For some of us, waking up and reading the alarm clock without reaching for glasses is a dream. Laser eye surgery makes this dream possible.

LASIK is performed by ophthalmologists to correct nearsighted and farsighted patients as well as those with astigmatism. When light enters your eye, it hits a clear covering called the cornea, the part of the eye that refractive surgery is performed on. Laser vision correction uses a cool UV laser to permanently change the shape of the cornea to reduce or eliminate someone’s dependency on glasses or contact lenses.

A flap is created with a hinge to lift it temporarily and have access to the middle layer of the cornea. A computer-controlled laser then will re-shape or vaporize a portion of this inner tissue, and the cornea is allowed to heal naturally.

There are two general ways to create the corneal flap before applying the laser. The traditional, mechanical method involves an oscillating blade called a “microker- atome.” The newer method uses a gentle, infrared laser operating at extremely high speed to precisely create the flap. We call this method “IntraLase,” or “all-laser” LASIK.

This IntraLase technique has been used in more than 14 million LASIK surgeries worldwide. Surgeons are now able to guide the laser in creating a more personalized flap for each patient. Although the microkeratome remains successful today, sometimes the blade can create abnormal flap edges resulting in complications. The higher safety trade- off with IntraLase is that it is slightly more expensive.

Another option when deciding on laser eye surgery is called Custom LASIK. This technology uses a machine to measure the way light travels through your eye, creating a detailed map of your eye’s unique characteristics.

The Custom Wavefront analyzer looks for any visual imperfections that affect both the clarity and quality of vision. These measurements are then transferred to the laser, creating a customized treatment plan, increasing the vision quality with less glare, halos, or visual disturbances. Just like fingerprints, everyone’s eyes are unique, making custom LASIK desirable for most and necessary for some.

Sometimes patients do not qualify for LASIK and will need to have a procedure called PRK instead. PRK has been practiced in the U.S. since 1995 specifically for patients that have undergone LASIK previously or are otherwise not a LASIK candidate. There is no corneal flap created with PRK; the outer epithelial layer of the cornea is removed before the laser is applied. The outcome is very similar to LASIK. However, the recovery is considerably slower and can take several weeks for the final result.

If you’ re in your 40s or 50s, you may find that your arms are too short when you’re reading. This is called “presbyopia,” where the eye loses its ability to change focus for near tasks. It progressively gets worse with age, and, unfortunately, no one can escape it. Laser eye surgery usually corrects distance vision only. This means presbyopic patients will still require reading glasses, even after surgery. “Monovision” is a technique specifically designed for presbyopic patients where one eye is corrected for distance and the other for near. If a patient is considering LASIK with monovision, a trial period wearing monovision contact lenses will be required to evaluate if he or she can tolerate it.

When you arrive on your procedure day, you will be given medication to help you relax. The eye is held open by an instrument called a lid speculum, and numbing drops

are applied. While looking at your eye through a micro- scope, the surgeon creates the flap, and, during this time, your vision may become blur- ry. After the flap is created and pulled away, you will focus on a flashing light. The invisible laser makes a fast clicking sound each time it pulses the cornea. Once the laser is done sculpting, the surgeon aligns the flap to its original position.

Each eye takes approxi- mately five minutes. After the surgery, you may experience mild irritation or discomfort for a few hours. Vision may be slightly hazy but will improve by the following morning. You will have regular follow up appointments and the physi- cian will prescribe eye drops to reduce any swelling and promote healing.

Most patients are satisfied with their LASIK results but

like any procedure, there is the possibility of complica- tions. Patients may develop glare, halos, and difficulty with night driving. Due to the creation of the flap, the eyes may not be able to produce enough tears, creating inter- mittent blurring and mild dis- comfort from dryness.

The goal of LASIK is to elim- inate refractive error, although it is impossible to predict the long term results for each individual. In some cases, additional treat- ment or an enhancement may be needed.

The surgery may only take a few minutes but those few minutes can have a tremendous impact. If you are inter- ested or have any questions, please do not hesitate to contact Coastal Eye Care.

Dr. Marissa Knutson works at Coastal Eye Care Clinic and can be reached at (503) 738-5361. 


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