eye’s nourishment. If this membrane is not in good condition, then recovery could take longer time.

Complications of the Flap

Compared to other laser eye surgeries, LASIK keeps the epithelial membrane that covers the cornea. Since this membrane provides natural nutrients for the eye, keeping it promotes faster recovery.

However, creating and replacing the corneal flap has possible complications, too. For instance, a misplaced corneal flap could cause aberrations. This could be a permanent condition and might require total removal of the membrane in order to address the problem.

Luckily, the years of enhancing the procedure found a way to attend to this concern. The help of technologically-advanced, computer-aided surgical equipment minimizes the risk of incorrectly placing the flap. The surgeon’s experience also lessens the risks. As for the patient, he needs to make sure that the flap is not touched, moved or displaced while it heals. The use of protective eye shield or goggles would help avoid the possibility of touching the flap whether intentional or not.

Eye Infection

While recovering, the eye is very susceptible to infections. Some surgeons would require patients to take antibiotics after the procedure to help lower the risk of infection. The use of eye drop solutions is another effective supplement.

Patients also need to make sure that his environment is sanitary. Dusts and dirt can hamper the eye’s recovery. At the same time, the gears used on or around the eye including bandages or eye wears should be sterilized. The eye should not be touch directly or by bare hands.

Over-correction and Under-correction

The surgical procedure entails reshaping the cornea through the use of laser technology so as to fix vision problems. Inappropriately shaped cornea could result to either over-correction or under-correction.

These cases are less common but human error could lead to incorrect shaping of the cornea. Experience and training of the surgeon helps minimize these mistakes so it is best to choose the ophthalmologist that you can truly rely on.

The use of computer-aided equipment also helps in identifying the ideal shape of the cornea. Some equipment could map the cornea in fine details so that the surgeon could correctly plan and re-shape it. These pre-operative preparations require the patient’s cooperation as it may take several sessions to ensure that the eye condition has been correctly diagnosed.

Over- and under-correction can be corrected with a follow-up procedure depending on the status of the cornea. In certain instances when the cornea is too thin to be reshaped, follow up surgery might not be an option. Instead, the patient will be advised to use contact lenses.

Other Factors Affecting the Risks

People with special medical conditions and those with advanced age or are pregnant are especially susceptible to risks. To assess an individual’s condition and determine the risks that could come with it, patients are advised to see an ophthalmologist to discuss the matter with.

While LASIK surgery comes with risks, it does not have to be something the patient has to be very worried of. With the help of technological advancement and with accurate examination, some of these risks could be fully eliminated.

However, it is still best for the patient to prepare for the operation as well as take care of his or her eyes after the procedure to get the best result.

Finally, always get the expert service that you can trust when choosing your surgeon. Remember that no matter how good or advanced the equipment is, it could only be as good as its user. Professional assistance is the key for patients to understand what to do and what not to before and after the surgery. You need to get the services only from an expert with good reputation if you want optimal success of the operation.

how-refractive-eye-surgery-came-to-be

Before the contact lenses were popularized in the 1950s, people suffering from vision problems have been relying on eyeglasses for more than seven centuries. Although it is the earliest and most practical means to correct refractive vision errors, people have eventually got tired of the heavy frames and large lenses of these glasses.

With medical advancements, more advanced procedures are offered nowadays. These procedures range from surgical insertion of artificial lenses to the ablation of the cornea through the use of laser technology. Such methods aim to provide permanent solution and eradicate the reliance on artificial lenses.

The Evolution

For more than two decades, the surgical tools, techniques and procedures used in corrective eye surgeries have rapidly evolved. The tools and techniques have been refined to achieve a more precise result. Eventually, newer procedures were developed in an attempt to compensate the limitations of a previous system.

Radial Keratotomy

The precursor of all corrective eye surgeries, Radial Keratotomy (RK) was widely used in the United States during the 1980s. The surgeons cut spoke-like incisions on the patient’s cornea primarily to correct conditions of nearsightedness.

Unfortunately, long-term results were unfavorable for some individuals. It created problems like significant glare, fluctuating vision, regression and night vision problems for many patients.

Later on, the procedure underwent various modifications and enhancements to minimize its side-effects. This paved the way to laser vision correction procedures. At present, RK is no longer widely practiced by eye surgeons.

LASIK and Other Refractive Eye Surgery Procedures

Photorefractive Keratectomy

Photorefractive Keratectomy (PRK) was the first successful procedure that used laser technology to remove tissues from the eye’s surface and reshape the cornea. It received FDA approval in 1995 and is still commonly used today.

In this process, a thin layer of the cornea’s outer layer is completely removed to expose the area that requires ablation. Using an excimer laser, the excess tissues in the cornea are removed until its desired curvature is achieved.  Since no flap is created in PRK, new epithelial cells are developed to cover the eye’s surface.

