LASIK - Laser Eye Surgery - Lasik Eye Surgery - Ophthalmologist - Orange County
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PRK ("No-Touch" Laser Vision Correction)
PRK or Photo-Refractive Keratectomy treats refractive errors by removing tissue from the surface of the cornea. First, your eye is numbed using a topical or eye drop anesthesia. Then, a surgeon removes the epithelium, a thin layer of protective skin that covers the cornea. This is done with either a brush or the excimer laser. During the actual procedure, the patient stares at a fixation light. In less than a minute, the laser removes the proper amount of tissue while it reshapes the surface of the cornea.

A bandage contact lens is placed on the eye for 2-3 days. Because the ephithelium was removed, patients may experience blurry vision for three to five days. Eye drops and the contact lens are effective in reducing postoperative discomfort. Final visual results may be fully realized anywhere from several days to a few months as the surface heals in accordance to each individual's healing tendencies. PRK is used to treat low to moderate amounts of nearsightedness, astigmatism, and farsightedness.

LASIK or Laser Assisted in-Situ Keratomileusis treats refractive errors by removing corneal tissue beneath the surface of the cornea. This procedure combines the accuracy of the excimer laser with the benefits of the Lamellar Keratoplasty (LK) in which an instrument called a microkeratome allows the surgeon to fold back a thin layer of the cornea.

Then the excimer laser removes the proper amount of corneal tissue with much greater accuracy. How much tissue is removed is controlled by the number of pulses and the size and shape of the laser beam. The thin flap of corneal tissue is then folded back into its original position where it bonds after only a few minutes of drying. No stitches or eye patches are required after the procedure.

Since only the edge around the corneal flap needs to heal, visual recovery is rapid and patients report little or no postoperative pain. Additionally, there may be less risk of scarring and developing corneal haze. There is also less need for postoperative medications with LASIK than PRK. However, because of the microkeratome, LASIK carries additional surgical risks.

LASIK also treats low to moderate amounts of nearsightedness, farsightedness, and astigmatism.

Comparison of PRK & LASIK

This information is presented to demonstrate the relative differences between PRK and LASIK. Additional factors such as surgeon experience and preference, type of laser, age of patient, amount of correction and clinical protocols may effect these comparisons.

Range of Correction
Low to moderate
Low to moderate
Wound Depth
20% deep
Intraoperative Pain
Postoperative Pain
Mild 24-48 hours
Minimal 12 hours
Postoperative Medications
3 months possibly more
1-2 weeks
Functional Vision Recovery
3 to 5 days
24 hours
Return to Work
1 to 5 days
1 day
Visual Results Fully Recognized
3 weeks to several months
1 to 4 weeks
Risk of Complications
Greater but still low
Long term weakening of cornea

Other Refractive Procedures

LASEK (Laser Assisted Epithelial Keratomileusis) is a new procedure that combines the best of PRK and LASIK. A very thin flap, consisting of epithelium only, is created and then the excimer laser correction is performed. Because the flap is so thin, the flap complications that may occur with LASIK and the corneal weakening that always occurs with LASIK are eliminated. At the same time, the post-operative discomfort associated with PRK is minimized. LASEK is still considered investigational and an "off-label" use of the excimer laser, so a special patient consent is required.

PTK or photo-therapeutic keratectomy is not strictly a refractive procedure but it is performed with the same excimer laser used for LASIK, PRK, and LASEK. PTK is used to remove certain corneal scars and smooth out corneal irregularities that might otherwise require a corneal transplant.

AK or astigmatic keratotomy is a refractive procedure but it is not done with a laser. Instead, it is a micro-surgical technique in which very tiny relaxing incisions are made in the cornea in order to reduce astigmatism. Either naturally occurring astigmatism or that caused by surgical procedures such as cataract extraction or corneal transplant may be treated in this way. The procedure is painless, takes only a few minutes, and may often be done in the office.

Are You a Candidate For Laser Vision Correction?
In general, the ideal patient has a healthy cornea, and must not have had a significant increase in their prescription in the last year. People with certain medical conditions or pregnant women may not be good candidates.

Realistic Expectations
The decision to have Laser Vision Correction is an important one that ultimately, only you can make. It is important that you have realistic expectations and that your decision is based on facts, not hopes or misconceptions. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses. Laser Vision Correction does not always create 20/20 or even 20/40 vision. It cannot correct a condition known as presbyopia, or aging of the eye, that normally occurs around age 40 and may require the use of reading glasses. In fact, people over 40 who have their nearsightedness reduced with surgery may find they need reading glasses after the procedure. Your doctor will provide you with additional information that will allow you to make an informed decision.

The First Step
Finding out more about the health of your eye and your refractive error is your first step toward visual independence. This is accomplished by calling us to schedule a complimentary personal consultation. Should your refractive error fall within the range of correction for Laser Vision Correction, more comprehensive tests will be necessary. This information will help you and your doctor determine which procedure is in your best interest.

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