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LIST OF SERVICES & PROCEDURES
Laser for Vision Correction
Would you love to wake up and be able to see your alarm clock without having to put on your glasses
first? How would you like to drive a car, play tennis, golf, or participate in water sports without
worrying about glasses or contact lenses? Thousands of Americans are changing the way they see the
world with LASIK! LASIK is short for Laser In-situ Keratomileusis. LASIK can not treat or correct this normal aging process of the eye.
Ophthalmologists have been performing Refractive Surgery to correct nearsightedness,
farsightedness and astigmatism since the 1970's. The approval of the Excimer Laser in December of
1995 dramatically improved the way we correct refractive errors. Procedures such as RK, AK and ALK
allowed many people to experience freedom from glasses and contact lenses, but could not provide the
accuracy or stability available today with the Excimer Laser.
| There are currently 2 procedures being performed with the
Excimer Laser. One is known as PRK and the other is LASIK. The
Excimer can not successfully treat through the surface layer
of your cornea (epithelial layer). During PRK surgeons use a
spatula to remove the epithelial layer and then treat the cornea
with the laser. It takes about 2 weeks for the epithelial layer
to reform and stabilize, and your vision to clear. |
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LASIK is performed by using an instrument called a microkeratome to lift
the epithelial layer, then the inner surface of the cornea is
treated with the laser and the epithelial flap is put back in
place without the need for stitches. The only area to heal after
LASIK is around the edge of the flap, and most patients see
well enough to drive and return to work the day after surgery.
The Excimer Laser utilizes state of the art computer technology to reshape the cornea and improve
the way your eye focuses light. The Excimer Laser produces a "cool" or non-thermal light beam to
reshape the internal cornea with an accuracy of up to 0.25 microns with each pulse. It is accurate
enough to remove single cells from a human hair. The unique non-thermal light beam allows surgeons
to remove cells from the internal cornea without causing damage to surrounding tissue.
The VISX STAR S2 Excimer Laser has been FDA approved to treat nearsightedness, nearsightedness with astigmatism and farsightedness.
Understanding Refractive Errors
Nearsightedness (Also known as Myopia)
In a normal eye light is focused directly on the nerve layer in the back of your eye known as the
retina. In a myopic eye the cornea is too steep and light is focused in front of the retina creating
a blurred image.
Astigmatism
Astigmatism occurs when the cornea has an irregular shape. Light coming into the cornea is focused
at different points on the retina instead of meeting at one point. This creates a distorted or often
double image. Patients with astigmatism can have difficulty focusing at a distance and up close.
They may also notice problems with glare when driving at night.
Farsightedness (Also known as Hyperopia)
In a hyperopic eye the cornea is too flat and the eye is too short causing light to be focused
behind the retina. This usually causes images to be out of focus at a distance as well as up
close.
Presbyopia (Often confused with farsightedness)
As we age the natural lens within our eye starts to become firmer and lose its elasticity. The loss
of elasticity in the lens results in a loss of accommodation, or ability to focus on objects less
than 2 feet away. Presbyopia occurs in most people in their mid to late 40's whether they have LASIK
or not.
HOW DOES LASIK WORK?
The goal in the correction of farsightedness is to flatten the cornea by removing tissue from the
center section of the cornea, causing light to be refocused onto the retina. The Excimer Laser is
able to treat astigmatism by changing the pattern of the laser beam and removing tissue from one
corneal axis more than another. This creates a more rounded or spherical cornea. To correct
Farsightedness the laser treats the area under the LASIK flap, around the periphery of the central
cornea, to steepen the central optical zone of the cornea.
LASIK is a 2-step procedure using the Excimer laser and an instrument called a microkeratome. Your
eye is completely numbed with anesthetic eye drops and an instrument is placed between your eyelids
to prevent you from blinking. A pass is made across the cornea with the microkeratome to create a
flap in the surface of the cornea. After the flap has been made the laser is used to treat the inner
layer of the cornea. During the treatment you be looking at a red fixation light to properly center
your eye for the laser treatment. In most cases the laser treatment lasts less than a minute. The
flap is then put back in place without the need for stitches, antibiotic eye drops are placed in
your eye and a clear protective shield is placed over your eye. You will be given 2 different eye
drops to prevent infection and inflammation, as well as lubricating drops. You will be instructed to
wear the protective eye shields to bed the 1st night. You will need to be seen the
following day for your first post operative appointment, and additional follow visits will be
necessary to monitor your healing.
You should plan to take it easy and rest the day of your surgery. You may notice mild burning or
tearing following the procedure, and it may feel like there is an eyelash in your eye. These
symptoms are usually mild and should go away within 24 hours. Most patients notice some glare or
halos around lights for a period of time after the surgery. These should diminish as the eye heals,
but may not go away completely. To reduce the risk of infection it is important that you do not swim
or go in a hot tub for the first 2 weeks after surgery, we also ask that you not wear eye make-up
for 1 to 2 weeks following the procedure.
You will notice a marked increase in vision the first day, but you should not expect perfection.
Your vision will improve daily for the first 10 to 14 days, and you may notice small changes for the
first 3 months. Most patients can see well enough the first day to drive and return to work. You may
experience a slight decrease in near vision for the first 2 to 3 days, but this should return to
normal by the end of the first week.
(Remember, if you needed reading glasses, or had to take your glasses off to read before surgery,
there is a very good chance you will need reading glasses after surgery.)
Your eyes may also feel noticeably more dry and scratchy and you may need to use lubricating eye
drops frequently for the first week or two.
WHO IS A CANDIDATE FOR LASIK?
Raleigh Ophthalmology is currently using the VISX Star S2 Excimer Laser. It is FDA approved to treat
the following levels of refractive errors:
Myopia -1.00 to -12.00
Myopia with up to 4 diopters of astigmatism
Hyperopia +1.00 to +5.00
Patients should be over 18 years of age and must not have had any significant changes in their
glasses or contact lens prescription for 1´ to 2 years. Patients with any corneal disease, certain
medical conditions, and women who are pregnant are generally not considered good candidates.
We have found that the patients who have surgery done who are the happiest, are those who can accept
that we can not guarantee perfect vision with LASIK surgery. Although the Excimer laser is the most
precise means we have to surgically correct refractive errors, it is not considered as accurate as
glasses or contact lenses. Most patients can see well enough to obtain a drivers license, swim, ski,
and enjoy most activities without the need for glasses or contact lenses.
After their initial procedure:
98% of patients with myopia (with or without astigmatism) see 20/40 or better
78% see 20/25 or better
90% of patients with hyperopia see 20/40 or better
65% see 20/25 or better
HOW DO I GET MORE INFORMATION?
E-mail us at Question.
Attend a free screening with our refractive counselor, Monday through Thursday evenings at 5pm, or
during regular business hours Mondays, Wednesdays and Fridays.
Attend one of monthly seminars given by one of surgeons who specialize in Laser Vision Correction.
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