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     The Laser Vision Correction Procedures

     Procedure Overview: In Lasik, a microkeratome is used to create a paper-thin flap on the surface of the cornea prior to the application of the laser. In PRK, the surgeon prepares the surface of the eye more superficially prior to the laser application. After the laser creates the desired refractive effect, the flap is placed back into position in Lasik, where it stays firmly in place without the need for sutures. In PRK, the surface of the eye must heal back over after the laser application, and usually a bandage contact lens is placed for comfort during the healing process, which may take one to three days. Both eyes can be treated in the same session with Lasik, while with PRK the eyes are usually treated a few weeks apart.

     The laser used is a state-of-the-art VISX Star S4 ActiveTrak Excimer Laser with the WaveScan WaveFront System . This system features an active eye tracking technology in all 3 dimensions (horizontal, vertical, and up and down motion of the eye), Variable Spot Scanning technology, and an 8.0 mm Blend Zone option. These features all help to give the smoothest possible laser application. Plus, unlike some lasers, dilation is not required for laser eye tracking during the procedure!

Procedure: Lasik

• Prior to the procedure, both the microkeratome and excimer laser are checked to insure proper functioning. The refractive error of the eye is programmed into the laser.
• The patient has anesthetic eye drops placed, and then reclines on the surgical chair with the eye facing upward toward the laser. Again, it is important not to wear eye makeup or use perfumes or cologne prior to the procedure.
• The eyelid speculum is place to hold open the eyelids of the operated eye, and the other eye is usually covered to prevent inadvertent exposure to the laser. Looking up into the laser, the patient can see a blinking fixation light, and it is important to stare directly at this light throughout the procedure.
• The surgeon will then place a suction ring onto the conjunctiva (white of the eye) around the cornea. This pressurizes the eye so that the microkeratome can be used. The microkeratome is then engaged onto the suction ring and is passed over the cornea to create the flap. The fixation light will disappear for a short period of time during this part of the procedure (seconds).
• The laser is then briefly retested and the corneal flap is folded back. The fixation light will now appear very blurry, but will be visible. The laser will then be used, which can take from 30 seconds to a couple of minutes. The laser makes a snapping sound, which is normal.
• After the laser application, the flap is repositioned and irrigated with sterile saline. The surgeon observes the flap for a few minutes to insure that it is adhering properly. A bandage contact lens is optional at this point, and is usually not needed. A protective shield is placed over the eye after the speculum is removed.

Procedure: PRK

• Prior to the procedure, the excimer laser is tested to insure proper functioning, and the refractive error of the eye is programmed into the laser.
• Anesthetic eye drops are placed into the operative eye, and the patient reclines onto the surgical chair, with the eye facing upward toward the laser. It is important not to use eye makeup or perfume or cologne on the day of the procedure.
• The eyelid speculum is placed to hold the eyelids open, and the other eye is covered loosely to prevent inadvertent laser exposure. Looking upward into the laser, a blinking fixation light is visible, and it is important to maintain the gaze at that light throughout the procedure.
• The surgeon will then prepare the surface of the eye for the laser, which takes a couple of minutes. The laser will then be used, and this takes from 30 seconds to a couple of minutes. The fixation light will become blurrier as the laser proceeds, but it will still be visible. The laser normally makes a snapping sound while it is working.
• After the laser application, the eye is irrigated with sterile fluid and a bandage contact lens is placed. The speculum is removed, and antibiotic and anti-inflammatory eye drops are given to the patient. Sometimes pain medication is necessary after the procedure.

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