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Procedure Types

The LASIK Procedure

Your laser treatment, whether conventional or CustomVue, can be delivered in a number of ways that differ primarily on the layer of the cornea that is treated and how that layer is exposed.

With the popular LASIK procedure, a microkeratome is used to lift a "corneal flap" that includes the epithelium, Bowman's membrane and a portion of the deeper, underlying layer known as the stroma. The laser treatment is then applied to the exposed corneal stroma. Afterwards, the flap is repositioned over the treated surface. Because the surface epithelium is relatively undisturbed, LASIK is the most comfortable laser procedure and offers the most rapid healing.

While most LASIK flaps in the US are still created with the reliable mechanical, bladed microkeratome, the new Intralase technology, all-laser LASIK, is already being used to create 1 out of every 7 flaps, and the number is growing every day. There are 150 of these ultra-fast laser devices in the world and we are very pleased to be one of these premiere sites. This reflects our ongoing commitment to providing our patients with the ultimate in surgical technology. Flaps created with the Intralase are less likely to have significant defects that could adversely effect the results. The more precise nature of the laser flap also enhances the effect of the subsequent excimer laser treatment.

The PRK Procedure

Unlike LASIK, with PRK, no flap is created. Instead, the epithelial cells over the treatment area are loosened and removed, and the laser treatment is performed directly on Bowman's membrane. In the Epi-LASEK variant of the PRK procedure, an attempt is made to put the epithelial cells back into place after the laser treatment, but with standard PRK, no such attempt is made, and the epithelium heals when new cells grow in from the periphery.

Because the surface epithelium is disturbed, PRK is less comfortable than LASIK and the eye heals more slowly. After PRK, you will need to wear a soft bandage contact lens for three to five days, until the epithelium is completely healed. This is to protect the cornea as it heals, as well as to keep the eye more comfortable. Your vision will improve daily, but it can take as much as a week for it to return to a functional level, and several weeks or months for it to reach its final clarity. For this reason, PRK is performed one eye at a time, with at least a week in between eyes. Postoperative follow-up is essential to assess the visual recovery.

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