Coloured Contact Lenses

Information on LASEK Laser Eye Surgery

LASEK (Laser Epithelial Keratomileusis) laser eye surgery takes the most beneficial elements of two other types of laser eye surgery and combines them into one very effective surgical procedure. These other two laser eye surgeries are LASIK and PRK.

Unlike the LASIK procedure which involves using a sharp blade to slice off the top of the cornea, LASEK uses a solution consisting of diluted alcohol to loosen a thin layer from the epithelium so that it can be moved off to the side.

Benefits of LASEK laser eye surgery

One benefit of LASEK laser eye surgery is that it eliminates the risks associated with the corneal flap. With LASIK surgery, a very sharp blade called a microkeratome is used to cut the corneal flap. There have been cases in which the flap was cut too deeply or cut off completely instead of leaving it attached with a hinge, both of which are capable of causing any number of serious vision problems.

Healing is faster with LASEK because there is no cutting and because the epithelial flap can be used somewhat as a natural bandage after the procedure is finished. And unlike PRK, the chances of developing a glare after the operation are greatly diminished when using LASEK.

Risks/disadvantages

Risks associated with LASEK laser eye surgery are greatly diminished mainly due to the fact that no sharp device is being used to cut the cornea. There is some pain but it is minimal and is most often treated with over the counter medicines. Also, it is not possible to guarantee any type of vision results and glare, halos and dry eyes are potential side effects.

The LASEK procedure

Prior to the LASEK procedure, a patient must provide the eye surgeon with a complete medical history. Eye tests and other diagnostic procedures are undertaken to ensure the patient is a good candidate for LASEK laser eye surgery. On the day of the procedure, the eye is cleaned and prepped and an eye drop to numb the eye is administered. A special tool will hold the eyelids in place, preventing them from blinking.

The diluted alcohol solution is applied, the epithelium loosens, and it is gently pushed out of the way. The pre-calculated beams of ultra violet light are then pulsed onto the cornea and in just a minute or so, the procedure is complete.

Most patients will have blurred vision at first and won’t be able to drive home from the procedure. Most need a day or two to rest. Vision will vary over the ensuing months.

For best results, always use an eye surgeon who has experience with the LASEK laser eye surgery procedure. Never be afraid to ask a surgeon you’re considering for the names and contact information of previous patients. If you get a list of contacts, be sure to call and ask about their experiences.

About Epi-LASIK Laser Eye Surgery

The most advanced of the surgical eye procedures using laser technology, Epi-LASIK laser eye surgery combines the best of traditional LASIK surgery with the best of the LASEK and PRK laser procedures. Epi stands for Epithelial and LASIK stands for Laser in situ Keratomileusis. Basically this newest procedure involves gently separating the epithelial from the top of the cornea using an epikeratome rather than slicing the top of the cornea and creating a hinge as is the case with LASIK.

A good candidate for Epi-LASIK laser eye surgery is someone who has a very thin cornea and who also has mild to moderate farsightedness, nearsightedness or astigmatism. As with the other types of laser eye surgery, best vision is achieved by using laser beams to reshape the cornea.

Benefits of Epi-LASIK laser eye surgery

The two main benefits of the Epi-LASIK procedure are its quicker recovery time and the speed at which vision is restored. Because the cornea is not cut with a microkeratome (a sharp blade) the cornea does not have to heal. And because only a thin layer of the epithelial is separated, it too has the ability to heal quickly. This type of procedure eliminates the potential risks associated with incorrectly cutting the cornea, which in some cases can cause a number of vision problems including a permanent loss of vision. There also is less pain.

Risks of Epi-LASIK

While no surgical procedure is without risk, proper candidate screening including thorough diagnostic testing will significantly reduce the risks associated with Epi-LASIK surgery.

The Epi-LASIK procedure

As with the other laser eye procedures, the Epi-LASIK procedure also takes less than 10 minutes to complete. Anesthetic drops are placed into the eye to minimize pain and discomfort. From there, the epithelial must be moved off to the side so that the laser can reach the intended target area.

Specialized equipment is used to first stabilize the eye. Then, the epithelium separator makes a pass across the eye and flattens the cornea which makes it easier to separate the epithelial. It is not separated completely, rather it remains attached in the middle instead of at one side as happens with the LASIK procedure. A small spatula-type tool is used to move the flap out of the way.

