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Laser In-Situ Keratomileusis (LASIK) combines the laser application of PRK with a method of applying the laser reshaping to the inside of the cornea. With LASIK, a flap of corneal tissue that has a hinge is created at about 20% depth. The flap is made either by a short pulsed scanning laser (technically known as the IntraLase) or by a precise instrument called a microkeratome. This flap of tissue is then lifted up, exposing the middle layer of the cornea. Next, the excimer laser reshapes the cornea. In LASIK, these laser pulses are applied to the middle layer of the cornea, instead of on the surface as is done in PRK. The flap is then brought back into position and the natural adhesive qualities of the cornea keep the flap securely in place without the need for any stitches. With LASIK, the visual recovery time is much shorter. There is less discomfort with LASIK than with PRK and for many patients, the result is more predictable. Most patients choose to have both eyes treated at the same session. The reasons usually relate to convenience, minimizing time out of work, and the practical difficulties of trying to function when only one eye has been treated. The reason we allow patients to elect same-session treatment of both eyes is the high degree of reliability of the LASIK procedure. Several large studies have shown no increased risk when both eyes are treated on the same day. Of course, the risk of a late onset complication that is not evident at the time of treatment and then affects both eyes is very low, but can never be completely eliminated. If you are more comfortable with the thought of treating only one eye at a time, that is quite reasonable and we are happy to accommodate your desires. Remember, however, that many patients cannot see comfortably with a spectacle lens correction in one eye and no prescription on the other side. A contact lens can be used in the untreated eye immediately after treating the first eye, but a soft contact lens must be discontinued at least 3 days and a rigid contact lens at least 2 weeks prior to treating the second eye. Most patients want to know what the likelihood is that they will have a great result. At the time of your evaluation, ask about our current statistics. The results do vary by the amount of correction that is being attempted. In general, results today are substantially better than the published studies, which lag several years behind current practice. One of the most attractive aspects of LASIK is our ability to lift the flap and perform an enhancement procedure, if appropriate. We cannot assure you of a perfect result, because biologic tissue responds differently from eye to eye. We do make every effort to obtain the result that matters most: freedom from dependency on glasses or contact lenses for most everyday activities. If an enhancement procedure has a reasonable chance of helping you, we will give you this option. |
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