What is excimer laser surgery?
Excimer laser refractive surgery is an outpatient microsurgical procedure to correct nearsightedness (myopia) by changing the shape of the cornea of the eye so that light rays may focus properly on the back of the eye. The procedure takes about 10 - 15 minutes per eye, depending on the degree of the correction required. It is performed in our clinic, requires no stitches, and involves very little or no pain.
back to top
The history of excimer laser
Laser correction of nearsightedness is a thoroughly tested and clinically proven treatment. Over 2,500 treatments were performed in the U.S. clinical trials for safety and effectiveness. After extensive testing and follow-up over a six-year period, the excimer laser has been proven safe and effective for the treatment of the large majority of nearsighted prescriptions as determined by the FDA. Millions of laser treatments have been done in the U.S. since 1996.
back to top
Photorefractive Keratectomy (PRK)
PRK uses the laser to reshape the corneal surface. The surface layer of cells, or the epithelium, is gently removed from the eye. Then the laser is used to reshape the surface. PRK has a longer recovery period than LASIK, but a better safety profile.
back to top
Laser Assisted In-Situ Keratomileusis (LASIK)
LASIK uses the excimer laser to gently remove a thin layer of corneal tissue, not on the surface, but under a thin flap of corneal tissue. The flap is made with a special shaving device, designed to gently create a reliable thin flap of cornea in seconds. Once the flap is laid aside, the corneal bed is then lasered and the flap is replaced. The flap heals overnight, and there are no sutures required.
back to top
What is the LADARvision Excimer Laser?
The LADARvision4000 system is the newest technology, offering the most advanced excimer laser treatment available today. This unique system combines active eye-tracking and small-beam corneal shaping, providing a new level of accuracy and precision.
back to top
Tour the LADARvision suite
Click here to see an interactive demonstration about the equipment and where you, your doctor and the technician will all be during the treatment.
back to top
How does LADARvision differ from other laser eye treatments?
LADARvision, unlike other excimer lasers, uses LADARtracker, a laser radar system developed by NASA that follows, or "tracks", eye movement at a rate of 4000 times per second. This is much improved over video-based lasers, checking eye movement only 60 times per second. All patients during surgery experience some eye movement during the procedure. These movements can affect the placement of the laser beam and can result in decreased visual acuity following the procedure.
The new LADARvision system allows the patient to completely relax during the procedure and know they will get the best possible results. LADARvision's cool, small-spot laser beam gives an increased accuracy in corneal shaping, removing less corneal tissue than the width of a human hair. Realigning with each laser pulse, the LADARvision system guides the placement of the laser beam to a predetermined location on the cornea.
back to top
Why is tracking important?
Click here to see an interactive demonstration.
back to top
Who may have excimer laser surgery?
Each person suffers from a different degree of nearsigntedness, farsightedness, or astigmatism. The success will vary somewhat depending on:
- The amount of correction
- The general health of the eye
Patients should have a prescription that has been stable for 12 months and should be over the age of 21. The best candidates have:
- A Disease-free Cornea
- Myopia between -1.00 and 13.00 with up to 6 Diopters of Astigmatism
- Hyperopia between +1.00 and +6.00 with up to 6 Diopters of Astigmatism
- Problems Wearing Contact Lenses
- Problems with Glasses Interfering with Professional and/or Social Lifestyle
- No Other Problem which Affects the General Health of the Eyes
back to top
What is the process?
The first step is a presurgical consultation in our office or your optometrist's office. This provides a complete explanation of PRK and LASIK, the benefits, risks, and alternatives. Specialized testing on our EyeSys Corneal Analysis System provides computerized color printouts of the cornea's surface, which help to determine your candidacy for surgery and aid in calculations for surgery. This accurate technology helps make the procedure precise and predictable. You should not wear hard contacts lenses six weeks prior to your evaluation or soft contacts five days before the evaluation.
When your laser is scheduled, you will be given a list of instructions that you must follow prior to having laser. The instructions emphasize that you should not wear hard contact lenses six weeks prior to your surgery or soft contacts five days before the surgery.
back to top
Laser Day
Your laser treatment is performed right here in our office in the surgical suite, and family and friends are welcome to accompany you. Patients must not be wearing any perfumes, aftershave, or strong smelling lotions or creams. (If you can smell it, it will affect the laser beam.) Once you arrive on the day of surgery, drops will be placed in your eye, and you will be given a mild sedative to help you relax.
back to top
What is involved in the LASIK LADARvision procedure?
