LASIK or Lasik is a type of refractive surgery for correcting myopia, hyperopia, and astigmatism. LASIK is performed by ophthalmologists using a laser. The procedure is generally preferred to photorefractive keratectomy, PRK, (also called ASA, Advanced Surface Ablation) because it requires less time for the patient's recovery, and the patient feels less pain overall. However, there are special instances where a PRK/ASA procedure is medically justified as being a better alternative to LASIK.

Many patients choose LASIK as an alternative to wearing corrective eyeglasses or contact lenses.

The LASIK technique was made possible by the Colombia-based Spanish ophthalmologist Jose Barraquer, who, around 1950 in his clinic in Bogotá, Colombia, developed the first microkeratome, and developed the technique used to cut thin flaps in the cornea and alter its shape, in a procedure he called keratomileusis. Barraquer also researched the question of how much of the cornea had to be left unaltered to provide stable long-term results.

Procedure:

There are several necessary preparations in the preoperative period. The operation itself involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser. The flap is repositioned and the eye is left to heal in the postoperative period.

 Preoperative

Patients wearing soft contact lenses are usually instructed to stop wearing them 5 to 21 days before surgery. One industry body recommends that patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts have been worn.[ Before the surgery, the patient's corneas are examined with a pachymeter to determine their thickness, and with a topographer to measure their surface contour. Using low-power lasers, a topographer creates a topographic map of the cornea. This process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and the locations of corneal tissue to be removed during the operation. The patient typically is prescribed and self-administers an antibiotic beforehand to minimize the risk of infection after the procedure.

Operation

The operation is performed with the patient awake and mobile; however, the patient is sometimes given a mild sedative (such as Valium) and anesthetic eye drops.
LASIK is performed in three steps. The first step is to create a flap of corneal tissue. The second step is remodeling of the cornea underneath the flap with the laser. Finally, the flap is repositioned.

Postoperative care

Patients are usually given a course of antibiotic and anti-inflammatory eye drops. These are continued in the weeks following surgery. Patients are usually told to sleep much more and are also given a darkened pair of shields to protect their eyes from bright lights and protective goggles to prevent rubbing of the eyes when asleep and to reduce dry eyes. They also are required to moisturize the eyes with preservative-free tears and follow directions for prescription drops. Patients should be adequately informed by their surgeons of the importance of proper post-operative care to minimize the risk of complications.

 

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