THE LASIK PROCEDURE - STEP-BY-STEP

LASIK, when performed by an experienced surgeon, takes about 4 to 5 minutes to complete, about the same length of time as PRK. Both PRK and LASIK procedures are completely painless. Patients are always amazed at the ease of both these procedures because of their speed and comfort. In both procedures only topical anesthetic drops are used to numb the eye for the procedures. An eyelid holder is inserted to prevent blinking while the drops eliminate the reflex to blink.

In the PRK procedure, the protective epithelial layer is first removed revealing the next layer known as Bowman's layer. Epithelial removal can be performed mechanically or with the laser, with most surgeons using the mechanical technique which is felt to be more predictable.

With LASIK, the epithelial layer is left intact, allowing for not only faster visual recovery but improved comfort and safety. With PRK, the surface of the cornea is lasered with the patient's prescription, removing Bowman's layer.

STEP 1   A suction ring is placed on the eye to secure the eye and maintain pressure within the eye while the corneal flap is created.

STEP 2   A microkeratome, an automated microsurgical instrument similar in design to a carpenter's plane, is used to create a thin corneal flap which remains hinged by the nose or beneath the upper eyelid. The corneal flap is about 150 microns thick, about 30% the corneal thickness which is typically about 550 microns. The creation of corneal flaps has actually been performed for four decades providing us with a long history of safety and stability. Patients do not feel or see the cutting of the corneal flap, which takes only a few seconds.

STEP 3   The corneal flap is then laid back and the inner stromal layers of the cornea lasered with the patient's prescription.

STEP 4   The corneal flap is then closed and the flap and interface cleaned with a sterile solution.

Once the procedure is completed, most surgeons wait 2 to 3 minutes to ensure the corneal flap has fully re-adhered. At this point, patients can blink normally and the corneal flap remains secured in position by the natural suction within the cornea. While it is possible to dislodge the corneal flap during the first day or two by physically rubbing the eye vigourously, this event is actually quite rare. After the first week, LASIK patients can resume their normal exercise and activities.

Since the protective layer remains intact with LASIK, no bandage contact lens is required. LASIK patients are only placed on an antibiotic and anti-inflammatory eye-drops for 2-3 weeks. Whereas the vision is usually quite blurry with PRK for 3 to 5 days, it is usually quite good within 12-24 hours with LASIK.

LASIK patients are instructed not to vigourously rub their eyes for 3 days. Most patients are able to travel immediately and return to normal activities within 1 week.