Pros:

PRK is ideal for patients whose cornea is too thin to undergo LASIK or those who have undergone LASIK before with thinner residual cornea. This is a better option for people with chronically dry eyes, too. There are also no risks of flap complications, like epithelial inagrowth.

Since it does not create corneal flap, the entire underlying stroma is available during treatment. Hence, it does not compromise the corneal thickness and the laser does not reach deeper tissues.

Cons:

PRK has comparatively slower recovery rate. This is because the epithelial cell takes longer time to grow back. It takes longer to achieve the best vision, too. In the early stage of recovery, PRK patients experience more discomfort than those who underwent LASIK. Finally, there are higher risks of post-surgery infection, haze and inflammation.

Laser-Assisted in situ Keratomileusis

The result of PRK can be comparable to that of LASIK surgery. This is because the two procedures are closely similar except that LASIK creates a flap from the epithelial layer to reach the underlying tissues. After the operation, the flap is repositioned to serve as natural bandage.

Pros:

LASIK has shorter recuperation period because regeneration of epithelial cells is much faster than the growth of new cells. The postoperative discomfort is usually mild and short-term. In fact, many patients can see normally a few hours after their operation. Their vision gradually improves before reaching peak quality after several weeks.

Cons:

The removal of thin flap from the cornea’s outer layer makes LASIK not suitable for patients with thin cornea. It also has the tendency to aggravate dry eye conditions. There have been reported cases of errors in the repositioning of the epithelial flap.

Laser Epithelial Keratomileusis

A variant of PRK, the Laser Epithelial Keratomileusis (LASEK) also removes the outer layers of the cornea completely. It uses an alcohol solution to loosen the epithelial cells before lifting it. LASEK uses laser technology, too, in reshaping the cornea.

After the operation, the flap is replaced. The patient will have to wear soft contact lenses in the first few days following the surgery to secure the flap in place while it heals.

Pros:

LASEK is a less aggressive form of PRK. It is an ideal option for people with thin corneas who cannot undergo LASIK. This is also more effective for patients with higher prescription. Since only the outer surface layers are removed, the surgeon has more corneal tissues to work with.

Cons:

LASEK takes longer time to recover full vision compared to LASIK. After the operation, the patient also feels more uncomfortable.

Bladeless/All-Laser LASIK

Instead of using mechanical cutting tool, using laser in creating the flap out of the epithelial layer is another option. This is sometimes referred to as IntraLASIK because the laser used for this purpose was originally developed by IntraLase Corp. The use of laser and computer-aided technology grants the surgeon better control over the size and thickness of the flap to be created.

Once the outer layer was removed, another type of laser, the excimer, is used to change the shape of the cornea’s curvature.

Pros:

Considered a superior form of LASIK, this procedure offers a more accurate result with fewer risks. Possible long-term damage on the cornea with traditional LASIK is also underplayed because of precision. Vision can be restored in a matter of hours, so the patient may return to work in a couple of days.

Cons:

The sole disadvantage of this procedure is its cost. This is one of the most expensive refractive eye surgeries at present.

Which Procedure is Right for You?

Without a doubt, these refractive eye surgeries are all safe and effective. These also carry high patient satisfaction rate. Thanks to the continuous progressions in medical technology, major drawbacks of every operation are being improved.

All the same, certain conditions make a candidate more suitable for a certain procedure than the others. The best person to ask for recommendations will be a trained eye doctor. You will be subjected to preoperative consultations and examinations to identify which surgery works best for you. The great news is that no matter what procedure you choose, you will most certainly be pleased with its results.

lasik-101-and-fda's-role

Are you considering Lasik to improve your vision? Are you looking forward to finally say goodbye to your corrective lenses and your embarrassing daily routine of wearing eyeglasses or contact lenses? Good. You are taking the first step to having a better vision. However, a successful Lasik eye surgery entails more than just courage. It will need your time and effort to make an informed decision to achieve desirable results that you imagine.

Just like you, Lasik has delighted and offered promising results to millions of individuals around the globe. However, this surgical procedure isn’t entirely suited for everyone who has vision problems. When you are considering Lasik eye procedure, it is very important that you do have a very clear understanding of what is all about, the surgery’s advantages and potential risk and most importantly, determining if you are a good candidate for the procedure. This is main reason why organizations such as the International Society of Refractive Surgery and the American Academy of Ophthalmology are continuously developing comprehensive guide to keep every individual informed regarding the Lasik procedure. More so, the Food and Drug Administration or also known as FDA is providing objective details right from the leading experts of Lasik Surgery of the country.

