Treatments

• L.A.S.I.K. is the acronym for Laser-Assisted in Situ Keratomileusis
• P.R.K. stands for Photo-Refractive Keratectomy        
• L.A.S.E.K. means Laser Epithelial Keratomileusis

You will undergo an in-depth eye examination with our highly trained and qualified Optometrists to assess the health and condition of your eyes. Your lifestyle and your expectations will also form part of your assessment.

I can't believe the difference L.A.S.I.K. has made to my eyesight. When I wake up each day I have to pinch myself that I no longer have to wear wretched glasses. Carla – Bristol

General Procedure
The eye is anaesthetised using drops. The eyelids are kept apart with the help of a lid speculum. This prevents them from blinking during the procedure.

Knit together
The top layer of cells in the cornea, known as the epithelium, is cut in a circle, using a microkeratome. The circular ‘lid’ or flap is peeled back and an Excimer laser applied to shape the cornea. The laser is programmed to operate with precision and accuracy, according to each patient’s eye problem: short-sightedness, long-sightedness, etc. The flap is placed back into position, allowing the epithelium cells to ‘knit’ together by regenerating themselves.

Knife-free
Afterwards, a special contact lens is placed over the cornea to protect it. Depending on the healing ability of the patient, the lens will stay in place for up to 5 days.

Both L.A.S.I.K. and P.R.K. surgery use an Excimer laser to shape the cornea. L.A.S.I.K. is the newer version of the P.R.K. technique. The P.R.K. treatment deals with the outer edge of the cornea.  L.A.S.E.K. is a ‘knife-free’ procedure.

The advantages of laser eye surgery
No instruments actually enter the eye so contamination and risk of infection is minimal.  Damage to the eye is also reduced as the laser is programmed for each patient.

L.A.S.I.K. treatment
L.A.S.I.K. is, in essence, the advanced version of P.R.K. It involves cutting a deep flap into the secondary layer of the cornea called the stroma. The stroma lies below the primary layer of epithelial cells. The circular flap is then peeled backwards. The Excimer laser is computer controlled for safety and accuracy and is programmed to remove the exact amount of corneal tissue. The flap, it should be pointed out, is sliced extremely thinly. You could probably compare it to the thickness of an eyelash.

No stitches
Once the flap is laid backwards, the laser is used to remove some tissue which re-shapes and re-focuses the cornea. The flap is put back into its original position and left to heal.  Healing starts within a few short hours. The epithelium cells (the primary layer) begin to grow by multiplying, thus sealing the flap.

No stitches are required, you’ll be pleased to know!

Microscopic
In short-sighted patients, tissue is taken from the middle of the cornea to thin it out. This brings the focus closer to the retina. With long-sighted patients, the laser takes microscopic pieces of tissue from the edge of the cornea. 

Where a patient suffers from astigmatism, this is treated by using an oval-shaped laser beam. An astigmatic eye is where the cornea – sideways on – has the shape of a rugby ball instead of being round. 

Mature patients
After surgery and healing, you shouldn’t need to wear corrective lenses. Alas, for people suffering from long-sightedness as a result of old age, it cannot be corrected with L.A.S.I.K. This is down to the condition of the eye itself rather than just that of the cornea. You may find that you still require spectacles or contact lenses.

The advantages of L.A.S.I.K. treatment

• The healing period for the eye under the L.A.S.I.K. treatment is much shorter.  Patients tend to experience a marked improvement in their vision just after surgery. This is mainly because the epithelium cells are hardly disturbed. A thin layer is lifted up and placed back into position.
  
• Any pain experienced is minimal and probably could be classed as discomfort.
• No instruments actually enter the eye so the risk of infection and damage are minimal
  

• There may be damage to the circular flap itself either during or after the procedure. It could even become lost. If the flap is not laid back in precisely the right position it could become distorted. A distorted flap means decreased vision of corrected eyesight.
• Infection may set in under the flap.

• The main thing is absolute precision. The eye with all its nuances and imperfections are registered very precisely.
• The laser can then be programmed, with precision, to take specific features of the cornea into account.
• Corneal haze is much reduced or unlikely to occur.
• Night vision is very good using this technique.

• Too much tissue from the cornea may be taken away. This means that this treatment may be unsuitable for patients diagnosed with thin corneas.

The advantages of P.R.K. treatment

• Recovery is quicker than with L.A.S.I.K.
  
• There are fewer complications because there is no flap to deal with.

• Vision can be blurred for up to 2 weeks after the procedure.
• There is a tendency for P.R.K. patients to suffer more discomfort after surgery than patients of L.A.S.E.K and L.A.S.I.K. treatments. The discomfort tends to reach its worst during the first 24 hours, disappearing within 3 days. It is believed that the pain stems from the exposed nerve endings of the epithelium cells.
• Another disadvantage is where scar tissue is left on the cornea causing corneal haze. It can disappear of its own accord, but the result may be blurred vision.
• Full recovery may take up to 3 months. You could be able to drive in about 3 weeks after surgery.
• There can be a relapse or regression whereby the sight returns to its original state – whether long-sightedness or short-sightedness.

Cone
The epithelium, the outmost layer of the cornea, is cut and a minute cone-like object placed on the surface. The weak solution of alcohol is dripped into the cone. The object of the cone is to ensure that the alcohol does not spread to other areas in the eye. The partially-dissolved area is peeled back to expose the next layer down, the stroma. This is the layer that is treated with the laser. After the laser has been used, the epithelium flap is placed back into position.

Thin Cornea
This treatment is ideal for those diagnosed after assessment as having thin corneas. It would exclude some from certain treatments like L.A.S.I.K.

You will be given special protective contact lens to wear to protect the cornea for a few days. They will be put in and removed for you by our ophthalmic surgeon or nurse. You should not touch them yourself as you may damage the healing cells underneath.

If you are a patient with a particularly thin cornea, L.A.S.E.K. treatment may be better for you. However, our surgeon will assess your suitability for L.A.S.E.K. well beforehand.

The advantages of L.A.S.E.K. treatment: