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LASIK is the acronym for Laser-Assisted in Situ Keratomileusis, one type of refractive laser eye surgery performed to correct vision defects caused by myopia, hyperopia, and astigmatism. During LASIK, a precision surgical instrument with an oscillation blade called a microkeratome is used to create a corneal flap. The normal human cornea varies from around 500 to 600 micrometres in thickness; and in the LASIK procedure, the microkeratome creates a 100 to 200 micrometre thick flap. Once created, the flap is lifted and the precision treatment selected by the surgeon is applied to remodel the tissue under the flap with the laser. Once the laser has been fired, the flap is repositioned and the eye is left to heal. The flap remains in place by natural adhesion, and healing begins immediately. The total surgical procedure often takes less than a minute.

Once the surgery is completed, patients are given a course of antibiotic and anti-inflammatory eye drops. These are discontinued in the weeks following surgery. Patients are also given a darkened pair of goggles to protect their eyes from bright lights and protective shields to prevent rubbing of the eyes when asleep. Both of these items are temporary, and although we recommend a quality pair of sunglasses post surgery, patients may discontinue the use of the goggles and shields after a day or so.

The LASIK procedure is generally preferred to photorefractive keratectomy, or PRK, (also called ASA, Advanced Surface Ablation) because it requires less time for the patient's recovery, and the patient feels less pain, overall. Since the cells covering the outer corneal surface are removed by this procedure, the healing process is around 2-3 days, during which time a soft contact lens or "bandage" lens is used to relieve some of the discomfort. Complete healing from this procedure can often take up to a few weeks, and often requires eye drops to aid the healing process. It should be noted however, that there are instances where PRK/ASA is determined to be a better alternative to LASIK for various medical reasons. For years, patients have chosen LASIK as an alternative to wearing eyeglasses or contact lenses.

LASEK (Laser Assisted Sub-Epithelial Keratomileusis) is a procedure very similar to PRK. The surface lining cells are removed but retained, and replaced after laser sculpting has occurred. The healing process is virtually identical to PRK, since the lining cells can be injured by the removal process, and are replaced by new cells as in PRK post procedure.

All three techniques use the excimer laser to perform the optical sculpting in exactly the same fashion. Performing the laser sculpting under a flap, as in LASIK, eliminates the removal of the epithelial cells, and thereby dramatically reduces any 'foreign body' sensation, discomfort or pain after surgery. Also, visual recovery is typically faster with LASIK than with PRK; virtually immediate in some cases because the optical integrity of the cornea is preserved. The benefits of LASIK include faster visual recovery, faster healing, less risk of haze or corneal scarring, and potentially less discomfort than with PRK.

There is also one other perceived advantage to LASIK. If the need for an enhancement or subsequent laser treatment is ever necessary, re-treatment can often be performed by lifting the original flap. This is considered easier and more comfortable than the initial LASIK procedure by the majority of patients who have enhancement. Following PRK or LASEK, if an enhancement is planned, the epithelium must be removed as it was during the original procedure, and patients will go through the same healing and recovery period again.

At H Rubin Laser Eye Centers, all relevant factors are measured, and taken into consideration as a part of determining your candidacy for vision correction. We will recommend the best procedure for you based on your unique prescription. To learn more about the pre-operative process, select Your Consultation from the menu above.