The laser then begins emitting pulses of ultraviolet light, quickly removing the excess tissue from the cornea. As the laser pulses, the cornea is being reshaped. This continues until the proper amount of excess tissue is removed, as determined by the eye surgeon. When finished, antibiotic drops are placed in the eye to protect against infection, and a contact lens-like bandage is applied. Those opting for the Epi-LASIK eye surgery can usually resume normal activity the day after the procedure. Several follow-up visits are required to monitor healing and vision.

It’s important to choose an Epi-LASIK eye surgeon with care. Discuss the surgeon’s experience with this type of procedure including success rates. Also discuss the type of care that will be provided during all stages: before, during and after the procedure and associated costs.

Is LASIK Surgery an option for you?

Many patients are very satisfied with the improved quality of life that they experience after LASIK Surgery. Read on to decide whether LASIK Surgery is right for you. 

The different types of LASIK Surgery

There are two basic types of surgery: Standard LASIK and Custom LASIK. With either type, the preparation work and post-operative procedures are similar. The difference between the procedures involves the customization of the laser.

Standard LASIK

Prior to the scheduled procedure date, the eye surgeon meets with patient to re-test for certain eye problems and diseases. When it’s confirmed that the patient meets the requirements, a procedure date is set.

On the day of the procedure, the eye doctor may perform another corneal topography to confirm that nothing has changed that would require changing the procedure. Three types of eye drops are then administered. The drops anesthetize the eye, protect the eye from post-operative inflammation and protect the eye from infection.

Next, the patient reclines and the laser is positioned overhead with the eye surgeon above it. To remove the flap, the patient’s eye must first be stabilized. The eye is kept from blinking by placing it into a restrainer. Suction is administered to the eyeball and the microkeratome makes one swift slice across the top of the cornea. The resulting flap (which should still be hinged to the eye) is pulled away with tiny tweezers.

The laser then emits a pre-determined number of laser pulses to remove the excess tissue, a process which takes literally seconds. The flap is pulled back into place and saline solution clears the eye of any debris. The eye is covered and the procedure is finished unless the other eye is receiving a LASIK Surgery treatment.

Custom LASIK Surgery

In standard LASIK, the computer inside the laser determines the number and location of laser pulses based solely on the patient’s prescription. With custom LASIK, the eye surgeon creates a three-dimensional image of the eye. The image results are then fed into the laser’s computer and the patient receives a laser treatment that is truly customized to that eye.

Risks and complications

As with any surgical procedure, there are risks associated with LASIK Surgery. The procedure may under- or over-treat the eye. Under-treatments can be corrected with additional surgery however over treatment generally results in the patient needing to continue wearing corrective lenses. Loss of vision or compromised vision, especially at night, are other risks. Dry eye syndrome can develop. And vision that has been surgically corrected may decline over time. Another serious risk involves using an inexperienced ophthalmologist.

Tips on selecting a LASIK Surgery surgeon

Get referrals from people you trust and then make arrangements to interview several candidates.

Make the most of the pre-procedure consultation. Prepare a list of questions to ask each surgeon and record the answers. It’s important to understand what care the ophthalmologist intends to provide during all stages of surgery: before, during and afterwards as well as all costs.

Remember that low cost doesn’t mean top quality. Your eyesight is far too valuable to allow cost to be the determining factor.

Information on Corrective Eye Surgery

Several types of correct eye surgery exist today and these different types of corrective eye surgery fall under two main categories: Excimer Laser procedures and Non-Excimer laser procedures. As is the case with other conditions that affect the body, major technological advances have been made in recent years in the field of corrective eye surgery. The following is a brief introduction to the two categories.

Excimer Laser Procedures

An Excimer laser is a tool that was approved for the treatment of nearsightedness ranging in severity from mild to moderate. Use of the Excimer laser is complicated and it’s important to work with ophthalmologists who are both trained in the surgical procedure and who have demonstrated the ability to properly operate and calibrate this precision instrument.

The Excimer Laser was originally approved for PKR, or Photorefractive Keratectomy and its usage was later expanded for LASIK procedures, or Laser in situ Keratomileusis. With PKR, the cornea is reshaped by eliminating excess tissue from the cornea’s outer surface. With each computer calculated lightening-fast laser pulse, a microscopic ultraviolet light beam removes the excess tissue. After only a few minutes and the application of local anesthesia, the procedure is over. In just a day or so, patients can resume normal activity.

