Improving Your Vision With Precision

From a military pilot being able to go back to duty and not worry about his vision, to a mom being able to watch her children in a dance recital, LASIK can provide better vision. LASIK, which stands for laser in-situ keratomileusis, is the most commonly performed type of laser eye surgery today. Although this procedure does not promise perfect vision, it can reduce or eliminate a person’s dependence on glasses or contact lenses.

The Different Types of LASIK

The cornea is the eye’s protective outer layer. In addition to protecting your eye, it plays an important role with your vision. As light enters your eye, it gets refracted by the cornea’s curved edge – allowing you to focus on objects near and far. Over time, though, changes can result in poorer vision. LASIK allows your physician to reshape the cornea, paving the way to better eyesight.

The procedure involves creating a “flap” on your cornea, gently folding the top layer of the cornea back so that the surgeon can reshape your eye underneath. Once the reshaping is complete, the flap (or a superficial cut along your cornea) is folded back onto the eye, without the need for stitches to secure it. LASIK has now advanced to be blade-free, using a laser to create the flap, which has added more precision and safety in the LASIK procedure.

There are several different types of LASIK:

• Conventional LASIK. The original form of LASIK eye surgery, in which the IntraLase laser is used to make a flap and does not include wavefront technology.
• Custom LASIK. Specialized wavefront technology looks at optical aberrations or distortions, which can include astigmatism. The laser then uses this information to improve your vision.
• Monovision LASIK. This technique corrects one eye for distance and the other for reading vision.
• Blade-free LASIK. Unlike mechanical instruments, IntraLase technology is uniquely able to program the dimensions of your flap based on what's best for your eye. Blade-free LASIK can be done with any of the above procedures.

Similar to LASIK, photo-refractive keratotomy (PRK) uses the same type of laser. However, a corneal flap is not created. Instead, the laser beam is applied directly to the surface of the eye to reshape the cornea. This procedure is appropriate for both nearsightedness, farsightedness and astigmatism.

Are You a Candidate for LASIK?

“The first thing is to come in for a consultation. Not everyone is going to be a candidate, so that is often the most important decision in the process,” explains Northwestern Medicine Ophthalmologist Paul J. Bryar, MD. For example, individuals with severe dryness or certain corneal conditions such as keratoconus, and people who are taking certain medications may not be good candidates. Additionally, women who are pregnant or nursing should not undergo this procedure. If you have already had previous refractive surgery, it may or may not be recommended to undergo again.

If you are an eligible candidate, the procedure is relatively quick, around 20 minutes. Here are some of the steps you can expect during the blade-free LASIK procedure:

• Ultra-fast pulses of laser light position microscopic bubbles at a precise depth predetermined by your physician.
• The laser light passes through your cornea.
• The IntraLase laser stacks bubbles around your corneal diameter to create the edges of your flap.
• The physician will then gently lift the flap to allow for the second step of your LASIK treatment.
• Then, using the laser beam, the cornea is reshaped to allow for better vision.
• When treatment is complete, the flap is gently put back into position and the healing process begins.

“A patient usually goes home in about an hour. We encourage them to rest. Around 80% to 90% of your vision will come back overnight,” says Dr. Bryar. Most people will be able to return to work the following day. Your vision should stabilize within the first few weeks after your procedure. In most cases, the improvement will be permanent. About 5% of people may need a laser enhancement to correct any residual nearsightedness, farsightedness or astigmatism over time.

When Is the Right Time?

LASIK is an elective surgery, and having the procedure is a personal decision. Dr. Bryar suggests LASIK is something to consider if you feel your current glasses or contacts are affecting your lifestyle and want to do something to eliminate those needs. This threshold might be different for everyone.

“Vision is such a precious thing,” says Dr. Bryar. “It’s a privilege to be able to have a positive impact on people’s lives like that.”

Learn more about LASIK and if this procedure is right for you.