FDA and LASIK

LASIK or known as  Laser in Situ Keratomileusis was first approved as outpatient refractive procedure and for medical use by FDA in the year 1998. Since then, the procedure has already been gaining wide popularity from many patients. It has also been recorded that there are approximately seven hundred thousand Americans who have undergone the procedure every year, where most of these individuals are highly satisfied and happy with the results of their Lasik procedure. However, just like all medical surgeries, there were cases of eye infections and complications which were recorded. Some of these patients, have experienced significant side effects which have also affected their eye conditions and  their daily activities.

LASIK – Understanding the Basics

LASIK, by definition, is an outpatient surgical process that is employ to treat vision problems such as farsightedness, nearsightedness and astigmatism. This refractive eye procedure could not be reversed and may not give you the perfect vision, precise vision could slightly diminished in the long run because of age-related vision problems. Therefore, it is very essential to take these into considerations and set realistic expectations before finally undergoing the surgical procedure. In general, LASIK will use a laser in order to reshape the eye’s cornea. By doing so, it will eventually improve the way our eyes focus on the light rays that enter the eye’s retina, which will allow a better vision. During the procedure, a surgical device called an Excimer laser is used to reshape the cornea. The process will start by numbing the eye through a topical anesthetic, the doctor will out few drops on the eyes. Then a device known as speculum will be placed between the eyelids of the patient in order to keep them open and avoid from blinking. Suction ring will then be placed into your eyes lifting and flattening the eye’s cornea, the moment is placed into the eyes the patient’s vision will go black or may appear dim. A hinged flap of the patient’s corneal tissue will be created by the surgeon with the use of an automated microsurgical device. After a paper thin flap is created, it is lifted and fold back, the flap won’t adhere to your eye’s surface as it is of the same strength it has prior to the surgery therefore there is just a very small chance of possibly risk of the flap to be displaced after the operation. The surgery won’t take long, in fact it may just take approximately less than 20 minutes for both eyes to do the LASIK surgery. Once the surgery is done, the doctor will advise the patient to avoid rubbing the eyes, prevent engaging to certain activities and using certain products in the face that may affect your recovery process or contribute to development of eye infection. Sometimes, a surgeon will put a transparent protective shield over the eyes in order to prevent you from rubbing your eyes and protect your cornea. Additionally, there may be prescribed medications and eye drops that will be given after your surgery. This is to keep your eyes moist and avoid severe dry eyes syndrome. It would be highly helpful for you to ask for any prescriptions to reduce any feeling of discomfort during the recovery period.

The Risks and the Rewards

The possibly risk factors which may affect you to choose LASIK surgery are dry eye syndrome, degree of refractive issue age and any health related concerns that could possibly affect the healing process. If you proceed to obtain LASIK procedure even with dry eye syndrome and it is left untreated, you will greatly be disappointed. There is a huge chance of having this condition aggravated by LASIK surgery when it isn’t diagnosed prior to the surgery or adequately treated. This is the reason why initial screening of the overall condition of the eyes is highly required to determine if LASIK is the right refractive procedure for you. In addition, patients who have very high level of refractive errors may not be suited for a LASIK surgery, followup operation may be needed when a patient persists to go for the procedure.

One thing is for sure, LASIK was able to provide great benefits to millions of people. A lot of companies and even researchers are continuously developing more advanced methods and facilities to achieve even greater results. Many surgeons today are employing scanning laser prior to the actual surgery which provide several potential advantages. Therefore it is never a surprise why LASIK has been able to continually attract patients around the world. Many of these patients claim that they are finally allowed to function on their daily activities without their contact lenses and prescription glasses. Although it has been also previously said that results cannot be guaranteed, just like all surgical procedures, many patients were able to obtain improved vision, better lifestyle and even better quality of life.

lifestyle-and-lasik-what-to-do-after-an-eye-surgery

Vision plays a very important role in our daily lives. From the time we wake up in the morning until we hit the bed at night, we use our eyes in everything that we do. As such, impaired vision caused by certain eye conditions can hamper our daily activities.

It is a relief that technological advancements in medical sciences introduced an effective permanent fix for such conditions. This procedure does not rely on artificial lenses like eyeglasses and contact lenses. Rather, it corrects the natural lens on the actual eye itself.

LASIK Surgery Explained

In a nutshell, LASIK is a refractive eye surgery that makes use of laser technology to carry out the procedure. Like any other refractive surgeries, it aims to make necessary corrections on the cornea- the eye’s lens- to achieve its ideal shape.

If a person’s cornea is too flat, he may not see close objects clearly. This is a condition known as hyperopia or farsightedness. On the other hand, a person whose cornea is steeper than normal has a condition medically referred to as myopia or shortsightedness. Hence, he may have trouble with objects from afar. Meanwhile, one other common eye condition is astigmatism. People with astigmatism have an irregularly shape cornea.

