The procedure is carefully controlled by the surgeon and can be stopped at any time. The excimer laser is presently used for surface ablations (PRK, LASEK, Epi-LASEK), conventional and Wavefront LASIK and Intralase LASIK.
In PRK no creation of a cap via either a microkeratome, or a laser, is required. The excimer laser energy is applied directly to the cornea to sculpt, or reshape, it allowing images to fall directly onto the retina resulting in clearer vision. Most laser treatments take less than sixty seconds and the procedure is pain-free (because of the anesthetic eye drops used).
In LASEK the cornea's surface cells are moved aside, the cornea is resculpted with the laser and the surface cells are gently put back in place. This is pain free because of the anesthetic eye drops used.
With Epi-LASEK a hinged cap, or flap, is created using the cornea's surface cells, the cornea is resculpted with the laser and the flap of surface cells is gently repositioned. This too is pain-free because of anesthetic eye drops.
For LASIK an instrument known as a microkeratome is used to make a protective flap on the surface of the cornea. During this process you may feel a little pressure, but no pain is felt because of the anesthetic eye drops. The flap, which remains attached at the hinge, is then carefully lifted and the excimer laser is applied to the inner tissue of the cornea to precisely sculpt, or reshape it, resulting in clearer vision. The flap is then put back into place where it bonds securely without the need for stitches. When a laser, known as Intralase, is used to create the flap, or cap, as opposed to a microkeratome, the procedure is called Intralase LASIK.
The Excimer laser is a computer driven laser. There are two software packages available for the surgery: conventional and wavefront, (a.k.a. custom). In general, wavefront technology affords people better quality of vision postoperatively and fewer problems with night vision (see "wavefront technology" for more detailed information).
People with myopia, hyperopia and astigmatism are excellent candidates for LASIK.
Laser vision correction underwent many years of data collection and clinical trials in order to receive FDA approval as being both safe and effective. The Excimer laser itself, surface ablations and LASIK are all FDA approved.
Conductive Keratoplasty (CK) was FDA approved in 2002. Using radio frequency waves, one cornea (of one eye) is reshaped to give the person good reading vision in that eye. The other eye is usually
left with good distance vision. This is a form of monovision and a trial of the intended correction using contact lenses is recommended first.
Accommodating Lens Implants are lenses surgically placed inside of your eyes after the removal of your natural cataractous lens. These newer lenses are intended to give people good distance and near vision as opposed to the lenses
we have been using for years which were designed to give people good distance vision (requiring reading glasses be worn for near tasks).
Intraocular (phakic) contact lenses (a.k.a. implantable contact lenses) were approved by the FDA in September 2004. These are plastic lenses that can be implanted into the eye (intraocular) to correct vision.
This procedure carries higher risks than laser vision correction and is therefore typically reserved for people with very high degrees of myopia or hyperopia.
