Procedure

LASIK is an acronym for Laser Insitu Keratomileusis, which means, "to shape the cornea within using a laser". Lasik, as opposed to PRK, corrects vision by reshaping the inner layers of the cornea so that light rays focus more precisely on the retina, thereby reducing or eliminating refractive errors. Patients are first given a medication to relax them. Antibiotic, anesthetic and anti-inflammatory drops are then instilled in the operative eye. The surgeon covers the eyelashes and applies a lid speculum to hold the eyelids open. A surgical drape is placed over the patient's face, leaving the eye to be operated on exposed. The patient will remain awake and comfortable throughout the procedure. The next step involves the creation of a thin flap of corneal tissue that is hinged at one spot. At Laser Institute of the Rockies we have two different methods of creating this flap. One is to use the standard mechanical microkeratome and the others involves the use of a second laser in lieu of the microkeratome. Which method is used is determined by the doctor and patient at the time of their pre-surgical evaluation. TRADITIONAL LASIK involves the use of a mechanical microkeratome to cut the flap of corneal tissue. A small suction ring is placed on the eye. Similar to a donut, the ring has a large central hole, which is centered over the entire cornea. This serves as a platform for the microkeratome and to correctly position it to make the corneal flap. It's normal for the patient to feel some pressure when the suction is turned on and for vision to temporarily go dim or black. The microkeratome is placed on the suction ring platform. The surgeon then engages the electric motor and the microkeratome begins its forward pass across the eye. After nearly cutting a circle, the blade reaches a "stop", creating a hinged corneal flap. The microkeratome direction is then reversed. When the reverse pass is completed, the suction is turned off and the microkeratome and suction ring are removed from the eye. This whole process last only 10-15 seconds and the red fixation light will again be visible. LiteTouch IntraLASIK involves the use of a femtosecond laser to create the flap of corneal tissue. A small suction ring is placed on the eye. This serves to hold the eye in a fixed position while the laser is operating. It is normal for the patient to feel some pressure when the suction is turned on, although it is dramatically less than from the suction ring with the microkeratome. The laser is aligned and begins delivering rapid energy pulses to a predetermined depth within the cornea. The cool, laser beam actually creates a tiny bubble with each pulse. It lays down a bed of thousands of these bubbles in a pattern starting in the center and spiralling outward to a predetermined size. When it finishes preparing the bed of the flap , it then creates the side cuts leaving a small area uncut to act as a hinge. Once this is complete, the suction ring is removed. This whole process lasts approximately 50 seconds and the red fixation light will again be visible. After the corneal flap is created, whether by the microkeratome or the femtosecond laser, the surgeon uses a special instrument to lift the flap, inspect it, and gently fold it out of the way. The patient is instructed to lock their gaze on a red target light and the surgeon aligns the laser with the patient's eye. The surgeon then engages the laser and a cool beam of ultraviolet light starts to reshape the exposed "stromal" layer of the cornea to the proper curvature. A clicking sound can be heard as the "flying spot" beam of laser energy moves around the stromal bed removing microscopic amounts of tissue. This process will last from 30 to 90 seconds, depending on the amount of correction that was programmed in the laser. The corneal flap is then carefully placed back into its original position. The surface of the flap is gently stroked with a special sponge to smooth the flap into its correct position. It is then allowed to dry for a few minutes. It adheres by itself - without stitches- due to the eye's natural intraocular pressure. In the case of correcting myopia, the cornea is now "flattened" and the light rays will now be able to focus correctly on the retina.