During the operation, the surgeon uses an Excimer laser to reshape the cornea. This is achieved by causing excess tissues of the cornea to evaporate due to the gentle heat of the focused laser.

Risks and Limitations

Not everyone who wishes to undergo LASIK surgery is fit for the operation. Considerations are taken into account to determine if one is a suitable candidate or not.

Prior to the surgery, a trained eye doctor will examine and evaluate the overall health of the patient as certain conditions may disqualify a patient. For instance, patients with relatively dry eyes may not go through this operation because the laser can further aggravate the situation. This may do more harm than good.

The same can be true for people with unusually thin cornea because this limitation increases the risks of over- or under-correction. Furthermore, pregnant women may not be exposed to lasers, so this procedure does not suit them, either.

Some of the potential side-effects of a laser eye surgery includes seeing halos around images, dry eyes, glare, fluctuating vision and difficulty driving at night. Most of these are just temporary conditions, though, while the eye is in the process of recovery. After a several weeks, the patient’s eyesight should have already recovered to its normal state. Otherwise, you must consult an expert for possible enhancement surgery.

Preoperative Consultations

The preoperative consultations are designed to increase the chances of a successful treatment and optimize its results at the same time. Identifying the patient’s anatomical state is essential in finalizing the details of the operation. This includes distinguishing the areas that need remolding, the thinness or thickness of tissues that must be removed, and the type of LASIK surgery to use among others.

During this time, the ophthalmologist may perform a comprehensive laser eye surgery exam. This typically includes exams that you might have already recognized, such as prescription measurement and pupil dilation. However, there are other tests that could be specific to laser vision correction like measuring the curvature, topography and thickness of your cornea. A tear-film test is also possible to check potentially dry eyes. Before performing any of these exams, the doctor will explain the process and its importance. All of these pre-surgical tests are painless.

Likewise, the doctor will also make his patient understand the real score of the operation, the likelihood of its results, the potential risks that come with it and the patient’s responsibilities before, during and after the operation. This is also the best time for patients to ask any questions related to the procedure.

Post-surgical Care

The success of the surgery does not end on the actual operation. In order to achieve the most ideal results, the patient must also be accountable in heeding the doctor’s prescription.

While laser eye surgeries are undeniably effective, complications are not unheard of. Rare cases of infection and unimproved vision were recorded. This can be attributed to the patient’s negligence when it comes to postoperative care among other factors.

What to Expect after the Surgery?

It is normal to feel slight discomfort after the operation. An eye drop causes the muscles in your eyes to feel numb during the operation so you do not feel pain. After the medicine has subsided, you start feeling the soreness. Just let it be. The eye is in its natural course of healing. Fight the urge to rub your eyes.

Dry eyes are also to be expected. This is because the natural moisture of the eyes was affected by the laser used during the operation. For this reason, your doctor will give you prescription eye drops. This can also help prevent inflammation and infection. An important caution: never use eye drops that are not approved by an eye doctor.

Healing is relatively rapid with LASIK compared to other methods of eye surgery. Although vision could be hazy and blurry in a day or two, patients will see improvements in the next few days.

Lifestyle Changes and Precautions

One good thing about LASIK eye surgery is that there are no massive changes in lifestyle. A few precautions will be in place to help the eye recover faster, but the patients can resume regular activities in a matter of weeks or months.

Water, soap, hair spray and any other chemicals must not get into the eye. Hence, body bath is possible but showering is discouraged. Washing the hair is possible but the head must be tilted backward to let the water run down to the back.

Protective goggles must be worn. Dirty and dusty environment must be avoided, too. You can resume driving as soon as you feel comfortable and with the doctor’s approval. Gardening, lifting, running and other physically strenuous activities must be avoided to avoid straining the eye muscles.

Makeup should not be worn at least a week following the surgery. Partially used makeup must be discarded to avoid any contamination of bacteria.

Most importantly, visit your doctor regularly. Normally, you have to return to the clinic within 24 to 48 hours after the operation for evaluations. Then, regular checkups follow at regular intervals depending on the surgeon for the next six months.

the-technology-behind-lasik-surgery

Over the past few decades, the world has witnessed a lot of unprecedented development in technology and the field of medicine is no exception. The use of laser has now been incorporated with medical operations including eye surgeries.

Corrective eye surgery which aims to fix impaired vision due to nearsightedness, farsightedness and even astigmatism, has employed laser technology to provide lasting result without needing eyeglasses or contact lenses. This surgical procedure, which works by reshaping the eyes’ natural lens, is called LASIK Surgery. LASIK stands for Laser-Assisted in situ Keratomileusis.

Further developments makes the surgery more precise, more effective and much safer compared to previous practices. As a result, various LASIK-related technologies have been made available and one may choose which technology to use.

