Looking into Vision Correction Surgery?
There are more corrective laser surgeries available today than ever before. Patients who may not have been able to have surgery done 20 years ago now have a variety of options to grant them clearer vision. At B-Town Eyecare, we will explain all of your refractive surgery options.
Visit Us For a Consultation
We will begin your consultation by performing a thorough eye examination to determine what level of correction is needed. We will also ensure that there are no conditions or eye problems that would make you an inappropriate candidate for laser eye surgery. Once we have completed your examination, we will explain the procedure which best suits your needs and give you an idea of what to expect. This is also your opportunity to ask any questions you might have and address any concerns that may have come to mind. Your comfort is important to us, so we will be sure to take our time responding to your questions, ensuring you understand and are satisfied with our answers.
Your Eye Health is in Capable Hands
Pending the results of your consultation, we will refer you to an ophthalmologist for surgery. Nothing is more important to us than the health and safety of our patients, which is why we refer them only to exceptionally skilled and experienced local surgeons. We will always follow up with you after your procedure to ensure you are healing properly and to test your vision.
Types of Refractive Surgery
Many people think that LASIK is the only type of refractive surgery, and today LASIK is the most commonly performed corrective eye surgery in the United States, but in truth, there are many different types and variations of LASIK and refractive surgery procedures to choose from. Refractive surgery, also known as corrective eye surgery, encompasses a multitude of procedures designed to treat and correct refractive errors including nearsightedness, farsightedness and astigmatism. In each of these procedures, a laser is used to reshape the cornea to alter the way light rays enter the eye to achieve focus. The process used, however, differs from surgeon to surgeon. There are a variety of corrective surgeries available. We will recommend the one that is most likely to yield the best results for you.
Types of Vision Correction Surgery
The reshaping of the cornea is often the focus of vision correction surgery. This is the transparent layer coating the front of the eye. Light travels through the cornea and focuses on the retina, in the back. Other types of laser eye surgery replace the natural lens. Vision correction surgery options include:
Laser In-Situ Keratomileusis
This popular laser eye surgery is highly-effective for patients who are nearsighted, farsighted or those with impaired vision due to astigmatism. During the LASIK procedure, the tissue beneath the cornea is reshaped to improve how the eye focuses light. A flap is also created in the outer later so the doctor can gain access to the area underneath the cornea. Laser in situ keratomileusis, or LASIK, is the most commonly performed refractive surgery procedure today. LASIK has advantages over other procedures, including a relative lack of pain and the fact that good vision is usually achieved almost immediately or in a very short period of time. With LASIK, the instrument used to create the flap varies. Many surgeons use an instrument called a microkeratome. A microkeratome is a device that uses a very sharp oscillating blade to cut the flap. Other surgeons prefer a more advanced bladeless technique, using a very precise laser to create the flap instead. Many surgeons use a femtosecond laser to create the flap during LASIK surgery.
Photorefractive Keratectomy (PRK)
For mild to moderate nearsighted, farsighted and astigmatism cases PRK can be used to transform the cornea with a laser, much like LASIK. The difference, PRK only affects the surface of the cornea, the underlying tissue is not touched, and there is no flap. Photorefractive keratectomy, or PRK, was the first refractive procedure that utilized the excimer laser to reshape the front surface of the cornea. After the eye has been anesthetized with topical eye drops, your doctor prepares the eye by removing the surface layer of the cornea called the epithelium. This layer naturally regenerates itself every few days. Pulses of laser light are then applied to the surface of the cornea to reshape the curvature of the eye. Postoperatively, patients typically wear a bandage contact lens for the first three to five days to reduce postoperative pain and irritation. Anti-inflammatory eye drops are used in a decreasing dose for several months. Vision is usually blurry initially and starts to clear over the first several weeks, while continuing to improve for up to one year.
