Laser Vision Correction Surgery
The procedures offered at the Laser Vision Correction Center include:
- Wavelight Allegretto Eye-Q Excimer Laser
- VISX CustomVUE® Treatments (with LASIK and LASEK) - a registered trademark of AMO
- CK (Conductive Keratectomy)
- IntraLase® (Femtosecond Laser) - a registered trademark of AMO
- INTACS ICRS (Intracorneal Ring Segments)
- LASIK (Laser Assisted In-Situ Keratomileusis)
- EpiLASIK and LASEK (Laser Epithelial Keratomileusis)
- PRK (Photorefractive Keratectomy)
- RK and AK (Radial and Astigmatic Keratotomy)
Wavelight Allegretto Eye-Q Excimer Laser is the first new laser to receive approval in the United States since 1999.
Using PerfectPulse Technology to safely and accurately control every single laser pulse from start to finish, it is the fastest laser system in the United States today. The system was designed to perfection based on knowledge and experience. It represents a new generation of refractive technology conducting High Performance Vision Correction that patients can rely on night and day.
The Wavelight Allegretto Eye-Q Excimer Laser offers a customized treatment that incorporates wavefront principles to patients with nearsightedness and even farsightedness.
Every procedure is tailored to the patient's corneal curvature and refraction with the intention of preserving the natural aspheric cornea shape, and maintaining or improving quality of vision and visual acuity.
VISX CustomVUE® Treatments (with LASIK and LASEK) can help correct "higher order aberrations," visual distortions that cause glare, shadows and halos in low light conditions and at night. These aberrations cannot be corrected by wearing glasses or contacts or be treated by traditional laser vision correction procedures. Using advanced wavefront technology, VISX CustomVUE® Treatments (with LASIK and LASEK) reshape the cornea to correct visual distortions as well as other common conditions that may exist, such as nearsightedness and farsightedness.
CK is the only vision procedure specifically designed for patients over the age of 40 for the temporary reduction of presbyopia. Using a controlled release of radiofrequency energy to heat and shrink corneal tissue, CK changes how the eye focuses light by reshaping the cornea.
INTACS ICRS (Intracorneal Ring Segments) is currently only available to treat a specific low range of nearsightedness (myopia). Two, tiny crescents or arcs made of a transparent plastic material are placed in the outer periphery of the cornea. Once in place, the two arcs flatten the cornea so that light rays properly focus on the retina.
IntraLase® is an all laser approach to vision correction. For certain vision disorders and corneal anatomy, this less invasive, computer controlled approach allows the physician to achieve more precise correction.
LASEK involves creating an epithelial sheet that is replaced after the PRK treatment. LASEK is a procedure that combines many of the advantages of LASIK and PRK in that there may be less discomfort than after PRK, and it is indicated in situations where LASIK cannot be performed (such as thin corneas and irregular corneal contours by topography).
LASIK can correct varying degrees of nearsightedness (myopia) and astigmatism and is generally the treatment of choice for patients with high degrees of myopia. In LASIK surgery, the underlying surface of the cornea is reshaped with the laser, allowing light to be refocused and vision improved. LASIK surgery generally results in little or no post-operative pain and rapid recovery of vision.
LASIK is performed utilizing the excimer laser, however, unlike PRK, the surface skin cells are not removed. Instead, a thin flap is created and retracted out of the way during the laser portion of the surgery. Once the excimer laser has reshaped the cornea, the flap is repositioned and naturally stays in place. Because the surface cells have not been removed, there is typically little, if any, post-operative pain as compared to PRK and vision tends to improve relatively quickly. The convenience of LASIK (due to the quicker visual recovery and lack of post-operative pain) is what has made it a popular option for many patients. The need to create a corneal flap, however, adds a slightly increased risk to the surgery, and therefore some patients may be better served with PRK as opposed to LASIK.
There are a number of factors that doctors must evaluate before they can determine who is eligible for LASIK. Some doctors deem certain pre-existing conditions to be contraindications to the procedure and will not perform surgery if you possess them. Other conditions may complicate the surgery and increase your risk of having post-operative problems. Patients with these conditions need to have a thorough conversation with their doctors regarding eligibility and expectation levels.
The procedures are not painful during the surgery itself. A vast majority of patients experience little, if any, pain following LASIK surgery. The response following PRK varies with every patient. Some feel a mild irritation similar to an eyelash in the eye, while others feel that the pain is more significant and requires pain medication for 1 to 2 days following the surgery. PRK tends to provide a slower visual recovery as compared to LASIK. Following PRK the vision will be blurred for two to four days and will slowly improve for the next one to two weeks before reaching a stable endpoint.
LASIK improves the uncorrected vision -- one's visual capacity while not wearing corrective lenses -- in most patients who have the procedure. Over 90% of patients with low to moderate myopia achieve 20/40 or better vision (the level most states and provinces require for driving without glasses or contact lenses). Many patients can also expect to see better than 20/40 uncorrected. Some studies show that approximately 70% of patients may achieve 20/25, or better, uncorrected visual acuity following surgery. However, there are no guarantees that you will have perfect vision, and patients with high myopia (more than -7D) and high hyperopia (more than +4D) should have lower expectations. People who are most satisfied with the results of laser correction clearly understand the potential risks and complications of the surgery and possess realistic expectations of what their vision will be like following surgery.
The effects of LASIK are permanent and do not wear off over time. However, a person's eye can still change internally (even after refractive surgery) and this is why many surgeons recommend proceeding only if a stable prescription exists. For instance, LASIK is not recommended on children because their eyes change a great deal as they continue to grow. If the procedure is performed after the age of 18, the chance of long-term stable correction is more likely, although the eyes of patients over the age of 18 can still change. Patients should also note that while results are stable long-term, a mild regression of the laser effect may occur during the first few post-operative months. This occurs in approximately 10% of patients and if noted, may require an enhancement procedure if your doctor feels it to be appropriate.
PRK reshapes the cornea with an excimer laser beam that emits ultra violet light after removing the epithelial surface layers of the cornea. Applying the laser to the cornea, the physician is able to remove a small amount of tissue without affecting the surrounding area and create a new corneal curvature, changing the focal point of light as it enters.
PRK is performed on the surface of the cornea and requires that the surface skin cells be gently removed prior to laser use. Once the surface cells have been removed, the excimer laser is used to reshape the cornea. Over the next 1-3 days, the surface cells grow back over the central cornea, and vision improves. During this time there tends to be some irritation to the eyes as the surface skin cells regenerate. PRK is characterized by a longer healing process and more discomfort than LASIK; however, it requires less instrumentation and avoids the creation of the flap that is required during LASIK.
RK is performed using a diamond blade to make radial incisions in the cornea to flatten it and change how light is focused on the retina. While RK reduces spherical error, AK employs two arcuate incisions to reduce astigmatic error. The two procedures may be conducted together or separately, as appropriate, and the recovery is generally brief.
For more information on procedures and costs, please call 617-573-3234.