LASIK Procedure

The surgery aims to reshape the Cornea of the eye to achieve its ideal focus. Patients with myopia or nearsightedness needs to have a flatter cornea while those who have hyperopia or are farsighted need a steeper shape. Meanwhile, patients suffering from totally blurred vision will need to alter the irregular shaped cornea to become much smoother.

Only the cornea needs to be shaped but since it is covered with a thin layer of transparent epithelial cells, the covering will have to be removed first. So the first thing to be done is to create a flap from the Epithelium about the size of the cornea, then fold it away from the field of the laser.

Keeping the flap and replacing it afterward has been observed to promote faster healing. This is because the epithelium provides protection and nutrition to the cornea. There are two ways to create the flap. The first is through a small mechanical blade and the second one is through the use of laser.

Bladed And Bladeless LASIK

Earlier versions of LASIK use an instrument called microkeratome to create the flap. In this procedure, a small mechanical blade is used by the surgeon. In the late 1990’s, however, femtosecond laser have been introduced as means in creating the flap instead of using a blade. Thus, making the procedure an all-laser surgery. At present, some modern surgical machines still use improved versions of microkeratome for added efficiency.

For patients undergoing LASIK surgery, both procedures do not have any direct impact on the result. As long as the procedure successfully went well, there is no difference in the way it affects the eye. Surgeons however notice that using microkeratome results in a flap that is thinner on the center as compared to flaps created by laser. Furthermore, Femtosecond laser appears to take more time, ranging from fifteen to twenty second compared to mechanical blade which could only take 3 seconds.

Excimer Lasers

To reshape the cornea, surgeons use excimer lasers. The laser is produced by applying electric stimulation and pressure to molecules which are usually of noble gas. The laser causes thin layers of the tissues of the cornea to evaporate. The areas where laser is applied depends on each patient’s condition and is determined through preoperative consultation and examination. As such, it is unique for every patient.

There are different types of lasers used in LASIK surgical procedure. Depending on the equipment used and on the manner how the laser is applied. Modern types are far more complex and are aimed to fix visual conditions that may be too complicated than what traditional LASIK could handle.

Spot Scanning Laser

The most common type of laser used in eye surgery is spot scanning lasers. It uses laser beams with small diameter scanned across treatment zone of the cornea. This approach has been observed to create a smoother and more even surface.

Slit Scanning Laser

The second laser type is the slit scanning lasers. Instead of using a circular beam, the device has slit holes that enlarge. The laser beam passes through the slits while the device rotates. This technique results in a more uniform distribution of beam than the spot scanning laser.

However, slit scanning lasers have higher risk of decentration which may cause glare, double vision and halos. This happens when the laser is not centered on the pupil upon ablation. This type has also been associated to higher risk of over-correction.

To address this issue, modern LASIK equipments use eye tracking system that follows the position of the eye. This lets the laser refocus on the correct area of the cornea in case the eye moves to ensure that the cornea is correctly reshaped as desired. Modern tracking system can follow the eye with the speed of four thousand times per second.

Wavefront-Guided Laser

The newest type of laser is wavefront-guided laser. This type tracks or maps the irregularities on the eye to apply varied or custom treatment. This is done with the help of wavefront sensor that is attached to the LASIK device. This benefits patients with irregular eye disorders with which traditional LASIK methods may not sufficiently fix.

Wavefront-guided laser machine uses either spot scanning lasers or slit scanning lasers during ablation process.

Choose The Right One

Some types or technology involved in LASIK are nothing but enhancement to get better, faster and hassle-free results which means they should not matter much to patients. However, some patients might need to get the more advanced option to get their conditions properly addressed. To better decide which type one needs, one may contact an ophthalmologist for examination.

The eye condition is critical in deciding which type to use. If given the option to select, it is important to remember that the more advanced the procedure is, the more expensive it can get. While many clinics offer the service at a fixed rate no matter what technology is used, others let you choose and quote the price based on your selection.

Generally, microketome surgery is much cheaper than all other laser surgeries. On the other hand, wavefront-guided lasers are typically the most expensive.

These technological advancements in the field of laser eye surgery are definitely welcomed by both patients and surgeons. One day, medical science could bring forth a completely risk-free and more precise procedures.

Notwithstanding, the tools can only be as good as the handler. It is still best to select an experienced and skilled surgeon to increase the chances of a successful operation. Patients need to do their part too in preoperative and postoperative care to achieve the best results.

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Wearing glasses or contact lenses all the time can be really undesirable at times. If you are wishing to see without them LASIK eye surgery might be a good option. However, before getting one you will need to determine if you are a good candidate for this procedure. In this article, you can find accurate and helpful insights about LASIK eye surgery with the hope to help you form an informed decision and overcome your fears prior to your procedure. With fine-tuned surgical skills and time-tested technology available today, LASIK procedure is perhaps one of the safest eye treatments available. Also, we highly believe that its benefits far outweighs the potential risks.

