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LASIK is a safe, reliable and painless way to improve vision without the need for glasses or contact lenses. LASIK, which stands for laser assisted in-situ keratomileusis, is a form of refractive surgery that changes the way light is bent, or refracted, as it passes through the cornea so that it focuses properly on the retina in the back of the eye and objects can be seen clearly. The procedure is effective for many patients with nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.
During the procedure, a device called a microkeratome creates a flap in the outer layer of the cornea called the epithelium. Patients are given topical anesthesia and a mild sedative so they are awake but calm and cannot feel the instruments. The epithelial flap is lifted and an excimer laser beam adjusts the corneal curvature so objects no longer appear blurry. The cornea is steepened for hyperopic patients, flattened for myopic patients, and made more spherical for patients with astigmatism. The flap is then closed.
The entire LASIK procedure takes only 15-30 minutes per eye, and patients are often ready to leave the office within an hour or two. A common complaint after surgery is sensitivity to light, but this will subside. Antibiotic eye drops will be prescribed for a few days, along with any other post-operative instructions. Full recovery takes a few weeks.
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We are pleased to now offer IntraLase™ to our patients. Intralase is a bladeless, computer-guided technology that is the latest advancement in LASIK technology. Instead of a microkeratome, Intralase creates the corneal flap with laser energy. Ultrafast pulses of laser light create rows of microscopic bubbles just beneath your corneal surface in a uniform plane.
Then, the IntraLase laser stacks bubbles around your corneal diameter to create the edges of your flap. These bubbles are stacked at an angle that is determined by Dr. Goodman and is individualized to the way your eye is shaped. The process takes only about 30 seconds from start to finish—it’s quiet and it’s comfortable. Once the flap is made, Dr. Goodman gently lifts the flap to allow for the second step of your LASIK treatment. When treatment is complete, the flap easily “locks” back into position and rapidly begins to heal. Both the microkeratome and Intralase create thin, precise corneal flaps, yielding excellent results. During pre-operative consultation, Dr. Goodman will determine which technology is most appropriate for each individual patient.
PRK, or photorefractive keratectomy, is also a type of laser refractive surgery. Unlike LASIK, a flap is not created within the cornea. Instead, the epithelium, the outer one cell width layer of the cornea, is removed to expose the inner layers of the cornea. The same excimer laser that is used in LASIK is then utilized to reshape the cornea to correct for nearsightedness, farsightedness, and astigmatism. A bandage contact lens is placed on the eye, and the epithelium grows back over a period of two to three days. This procedure is more appropriate for patients who have thinner corneal thicknesses and who may not be candidates for the LASIK procedure. Testing during the pre-operative consultation will determine if a patient is a candidate for the LASIK or PRK procedure.
Using methods similar to those in cataract surgery, refractive lenses are implanted in front of (phakic intraocular) or in place of (clear lens replacement, or CLR) the eye’s natural lens. Both procedures use local anesthesia and take approximately 15-30 minutes.
Phakic Intraocular lenses are implanted in front of the patient’s natural lens either in the anterior chamber (in front of the iris) or the posterior chamber (between the iris and natural lens). The new lens helps the patient focus better, leaving the natural lens in place allowing the patient to “accommodate,” or shift focus between distant and nearby objects. The procedure is reversible.
Clear Lens Replacement (CLR) is usually recommended to patients over 45 who wear bifocals, since it replaces the natural lens with an artificial one that cannot “accommodate” (shift focus between distant and nearby objects). Three options are available to correct for this loss:
- Bifocal or multifocal glasses or contact lenses
- Multifocal lens implants have several built-in correction levels which the
brain chooses from for the clearest view of any given object
- Monovision- the eyes are adjusted so that one focuses on distant objects
and the other on nearby objects
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