Laser Epithelial Keratomileusis, (LASEK)
Laser Epithelial keratomileusis, or LASEK, is a laser procedure that is used mostly for people with corneas that are too thin or too flat for traditional LASIK. It was developed to reduce the chance of complications that occur when the flap created during LASIK is not the ideal thickness or diameter. In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome blade or laser used in LASIK, but with a blade called a trephine. Next, the surgeon covers the eye with an alcohol solution for around 30 seconds. The solution loosens the edges of the epithelium. After sponging the alcohol solution from the eye, the surgeon uses a tiny tool to lift the edge of the epithelial flap and fold it back out of the way. Then the surgeon uses an excimer laser, as in LASIK or PRK, to apply pulses of laser light that sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye. There is a possibility of a reaction to the alcohol that may kill some of the epithelial cells. Patients typically wear a bandage contact lens for around four days and may feel eye irritation during the first few days afterward. The time it takes to recover good vision is up to four to seven days longer than with LASIK.
Epi-LASIK is a cross between LASIK and LASEK. During Epi-LASIK, a flap is cut in the cornea’s outer layer, just as in LASIK and LASEK. However, with Epi-LASIK the surgeon uses a blunt, plastic oscillating blade. Instead of the alcohol that is used in LASEK to loosen the epithelial sheet, during Epi-LASIK the surgeon uses the blunt plastic blade, called an epithelial separator, to scrape the sheet across the eye. Next, the surgeon uses an excimer laser, as in LASIK, LASEK or PRK, to apply pulses of laser light that sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye. Then, a special contact lens is placed on the eye to keep the flap in place while it re-epithelializes. Vision will probably be cloudy or variable at first, unlike traditional LASIK. Some patients report good vision within a week or two, while others take three to six months to reach their final result. These recovery times are significantly longer than with LASIK, which usually allows people to achieve good vision from the same day up to a few weeks later and to drive by the day afterward.
Lens Implants — An Alternative to LASIK
LASIK surgery is not an option for everyone. A very high refractive error, thin corneas or severe dry eye may prohibit someone from being a good LASIK candidate. Fortunately, implantable lenses may provide an alternative. Examples of these lenses include the Visian’s Intraocular Collamer Lens and Alcon’s Acrysof® ReSTOR® Intraocular Lens. Unlike LASIK, which reshapes the outer part of the eye, lens implants are inserted inside the eye. Once in place, the lens stays in place indefinitely and should require no maintenance.
Refractive Lens Exchange (RLE)
This vision repair procedure is the same as cataract surgery. A small incision is made on the edge of the cornea. The surgeon removes the natural lens and replaces it with a prosthetic lens. This refractive eye surgery can effectively treat severe farsightedness or nearsightedness. To correct astigmatism, RLE may be combined with LASIK or some other similar procedure.
Phakic Intraocular Lens Implants
This vision correction surgery is ideal for severely nearsighted patients who are not candidates for LASIK and PRK. A small incision is made at the edge of the cornea, and the implant is attached to the patient’s iris or is inserted behind the pupil. The natural lens remains intact.
Are you a candidate?
How well you see without glasses or contact lenses following laser vision correction eye surgery depends in part on your vision before the procedure. In most cases, you will be able to obtain the same vision correction with laser surgery as you had with glasses or contact lenses. People with mild prescriptions generally have the best success in obtaining normal vision after eye surgery procedure. People with more severe vision prescriptions may require glasses or contact lenses for some special situations such as night driving. People who undergo an eye surgery procedure for vision correction agree that it has made a positive impact on their quality of life. Laser vision correction is right for many people, but it is not for everyone. If many or all of the following statements are true for you, you may be a good LASIK candidate and should call us for a refractive surgery consultation.
Questionnaire: Are you a LASIK candidate?
If you answered yes to many or all of these questions, you are likely to be a good candidate for laser vision correction. Call us at 206-242-8545 to schedule a refractive surgery consultation!
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Due to the current circumstances with COVID-19 and our commitment to keeping our patients, staff and the general public safe, we will be temporarily closed. We expect to be able to see patients again on April 1st and we will provide updates via our website and social media.
Dr. Bansal will continue to manage emergent cases. If you have any urgent issues with your ocular health and need to be seen immediately, please email [email protected] immediately and she will get back to you as soon as possible.
If you need to order contact lenses, please email us and we can have them shipped directly to your home from our vendor.