LASIK Eye Surgery – An Overview

LASIK is an abbreviation of Laser in Situ Keratomileusis that simply means using an equipment (laser) underneath the patient’s corneal flap in order to reshape the cornea (keratomileusis). The surgeon will typically folds back the flap then remove the corneal tissue using the excimer laser. Then the flap will be laid back in place to cover the area wherein the tissue was removed. While laser is often desirable by doctors because of its precision for the procedure, many patients are attracted to choose this type of treatment because of its significantly fewer complications compared to other eye treatments available.

LASIK eye surgery is performed in order to correct astigmatism, farsightedness and nearsightedness. For patients with nearsightedness condition, the main goal of the procedure is to flatten its too-steep cornea. For those woth farsightedness, a steeoer cornea should be achieved while smoothing an irregular into its normal shape is the aim for patients with astigmatism.

LASIK Eye Procedure – The Preparation

If you are one of those many people who are considering LASIK eye procedure, the first step should be choosing a good LASIK surgeon. Everything will start with proper medical evaluation whether LASIK is really right for you. The initial examination will include checking your past and present medical and your eye conditions. Your previous surgeries are also taken into account as well as the medicines you took which may have affected your vision or surgery. Also, it is very important to mention the medication allergies you have. Your eye structure and general prescription are carefully considered in order to help determine the best procedure that suits you.

Expect that the doctor will discuss the risks, benefits and alternative surgery for your eye condition. Also the doctor should explain the things you will need to expect before, during and after the LASIK eye surgery. During this time it is highly important that you should raise all the questions you wanted to ask to your surgeon. Ideally, the doctor should be very much willing to answer your questions with all honesty and even provide important handouts for you to review and further understand the process. Then you will be provided with a form,  you will need to sign an informed consent form.

What is your surgeon Looking for during the Evaluation?

The eye doctor will look for the potential risk factors prior to the actual surgery. Commonly, patients with extremely high eyeglass prescription are not recommended for LASIK surgery since there would be a need to remove too much corneal tissue and it highly demands to be safely performed. Patients with very thin corneas could also be at high risk as it can excessively weaken after the surgery. For this case, other procedures such as surface ablation could be more appropriate. Patients who possess dry eye symptoms may not be ideal for LASIK surgery. Dry eye symptoms such as redness, tearing and burning, though there are many post care available, may be worsen after LASIK surgery.

During the surgery, it is expected the the surgeon will perform the procedure within 30 minutes for both eyes. The patient will typically be taken to a surgical suite and into the reclining chair or bed. The surgeon will then attach the laser system to a large machine and computer screen, the patient will be positioned underneath the laser where numbing eye drops are applied. After the surgery, patients will not be allowed to drive, arranging a transportation beforehand is therefore highly required. As soon as the process is finished, you will feel itch, burn and irritated however it is highly recommended not to rub your eyes under any circumstances. In order to ease these undesirable sensations, you could use copious artificial tears. Your doctor will also recommend you to buy and take a pain reliever in some instances when you feel increased discomfort. In most cases, you will need ibuprofen or other anti-inflammatory drugs.

LASIK is an outpatient procedure, you will not be asked to stay at the clinic overnight. Before leaving the clinic, you should ask your surgeon how long you should wait to start participating in activities such as jogging and walking. Typically, patients will need to rest for about three days following the procedure to start low impact activities again to avoid possible eye trauma. You will be asked to avoid exposing yourself to possible eye infection like going in hot tubs, pools and lakes during the healing process. Creams, makeup, lotions and any perfumes should not be used during these times as well as they can commonly cause buildup on your eyelids which can develop risk for infection.

Although most patients claimed that they are already having better visions after just very few days of their surgery, you may still experience hazy or blurry vision. Mild burning sensations may also occur from time to time, special eye drops which your doctor usually recommends will help ease the pain, keep your eyes moist and prevent infection. It is highly important to keep your eyes lubricated with prescribed drops and artificial tears to protect your vision.

A regular visit for the first six months from the day of your LASIK surgery is often required. This is when the doctor will closely examine your eyes and ensure that they are in good conditions. It’s highly important that your eyes are assessed regularly and your LASIK surgeon will guide you to correct and maintain your vision.

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The importance of one’s eyesight can never be undervalued. We always use our eyes from the time we wake up in the morning until we go to bed at night. Hence, good eyesight is not only an asset, but a necessity.

Unfortunately, there are many different factors that could lead to poor eyesight. Poor eye care, inadequate maintenance, diseases and aging are just to name a few. Not to mention natural degeneration. Try as we may, our vision gets poorer eventually.