The doctor will take a picture of your eye to help the laser to determine the exact dimensions of your eye. After your pupil has dilated to the correct size, you will be taken into the LADARvision suite. You will lie down on the table, as the doctor looks into your eye through a microscope. The LADARvision system will confirm the parameters of your eye, matching it to the photograph taken previously.
After your eye is numbed using an "eye drop" anesthesia, an eyelid holder is put in place to prevent blinking. Next, a device called a microkeratome makes a thin protective flap of the outer layer of the cornea, which is gently folded back.
The laser radar beam "locks on" to the eye, constantly checking the eye's movements to know the exact location of the vision correction area. While you relax, a small-spot laser "ablates", or removes, tiny amounts of corneal tissue, gently shaping the inner layer of the cornea to match your vision correction requirement.
When the ablation process is complete, the protective flap of the cornea is folded back into place. After the surgery, you will be given doctor's instructions to follow for recovery.
back to top
How LASIK works
Click here to see an interactive demonstration about how LASIK can treat common vision problems like nearsightedness, farsightedness or astigmatism.
back to top
What is involved in the PRK procedure?
The doctor will take a picture of your eye to help the laser to determine the exact dimensions of your eye. After your pupil has dilated to the correct size, you will be taken into the LADARvision suite. You will lie down on the table, as the doctor looks into your eye through a microscope. The LADARvision system will confirm the parameters of your eye, matching it to the photograph taken previously. After your eye is numbed using an "eye drop" anesthesia, an eyelid holder is put in place to prevent blinking. Next, the doctor gently removes the epithelium with a micro-spatula. The laser radar beam "locks on" to the eye, constantly checking the eye's movements to know the exact location of the vision correction area. While you relax, a small-spot laser "ablates", or removes, tiny amounts of corneal tissue, gently shaping the inner layer of the cornea to match your vision correction requirement. When the ablation process is complete, a soft bandage contact lens is placed on the eye. After the surgery, you will be given doctor's instructions to follow for recovery.
back to top
Frequently Asked Questions
- How long does the treatment take? How long will recovery be?
The laser treatment itself takes about 15-90 seconds, based on the degree of correction necessary. Sometimes, only one eye is treated at a time. Typically, you'll notice improved sight the next day following the treatment, and can usually go back to work in two days. Often patients prefer to be treated on a Thursday afternoon to minimize time away from work.
- How do I know it's safe?
The excimer laser has been proven to be safe and effective for the treatment of the great majority of nearsighted prescriptions. In the U.S. clinical trials' three-year follow-up, no sight-threatening complications have occurred. Millions of laser treatments have been performed in the U.S. over the past five years. As added proof, some of the nation's top eye institutes are working with an independent medical council on an ongoing basis to ensure that the highest standards of safety are met.
- Will I be in any pain?
The treatment itself is painless. Typically, people experience discomfort and a "gritty" feeling during the 24-48 hours after the treatment with PRK, but not LASIK. Patients who are treated will be given medication they can use to control any discomfort they might experience.
- What are the side effects?
The most common side effects are a "halo" effect and some glare at night around lights. However, these problems are no worse than what most contact lens and eyeglass wearers often experience. In addition, the eyes will tend to be drier than usual and may need artificial tear afterwards.
- Will the treatment be permanent?
Given the results of the U.S. clinical trials and the results reported internationally, the treatment appears to be permanent.
- Can I afford the treatment?
Eyeglasses usually have to be replaced once a year or so. And contact lenses can be extremely costly, especially when you add in the cost of solutions. You'll find that laser correction of nearsightedness can probably pay for itself in a few years' time. Although laser is covered by insurance in some cases, it is not common because many insurance carriers consider it an elective surgery. Financial counseling and payment option information is available through our business office.
back to top
The White Eye Associates' ophthalmologists who specialize in diagnosing and treating laser vision correction is Jeffrey J. Viscardi, MD and Robert M. Bauer, II, MD, PhD.
