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Alternatives to LASIK

LASIK is currently the most commonly performed laser vision correction procedure in North America, making up about 95% of all refractive surgeries performed. However, depending on your particular circumstances and prescription, other options may better suit your vision correction needs.

-CustomLASIK- ("Wave" LASIK)
The FDA has recently approved a new technology that may change how your eye doctor treats your vision problems. It's called CustomLASIK. CustomLASIK is a laser vision correction procedure that uses the unique visual characteristics of your eye to customize your treatment.

CustomLASIK provides an additional level of precise data about your vision requirements using wavefront technology. A device called a wavefront analyzer measures the way light travels through your eye and compares it to the way light travels through an eye with perfect vision. This device then creates a 3-D wavefront map that is unique in the same way that your DNA is unique to you. Your wavefront map provides a detailed diagram of your vision that allows your doctor to provide you with truly personalized vision correction.

-Conductive KeratoplastySM-
Conductive KeratoplastySM (CK) uses the controlled release of radiofrequency (RF) energy, instead of a laser, to reshape the cornea. CK is performed using a small probe, thinner than a strand of human hair, that releases radiofrequency (RF) energy. The probe is applied in a circular pattern on the outer cornea to shrink small areas of corneal tissue. This circular shrinkage pattern creates a constrictive band (like the tightening of a belt), increasing the overall curvature of the cornea. The procedure, which takes less than three minutes, is done in-office with only topical anesthesia (eye drops). CK is the first alternative to laser for hyperopia.

-LASEK-
LASEK (laser epithelial keratomileusis) is a laser refractive procedure to correct nearsightedness, farsightedness and astigmatism. LASEK is sometimes referred to as “Epi-LASEK.” It involves removing the top layer of the cornea as a flap-like sheet before re-sculpting the cornea with the excimer laser. The epithelial sheet is then replaced on the surface of the eye and a soft contact lens is inserted for a few days following the surgery.

What is the difference between LASIK and LASEK?
In the LASIK procedure, an instrument called a microkeratome is used to create a protective flap of tissue. LASEK also involves the creation of a protective epithelial flap, but there is no microkeratome used. Instead, the tissue is loosened with a medical solution and then is carefully moved to the side for the laser portion of the procedure. After the laser procedure, the tissue is then repositioned and healing begins.

Why would I have LASEK over LASIK?
LASEK is a great option for patients previously turned down for LASIK because of thin or unusually shaped corneas. It is also a nice option for those patients who are uncomfortable with the microkeratome.

-PRK-
PRK (photorefractive keratectomy) used to be the most common laser vision correction procedure. LASIK has since surpassed PRK due to its ability to correct more severe visual acuity with less recovery time and with decreased risks of infection, haze and scarring.

The Procedure
No scalpels are used and no incisions are made with the PRK procedure. Before the procedure, an extremely detailed map of the surface of your eyes is created by a computer. Your surgeon uses this map to calibrate the excimer laser to your exact prescription.

After calibrating the laser properly, an eyelid holder is placed in your eye to keep it open throughout the procedure.

You will also be given some anesthetic drops to numb the eye and prevent pain.

With the laser, your surgeon prepares the eye by gently removing the epithelium, the eye’s protective first layer of cells, which will naturally regenerate itself in a few days. This reveals the next layer of corneal tissue known as Bowman's layer. The surgeon will then smooth the area and proceed with applying computer-controlled pulses of cool laser light to precisely and delicately reshape the curvature of the eye. Deeper cell layers remain virtually untouched.

The entire PRK procedure is usually finished in less than five minutes and is painless. Since a layer about as thin as a human hair is typically removed, the cornea maintains its original strength.

After the procedure you are given antibiotic drops, along with anti-inflammatory agents to promote comfort and reduce any swelling that may occur. You may also be fitted with a bandage contact lens to improve your comfort while your eye is healing. Once the epithelium has healed, usually on the second or third day after the procedure, the bandage contact lens is removed by your doctor. Daily eye examinations are required during this initial healing process to ensure an infection does not develop.

As a PRK patient, you will use steroid anti-inflammatory drops for typically around 2 months under the direct supervision of your eye doctor to complete the healing process.