Correcting Eye Conditions

When one suffers from vision problems, there are different methods he can choose from to correct this. The most common is the use of eyeglasses. This is particularly used by people who suffer from farsightedness, nearsightedness and astigmatism.

Its artificial lenses correct the eye condition through refracting or bending the light before it reaches the Retina. This aims to tweak the light’s focal point. However, people have become tired of having to wear eyeglasses every day.

Then, modern science introduced the use of contact lenses. This functions similar to the traditional eyeglasses except that it does not require frames since artificial lenses are directly applied to the eyes. However, this has its own downside, too. Abrasion and infection may arise if the lenses are not carefully applied.

A better approach that treats impaired vision will have to correct the actual Cornea for a long-term effect. This way, one does not have to rely on artificial lenses anymore. This process makes use of a computer-aided device to reshape the Cornea.

What is LASIK?

In a nutshell, LASIK is a refractive eye surgery that aims to reshape a patient’s cornea with the use of laser technology. This is an effective and highly successful method to correct myopia, hyperopia and astigmatism.

When the cornea is too steep, it leads to nearsightedness or myopia; if it is extremely flat, it causes farsightedness or hyperopia. If the cornea is shaped like a football, astigmatism occurs.

To reshape the cornea, the surgeon cuts a flap of tissue from the Corneal Epithelium. This is done to gain better access to the actual tissue behind it. At the same time, the flap serves as a protective covering after the procedure.

Risk Factors and Limitations

Like any other procedures, not everyone is suited for LASIK eye surgery. Initial tests, diagnosis and preparations are essential to determine if one is a suitable candidate. There are particular anatomical factors and conditions that must be considered as well since certain conditions can increase the risks of complications.

For starters, patients with dry eyes are not advised to undergo this procedure. This is due to the laser’s inherent ability to reduce moisture in the eyes.

This is also not recommended to candidates with corneas that are irregular or too thin because these conditions increase the chances of refractive error that could result in over-correction or under-correction.

Pregnant women may not be subjected to lasers, so they are not good candidates for this process either.

Age is one other major factor to consider. Patients aging 18 years old and above are the most ideal candidates. Although the surgery can be done on younger patients, it requires permission from the parents or guardians.

Possible Complications

LASIK procedure is generally safe with success rates continuously increasing as technology evolves. Instances of under- and over-correction are also minimized as the surgeon gains more experience. Still, possible complications cannot be completely overruled.

It is normal for patients to feel slight discomfort following an operation. Light sensitivity and mild irritation are to be expected while the eyes heal itself. Glare, halos, reduced sharpness, hazy visions and other disturbances may also be experienced by the patients in the first few weeks to up to six months.

Some cases of epithelial in-growth have also been reported in less than 2 percent of the LASIK procedures. This occurs when cells of the epithelium or the cornea’s outer cells grow underneath the flap. Luckily, this anomaly is self-limiting and poses no serious threat.

Other procedures have resulted to irregular astigmatism. This happens when the corneal surface becomes uneven after the procedure. This condition may require re-treatment or an enhancement surgery to be corrected.

Only rare instances of eye infection have been noted, too. This is due to the sterile nature of the flap- the tissue that has been lifted and repositioned to serve as a natural bandage. Surface ablation procedures like the PRK have higher percentage of eye infections.

How to Reduce the Risks

No surgical procedure is absolutely safe and complications may arise. Fortunately, there is a way to mitigate the risks and increase the success rate at the same time. If you are thinking about undergoing LASIK surgery, here are some of the most important things to remember:

1. Look for a qualified doctor. A successful outcome is largely dependent on the practitioner as it is on the process. Look for an efficient ophthalmologist to properly diagnose your condition. They are most fitted to provide you with the best methods to undertake. If a surgery is positively necessary, choose a surgeon who uses sophisticated technology with good surgical skills.

2. There are no shortcuts. There are some preparations to be done before the actual surgery. Make sure that you comply with all the required diagnostics tests. Conversely, you have to dutifully follow the doctor’s prescription on post-surgical care to speed up the recovery process and avoid complications.

3. Visit your doctor regularly. Just because your vision problem has been corrected does not mean you can care less of your eyes. Make it a habit to visit an eye doctor for proper maintenance.

Conclusions

Vision is highly important in everything we do. To lose it is very critical. Luckily, the success of LASIK surgery has been overwhelmingly positive. Around 96 percent of patients achieved their desired vision after a successful operation.

Furthermore, the procedure is painless and does not require bondages or stitches. Most importantly, it is perfectly safe to redo the process if age and natural degeneration cause your vision to eventually deteriorate.

As long as you take the time to do thorough research, systematic preparations and diligent post-surgery care, then you can rest assured the procedure will turn out successful.

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The sight is regarded as one of the most important of our senses and so are the eyes through which we see. Through the sense of sight, we go through our everyday routines with unparalleled ease. We are heavily dependent on sight most of the time and even as we interact.

