Treating Refractive Eye Problems with LASIK

What does LASIK Stand for?

LASIK stands for Laser Assisted In-Situ Keratomileusis.  It is a one of the techniques used in corneal or refractive eye surgery intended to correct astigmatism, myopia or nearsightedness and hyperopia or farsightedness.  As the term suggests, it uses laser technology and the procedure represents current medical advances in radial keratotomy in treating vision problems.  Refractive surgery is one of the viable alternatives to correcting such problems if you don’t want to bother wearing prescription contacts or eyeglasses that are the more common solutions. And LASIK, along with PRL (Photorefractive Keratectomy) represent the latest in refractive surgical technologies.

A Short History

The technique was made possible in an eye clinic in Bogota, Columbia by a noted local ophthalmologist Dr. Jose Barraquer sometime in 1950.  He developed the world’s first microkeratome and the surgical procedure called Keratomileusis for cutting thin flaps in the cornea to alter its shape while retaining the right corneal mass unaltered to create long term prognosis.  In 1970, the procedure was enhanced to develop radial keratotomy by Dr. Svyatoslav Fyodorov.  It was in 1983 after the excimer laser was first patented in 1973, that another Columbian ophthalmologist Dr. Steven Trokel of the Edward S. Harkness Eye Institute published an article in the American Journal of Ophthalmology about the use of the lasers in refractive surgery. He along with other professionals founded the VSX Corporation that developed the excimer lasers.

Three years earlier, the Rangaswamy Serinivasari from the IBM Research Lab that discovered ultraviolet excimer laser as a suitable option in etching living tissue with precision never before possible and without thermal damage to adjacent tissues. He named the procedure as APD or Ablative Photodecomposition.  Finally, the first human eye surgery was performed by Dr. Marguerite B. MacDonald in 1989 using a VSX laser system.

The LASIK procedure had been successfully performed in other countries before the US benefited from it. It was first patented as a “method for modifying corneal curvature” in the name of an Iranian American Ophthalmologist Dir. R. Gholam A. Peymen in June 1989, who is generally credited for the LASIK invention. The US-FDA only started excimer laser trials in that year and the LASIK concept was first taught to a few surgeons chosen by the FDA in 1992 by Dr. Ioannis Pallikaris who is credited for performing the first LASIK procedures on the human eye.

How is it Done?

The operation itself is straightforward, involving the creation of a flap on the cornea, folding it to remodel the tissue underneath with a leaser and then repositioning the flap to heal during the post operative period.  It is faster and less painful than other laser-based refractive surgery such as PRK or Photorefractive Keratectomy. There are just several pre-operative preparations to do

• Preparation: Contact lens wearers are advised to stop wearing them in 5-21 days poor to surgery. Those wearing hard contacts are instructed to desist wearing them for a minimum of 6 weeks with another 6 weeks for every 3 years they have been worn.  Before surgery, a pachymeter is used to determine the corneal thickness and a topographer to measure the contour. The information is used to calculate the location and amount of corneal tissue to be removed.  Patients are usually prescribed with antibiotics prior to the procedure.
• As a local outpatient procedure, local anesthesia drops are applied as well as mild sedative like valium is administered.
• LASIK operation involves three stages.  First is the flap creation where the ophthalmologist or eye surgeon uses a microkeratome or femtosecond laser to excise a flap of the corneal tissue ranging in thickness from 80 to 100 micrometers. It is folded back to reveal the corneal stroma or mid section and the process can cause discomfort. Second is the laser remodeling where the excimer laser (193nm) precisely vaporizes corneal stroma tissues to reshape it. And the last step is to reposition the reshaped stroma layer, checked for air bubbles and debris before leaving it for natural adhesion until healed. No suturing is needed.
• Postoperative Care:  A course of anti-inflammatory and antibiotic medication is administered lasting for weeks after surgery.  Patients are advised to sleep more often and use dark sunglasses, not to rub eyes and moisturize eyes with artificial tears that contain no preservatives.

Excellent Results

92% to 98% of LASIK patients have expressed satisfaction with the results in the operation.  A post operation analysis conducted by the American Society of Cataract and Refractive Surgery over the last 10 years ending in march 2008 revealed that 95.4% satisfaction rating of LASIK patients around the world.

Additional Information on Lasik:

• What is Lasik Eye Surgery
• Treatment with LASIK
• General Information and Questions about Lasik
• Lasik Eye Surgery Cost