LASEK, or Laser Assisted Sub-epithelium Keratomileusis, uses the excimer laser as in LASIK, but the flap is not cut with a microkeratome. Instead, the flap is made with a finer blade made of an alcohol solution called a trephine. The alcohol solution softens the outer layer of the cornea (the epithelium) and then it is rolled back into a flap. LASEK laser eye surgery is often preferred for patients with very thin or very steep corneas, patients with dry eye, or patients who engage in activities that put their eyes at risk, such as boxing.

LASIK eye surgery is used to correct refractive errors in the eye with the use of two sophisticated surgical methods, the microkeratome to cut a corneal flap and a excimer laser to reshape the corneal surface. The term LASIK is derived from “laser in-situ keratomileusis,” the Greek word “keratomileuses” means “to shape the cornea” and “in-situ” means “in place.” While we know LASIK as laser eye surgery, it literally means “to reshape the cornea in place using laser.”

How do I know if LASIK surgery is right for me?

If you are interested in LASIK surgery, in order to decide if it is the right option for you, take the time to research, ask questions, and view the options. Websites such as this one and many others can provide you with information to help you with your decision. If LASIK surgery is something you want to pursue, the next step is to choose a doctor and determine if you are a good candidate for laser eye surgery.

What is a microkeratome?

A microkeratome is a very flat and thin metal blade used in LASIK surgery to cut the corneal flap. The device is affixed to the eye with a vacuum ring, the cornea is flattened with a clear plate, and the cut is made under the plate. The microkeratome technique was first used in combination with laser treatment in the early 1990’s, but it had been used successfully for about 30 years before that in South America in non-laser applications.

What is an excimer laser?

An excimer laser is a cold, invisible, ultraviolet laser used in LASIK to remove corneal tissue and reshape the surface of the cornea to correct the refractive error. The excimer laser was approved by the FDA in 1995 for the use of correcting nearsightedness, but the technology was originally developed for etching computer chips. The excimer laser is a able to remove tissue accurately without producing heat that could harm surrounding tissue. The excimer laser is also used in PRK.

What is Wavefront LASIK?

Wavefront technology allows LASIK treatment to be customized to each patient. With Wavefront, the surface of the eye is mapped and measured to determine exactly where and how much tissue needs to be removed to correct the refractive error. Because treatment is customized, many patients can expect better results than with conventional LASIK.

What is IntraLase?

IntraLase is one of the new advancements in LASIK technology. With IntraLase, the corneal flap is cut with a laser, rather than with a microkeratome. While this advancement costs more than conventional LASIK, many believe it has benefits that are worth paying more for, including a more accurate and cleaner cut when making the flap, a flap that adheres more firmly to the underlying corneal surface when healed, and the ability to treat patients with thinner and flatter corneas that might not be good candidates for conventional LASIK.

What is monovision?

Monovision is when eyesight is corrected so one eye is used for near vision and the other eye for distance vision. The reason for monovision is to limit the effects of presbyopia, the condition that first affects just about everyone sometime during their 40’s and 50’s. As we age, the crystalline lens in our eyes loses flexibility and it is difficult to see up-close. The primary advantage of monovision is to reduce or eliminate the need for reading glasses for close-up vision. Although the exact treatment will vary based on a patients current eyesight, for many LASIK patients this means laser eye surgery is only performed on the dominant eye which will be used for distance vision. The brain then learns which eye to use and when. Many patients are able to adapt to monovision, but some are not, so it’s important to discuss the advantages and disadvantages with your doctor.

What is dry eye?

The symptoms of dry eye are discomfort and a feeling of dryness, burning or stinging, or grittiness in the eye. With LASIK, some patients may experience temporary dry eyes as the eyes heal and may need to use artificial tears to help soothe the eyes. Individuals with severe dry eye before laser eye surgery, may not be good candidates for LASIK treatment. Dry eyes can occur from many conditions such as aging, corneal ulcers, infections, or climate. Two of the most common tests used are the tear breakup test (TBUT) or Schirmer’s test. Schirmer’s test helps determine if the eye produces enough tears to keep it moist by inserting paper strips under the eyelid to measure the production of tears. Before undergoing LASIK surgery, make sure your doctor tests you for dry eyes.

What is an enhancement procedure?

An enhancement procedure is a follow-up treatment that is done to refine or improve the original LASIK results. Although most patients don’t require an enhancement procedure, some patients might. The LASIK patients that usually need an enhancement treatment are those with a large refractive error, as outcomes are more difficult to predict with large refractive changes than small changes. Before additional treatment is performed, the eyes need time to heal and stabilize. Most enhancement procedures are performed between three and six months after the first LASIK surgery. During your pre-op appointments, make sure you discuss with your doctor how he handles the cost and determination for enhancement treatments.