In a LASIK procedure, the eye doctor rather than the laser’s built-in computer determines where incisions will be made and how much tissue will be removed. This is a more complex and invasive procedure and it is one that is recommended for more severe refractive conditions. Using a microkeratome (a knife), the eye surgeon slices and then pulls back a flap of the tissue covering the cornea. With the tissue out of the way, the laser is then used to remove tissue and reshape the cornea. The flap is put back into place and the patient typically can see well enough to drive home after the procedure. LASEK and epi-LASIK are variations of the LASIK procedure.

Non Excimer Laser Procedures

These are procedures that rely on artificial implants, surgery and reshaping to correct eye problems. Lens implants are effective for individuals who have cataracts, nearsightedness and farsightedness. Intraocular lenses or IOLs are used as replacements for the damaged cloudy lenses caused by cataracts. New and improved artificial lenses now incorporate the use of hinges that allow the eye to move and act like a real lens.

Other types of implantable contact lens can correct nearsightedness and farsightedness. They act much like removable contact lenses but require no maintenance and wearers cannot feel these lenses and implants.

Thermokeratoplasty involves the use of heat to manipulate the collagen within the cornea. In doing so, refractive errors can be corrected in a matter of minutes. There are two types of Thermokeratoplasty procedures. Laser thermal keratoplasty or LTK involves the use of holmium YAG laser and CK or conductive keratoplasty involves use of radiofrequency waves.

Astigmatic Keratotomy (AK) involves cutting the cornea in order to reshape it. However, its use has diminished since laser treatments involve less risk and are far more effective at reshaping the cornea.

Eye Problems – Astigmatism

What is Astigmatism?

Astigmatism is a common eye problem in which a person’s cornea or lens has an irregular shape. These problems are known as Corneal astigmatism and Lenticular astigmatism respectively.

The cornea is a clear layer that completely covers the part of the eye that has color. Ideally, the shape of the cornea is round, like a tennis ball. The cornea’s job is to bend rays of light that enter the eye so that these light rays can be better focused on the lens enabling the retina to produce a clear image.

When the cornea has a more oval shape, like that of a football, light cannot focus properly. Instead of one focus point, as is what happens when the cornea is properly shaped, the misshapen cornea focuses light onto two areas of the retina. That is what results in blurred vision and/or the appearance of doubled vision.

Symptoms of Astigmatism

Blurred vision, ‘ghosting’ or images that are doubled are the most common symptoms of astigmatism. These types of vision problems occur at all distances. Fatigue, eye strain and frequent headaches are other symptoms that may indicate astigmatism.

Who is at risk?

The shape of the cornea can be affected by anything that causes the eyelids to exert excessive pressure on the cornea. Other risk factors for astigmatism include hereditary, poor posture and performing redundant and excessive amounts of up-close work. Those who are nearsighted or farsighted are also at higher risk of developing astigmatism. Other factors that can increase the appearance of astigmatism include head trauma or a cut, tear or scar on the cornea.

Keratoconus, a condition which over time causes the cornea to thin and take on a more cone shape can also cause astigmatism. This condition develops around puberty and affects more women than men. It’s also caused by excessive rubbing of the eyes.

Finally, diabetics are at increased risk of developing astigmatism as elevated blood-sugar levels can cause the shape of the lens to change.

Early Detection/Treatment of this eye problem.

A routine eye exam is the easiest way to detect astigmatism. The eye doctor will do a number of tests to determine vision clarity. To determine how light rays focus on the retina the eye doctor can perform a refractive evaluation. Reading the eye chart is a good way to determine visual acuity. Checking eye muscle performance, eye coordination and eye focusing capability are also part of a routine eye exam and can all help determine the presence and degree of astigmatism. Astigmatism is measured in terms of diopters and ranges from mild to severe.

Since astigmatism is an eye condition and not an eye disease, it is highly treatable. Common treatment options include corrective eye glasses and (toric) contact lenses.

Surgical treatment options have been highly successful at correcting the shape of the cornea. Photorefractive Keratectomy or PKR uses laser beams to change the cornea’s shape. LASIK surgery involves making small incisions on the sides of cornea using laser beams. With Radical Keratectomy, laser beam incisions are made into the cornea.