LASIK/ Laser Vision Correction

With the development of the excimer laser, more precise vision correction procedures such as Photorefractive Keratectomy (PRK) and Laser in Situ Keratomileusis (LASIK) were developed. LASIK allows the surgeon to reshape the cornea, the front surface of the eye. This technological breakthrough has changed the way people think about vision correction. The LASIK procedure is performed as an outpatient procedure with only a topical eye drop anesthetic. The vast majority of patients are spectacle or contacts lens-free shortly thereafter!

While both LASIK and PRK are bundled under the umbrella of "laser refractive surgery," each method has both advantages and disadvantages. It is important to consult with a refractive surgeon to determine which procedure is most appropriate and safest for your eyes. At Hudson Valley Eye Surgeons, PC, we are able to custom design the correct procedure for each patient, rather than a "one size fits all" philosophy.

To treat nearsightedness, the cornea must be made flatter. This is accomplished by removing tissue from the center of the cornea.	To treat farsightedness, the central cornea must be made steeper. This is accomplished by directing the laser beam to remove tissue from this area.
To treat astigmatism, the cornea must be made for spherical. By changing the pattern of the beam, more tissue is removed in one direction than the other.	PRK removes tissue from the surface of the cornea to help the eye focus more directly on the retina.

Surgeons performing LASIK surgery use an instrument called a microkeratome to create a thin, circular flap in the cornea. The surgeon then folds the flap back and applies the laser to reshape the underlying corneal tissue. The excimer laser removes tiny bits of tissue from the cornea and reshapes it with a cool ultraviolet light beam. The flap is then laid back in place, covering the area where the corneal tissue was removed.

PRK is also performed using an excimer laser, a cool ultraviolet light beam that removes tiny bits of tissue with precision from the surface of the cornea. Rather than create a flap in the surface of the cornea, the cornea is gently brushed to remove the very superficial corneal cells. The laser is then applied to the underlying tissue. Over the next week or so the superficial cells that were removed heal back into place.

People with nearsightedness, farsightedness and astigmatism can benefit from LASIK and PRK. With nearsighted people, the goal is to flatten a cornea that is too steep. The opposite is desired for farsighted people--a steeper cornea will provide clearer vision. Excimer lasers can correct astigmatism as well, because it can smooth an irregular cornea into a more regular shape.

Our office uses the VISX STAR S4 ActiveTrak™ Excimer Laser System as well as Wavefront CustomVue. Using ActiveTrak and Wavefront CustomVue technology allows the doctor to center the laser beam most accurately, providing the ability to create the most accurate and precise treatment for each eye.

The VISX ActiveTrak eye-tracking system was developed exclusively for ophthalmic use, and specifically for eye tracking during laser vision correction (LASIK or PRK). The older, first generation LADARVision® tracking was originally developed for military applications, not ophthalmology. It was later adapted for ophthalmology.

ActiveTrak uses the only 3-D eye-tracking system. That means that ActiveTrak follows not only the left and right movements of the eye, it also follows the up and down movements that can happen when you breathe.

VISX STAR™ laser systems, which combine flexibility through variable beam and scanning technology, produce smoother treatments. Additionally, variable beam technology removes less tissue, which results in a faster, safer treatment than flying spot lasers.

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