LASIK (Laser Assisted in Situ Keratomileusis) has actually been around since 1991, though it has continued to evolve to allow more people the ability to have laser eye surgery. It is a 2-step process: the first step is the creation of a flap of corneal tissue. This used to be done with a hand-held motorized instrument with a blade called a microkeratome (which has been around since the 1960s!). While used successfully for many years, many of the safety issues and concerns associated with LASIK were related to the use of this microkeratome. The flap is now created with a femtosecond laser called Intralase®. Intralase® allows your surgeon to offer you an all-laser, no blade laser vision correction, thus the term iLASIK.
Once the flap is created, it is gently lifted and folded over, exposing the inner corneal tissue. The VISX® Star S4 IR Excimer Laser then removes the appropriate amount of tissue with a series of cool, computer controlled laser pulses. The first laser procedure was performed in 1986. The flap and laser (or “flap and zap”) combination was the idea of a Greek ophthalmologist, Pallikaris, in 1991. This can be done as a “Standard or Conventional Treatment” or as an “Advanced CustomVue or Wavefront Treatment”. Your surgeon and staff will guide you in the direction that best suits your vision correction needs. The total laser time varies depending on the prescription being corrected, but is usually no more than 60 seconds long.
As mentioned above, there are two ways to instruct the excimer laser to correct your prescription:
Standard or Conventional:
Once all tests and examinations are done, the laser is programmed with your prescription. The treatment is a uniform reshaping of your cornea. While this was the only way to perform laser vision correction for many years, since the advancement of Wavefront technology, a Standard treatment works best for people with low prescriptions, little or no astigmatism, and with smaller sized pupils.
iDesign and Amaris Wavefront-guided treatments:
While all the same tests and examination are performed as for a Standard treatment, there is an additional test done (Wavescan) that then allows your doctor to measure and treat the unique details of your vision along with your eye prescription. While you may have the same prescription as another person, every eye is unique and thus, your laser vision correction procedure should be just as unique and personalized. Though this is a good treatment for any type of prescription, it is especially needed for people with higher prescriptions, those with astigmatism, and those with larger pupils, as a Wavefront treatment allows the laser to customize its diameter to reduce the risk of glare or halos at night. The clinical end result and benefits of Wavefront treatments include: better chances of 20/20 vision without glasses, better quality of vision and better quality of night vision.
Once the treatment is completed, the flap is gently repositioned. It will securely adhere within two or three minutes. After confirming proper positioning of the flap, you will have some clear protective shields placed over your eyes to protect them as you return home to rest for several hours.
With the use of the Intralase® laser, your surgeon is able to tailor the corneal flap to best suit each individual eye. Due to its accuracy, LASIK may now be a possible option for patients who previously did not qualify. Dr. Rocha has been using the Intralase® since 2004 and was among the first in Western Canada to provide it as an option.