LASIK Eye Surgery (cont.)
J. Bradley Randleman, MD
Dr. Randleman received his BA degree from Columbia University in New York City. He earned his MD degree from Texas Tech University in Lubbock, Texas, where he was elected to the Alpha Omega Alpha Medical Honor Society. He completed his residency training at Emory University, serving as Chief Resident in his final year. He then completed a fellowship in Cornea/External disease and refractive surgery at Emory University.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- What is LASIK?
- How does LASIK work?
- What is refractive error?
- What are the primary types of refractive error?
- How do glasses or contacts improve vision in people with refractive errors?
- What happens to vision when we age?
- Are there different types of LASIK?
- What is conventional LASIK?
- What is wavefront-optimized LASIK?
- What is wavefront-guided LASIK?
- What other types of refractive surgery are available?
- Am I a good candidate for LASIK?
- What is my doctor looking for during my evaluation?
- What are the risks of LASIK?
- How do I find the right doctor?
- What should I expect before, during and after surgery?
- What are the advantages of LASIK surgery?
- What are the disadvantages of LASIK surgery?
- LASIK checklist
- Find a local Eye Doctor in your town
What is wavefront-optimized LASIK?
Wavefront-optimized LASIK is the type of laser treatment available on the Wavelight laser. This treatment is also based on the patient's glasses prescription, but also takes into account corneal curvature and thickness, and applies laser energy in a unique fashion in the periphery of the cornea. This laser has been found to reduce the aforementioned complications such as glare, halos, and other nighttime visual aberrations that can occasionally occur with conventional treatments.
What is wavefront-guided LASIK?
Wavefront-guided LASIK, also referred to as custom LASIK or wavefront LASIK, is similar to conventional LASIK, except that in addition to treating a patient's basic refractive error, specific alterations in a patient's eye (high order aberrations) can also be treated. In wavefront-guided LASIK, special mapping is performed prior to surgery to identify any small irregularities in the patient's optical system. When these irregularities are severe, they can affect vision quality, contrast sensitivity, and night vision. When significant irregularities in a patient's wavefront mapping are found, wavefront-guided LASIK can be used, and the treatment will be based on the wavefront-map generated.
What other types of refractive surgery are available?
Other types of refractive surgery are available and may be more appropriate than LASIK for certain individuals.
Advanced surface ablation: There are a variety of other techniques that utilize the excimer laser to reshape the cornea in much the same way as LASIK, but without the creation of a corneal flap. These are generically termed advanced surface ablation (ASA) and include photorefractive keratectomy (PRK), laser subepithelial keratomileusis (LASEK), and epipolis laser in situ keratomileusis (Epi-LASIK). All of these techniques involve first removing the most superficial corneal layer (epithelium) and then performing excimer laser ablation.
Phakic intraocular lenses: For patients with extreme myopia, LASIK and advanced surface ablation are not reasonable options. In these cases, a phakic intraocular lens may be used. This lens is implanted inside the eye and can effectively treat nearsightedness up to -20 diopters.
Conductive keratoplasty: Conductive keratoplasty (CK) is a technique that can be used for the temporary correction of hyperopia or presbyopia. CK involves using radiofrequency waves in the peripheral cornea to cause peripheral corneal shrinkage and central steepening. This procedure is very safe, but its effect is often not long-lasting, and regression is common after a few years.
Intracorneal ring segments: Intacs (Addition Technology, Inc.) are approved for the correction of low myopia and for patients with keratoconus in the U.S. Intacs are micro-thin plastic segments that are implanted into the peripheral cornea in order to flatten the cornea centrally. Once implanted, the rings generally cannot be felt by the patient. These rings can be removed, and their effect is usually completely reversible. They are only able to correct up to -3 diopters of myopia, and visual recovery is generally slower and less predictable than LASIK.
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