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Lasik Eye Surgery

If you or someone you care about has been considering corrective eye surgery, you've probably heard the term lasik eye surgery. You may have wondered if it's just a fancy term for laser eye surgery or if there's more to it than that. The answer is yes and no. Lasik eye surgery is a specific eye procedure whose purpose is to reshape the cornea.

Its full name is 'laser assisted in situ Keratomileusis'. Lasik surgery was approved by the Food and Drug Administration (FDA) as a method of refractive eye surgery in November 1998. At the time, it was touted as a corrective surgery for all types of nearsightedness. But advances, since then, have opened the doors for very specific operations and custom operations on the eye that can improve nearly all types of vision problems.

In traditional lasik surgery, the ophthalmologist uses a very fine knife called a microkeratome to carefully cut a circular 'flap' into the cornea of the eye. After pulling it out of the way, he uses a cool laser to literally sculpt the surface of the cornea. When the reshaping is finished, the corneal flap is replaced over the surface.

The difference between "lasik eye surgery" and "Custom lasik surgery"

The major difference between traditional lasik eye surgery and custom lasik surgery is the way that measurements are taken before the procedure. In traditional lasik corrective surgery, the laser is calibrated to measurements based on your eyeglass or contact lens prescription. In custom lasik, the ophthalmologist uses a device called a wave analyzer to measure the way light passes through the eye. By measuring the way light hits your retina, he has a precise map of YOUR cornea. This gives him custom measurements to program the laser when shaping your cornea. It's like the difference between buying an off-the-rack suit and having one custom-fit just for your body.

So does that mean that custom lasik vision correction is better? Not necessarily, doctors say. To understand why a doctor might recommend a conventional lasik surgery rather than custom lasik, you need to understand how and why lasik vision correction works.

How Lasik Vision Correction Works

The cornea is a layer of clear tissue over the front of your eye that allows the light to pass through, and helps to focus it properly on the retina. Many vision problems are caused by malformations or small aberrations in the shape of the cornea that distort the passage of light. Lasik vision correction works by using cool lasers to literally reshape the cornea, and then correct the way that light passes through it to focus on the retina.

Ophthalmologists divide vision aberrations into 'low order aberrations' and 'high order aberrations'. Vision problems like nearsightedness or farsightedness are caused by variations that are considered lower order aberrations. Conventional lasik surgery is the usually recommended treatment to correct them. Higher order aberrations cause distortions of light or contrast and may result in halos and starbursts. Generally, if there are higher order aberrations, a doctor will recommend custom lasik surgery.

Since the FDA first approved lasik eye surgery in 1998, there have been advances in both laser and surgical technology that have led to variations of Lasik. Some of these, like Lasek, or e-lasik, make refractive eye surgery possible for people who aren't good candidates for conventional lasik surgery. Lasek was developed for use in people whose cornea is too thin or flat for the more traditional surgery. Instead of a microkeratome, the surgeon uses a finer-bladed cutting tool called a trephine to cut the cornea.

Other forms of lasik eye surgery

Other variations of lasik surgery like Lasik Plus Interlace and Epi-Lasik do away with the blade entirely, and use lasers to make the corneal incision. In addition, there are other alternatives to lasik surgery like CK, or conductive keratoplasty, which uses radio waves to treat farsightedness and PRK, or photorefractive keratectomy, which uses lasers to reshape the cornea.

What are the potential lasik complications and risks?

Lasik complications and risks associated with lasik surgery include vision aberrations like halos and starbursts or reduced contrast vision. Complications from lasik surgery are rare, but when they do occur, they're often caused by problems with the 'flap that cause vision distortion. Other risks include a worsening of the vision after surgery, dry eyes, and in very rare cases, permanent vision loss. These complications are rare, but should be considered if you're considering lasik surgery.

What is the cost of lasik eye surgery?

The cost of lasik surgery is another consideration in your decision. It will depend on the amount of correction required to your vision and the type of lasik eye surgery procedure you selected. In the last quarter of 2004, the average cost of lasik eye surgery procedure was US$1800. You can find prices as low as US$425 per eye, or as high as US$2500 per eye. In addition, keep in mind that most health insurance doesn't cover the cost of lasik surgery when making your decision.

How to choose a lasik eye surgeon?

Choosing a good lasik eye surgeon shouldn't be based on cost alone. While lasik eye surgery may seem uncomplicated, it's still surgery, and you will want the best doctor that you can find. To help you find a good lasik eye surgeon, follow these recommendations:

* Ask your regular eye doctor for a recommendation.
* Choose a doctor associated with a leading teaching hospital or university.
* Choose a surgeon who is a Fellow with the American College of Surgeons.
* Visit the American Academy of Ophthalmology web site
* Bring a list of questions from the Council for Refractive Surgery Quality Assurance.

Remember - they're the only eyes you have. Choose someone who'll care for them right.


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