Whenever we communicate to everybody around us, eye-to-eye contact is almost a must. From relaying the message to understanding emotions and even to observe reactions, we rely on what we see.

Entertainment has also been developed to better please the sight. The better we see things, the more we enjoy them. That is why the development of HD monitors and screen was welcomed by consumers of electronics. Modern gaming is even witnessing the introduction of the use of wearable eye gadgets for an improved gaming experience.

Important as it is, the eye needs to be protected and be well-cared. The organ is well-positioned for better perception and protection. Like most organs in the head, the eye ball is protected by the skull against hard objects. The frontal part of the human eye is also protected by the eyelid to prevent injury. Other glands also provides nourishment to eye tissues.

Despite the anatomic protection and proper care of the eyes, diseases and disorder may still affect the eyes and therefore the vision. Hence, it is important to cure and correct these conditions.

How We See

For us to see, the light that gets into the eyes through the hole in the eyes called ‘Pupil’ needs to be focused right at the tissue called the ‘Retina’ which is responsible for sending the message to the brain. To do this, our eyes have 2 lenses working with each other. The first one is called ‘Cornea’ which is located outside of the Pupil. The second one located behind the Pupil is simply called the Lens.

Any problem with the Cornea could affect the vision resulting in unwanted eye conditions. Common conditions are near-sightedness or myopia, farsightedness or hyperopia and astigmatism wherein images appear distorted or blurry whether near or far. These conditions are mainly due to light not focused on the Retina. If the light or image is focused before it reaches the retina when looking at a distant object, it results in myopia. When a nearby object appears to be blurry because image or light doesn’t come into focus before the retina is reached, then you get hyperopia. As for astigmatism, deformation or uneven surface of the cornea usually resulting to the image being focused twice causes all images to be distorted.

For the longest time, eyeglasses have been used to correct impaired vision. The device works by refracting or aligning the light so that the focus reaches the Retina. Through time, contact lenses were also developed so that they can be placed directly on the eye without the need for frames.

In the late 80’s and early 90’s, a newer approach is developed to address these eye conditions without the need for wearable devices and with permanent result. This method is the LASIK eye surgery.

The procedure primarily involves reshaping the Cornea to ensure that the focal point of the image reaches the Retina without having to rely on artificial lenses like eyeglasses and contact lenses. This is a one-time procedure done by ophthalmologists.

The entire procedure uses a machine run by computer system to ensure precision. The process starts by applying alcohol directly on the Epithelium so that the cells would weaken. Then, LASIK surgery equipment creates a flap of the Epithelium or the outermost layer covering the Cornea. The flap is then folded away from the laser field so that it doesn’t get in the way of the operation.

Once the outer layer is removed, the laser could now reshape the Cornea by applying laser in a finely controlled manner so that the tissues, which are usually tens of micrometers thick, evaporates. This procedure is much like shaping lenses to achieve the desire refraction of light and therefore ensuring that the focal point is right on the Retina. The process involves flattening the surface of the Cornea, to treat myopia, or making the surface much rounder for the treatment of hyperopia. As for astigmatism, the treatment works on making the surface of the Cornea much more even.

The process has both advantages and disadvantages as with other surgical procedures. But overall, the procedure has excellent success rates.

Advantages

Long-lasting result

Like any photorefractive or laser surgeries, the procedure only needs to be done once and the result lasts, which means there is no need to use your eyeglasses or contact lenses anymore and no maintenance needed.

Precision

Computer-aided machines do the job which means fine precision.

Fast Recovery

Compared to other laser eye surgeries, LASIK has been proven to cause lesser quicker recovery  and inflammation. It also causes lesser irritation and discomfort after the operation.

Better quality of life

After a successful operation, patients could expect to live a better life with better vision. When you can see things clearly immediately after opening your eyes without the need of eyeglasses or contact lenses, it surely means life is now hassle-free.

Disadvantages

Dryness

The eye might experience dryness after the procedure and therefore a bit of discomfort but are usually temporary. The patients are therefore usually prescribed anti-inflammatory eye-drops to address this.

Risks

Possible risks of the procedures may include loss of vision due to infection. Some patients have also reported cases of either under or over-corrected conditions. Any irregularity with the position and healing of the flap may also cause discomfort and may affect visual acuity though oftentimes could be corrected.

Most of the risks mentioned could be avoided by doing proper consultation and strictly following preoperative procedures to ensure that the eye is at its best condition. It is also necessary to follow the guidelines and care after the surgery to ensure that the eye recovers well and to avoid infection. Furthermore, patients need to find the best possible clinic offering the surgery since a more advanced equipment and a well-experienced ophthalmologists guarantees better chances of successful operation.

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