Laser Eye Surgery:
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What is Laser Eye Surgery?

Laser eye surgery is currently the most frequently performed Elective Procedure in the world where a cool beam of light from an Excimer Laser gently reshapes the front surface 'Cornea' of your eye, or Eyes; this procedure improves vision and could give you complete freedom from glasses and contact lenses; over 22 million laser eye surgery procedures have been carried out worldwide helping to change people's lives for the better.

What does an Excimer Laser do?

'Excimer' is a contraction of the words 'Excite' and 'Dimer'; dimers are produced by electrically stimulating a combination of reactive gases, like chlorine or fluoride, with inert gases such as xenon, krypton or argon; the resulting dimers produce a cold ultraviolet laser light; an Eximer laser uses the rare gas Halides as the active medium.

When highly focused, the beam of light is absorbed into the outside layer of whatever it is aimed at and the strength of the light breaks down the materialís molecular structure; the laser actually vaporizes, at the atomic level, the 'meat' of your cornea, because of this the cuts are very, very precise, even as viewed with an electron microscope at thousands of times magnification.

In eye surgery, a specially trained technician operates an Excimer Laser in conjunction with the ophthalmologist responsible for the surgery; the Excimer Laser is aimed at the cornea to remove tiny tissues as small as a molecule, about 1/1000th mm, which is about half a % of the width of an hair, without damaging the surface of the eye and is therefore able to reshape the cornea; the laser beam adds so much energy to the molecular bonds of the corneal stroma that the tissue actually blows itself away in tiny atomic explosions; in stop action, microphotography little mushroom clouds can sometimes be seen.

During a PhotoRefractive-Keratectomy (PRK) laser eye surgery procedure the surgeon will direct the laser beam towards the cornea, which will evaporate tissue in the front part of the cornea, making the cornea less steep; this steeping of the cornea changes the shape of it and allows the eye to focus properly, improving vision.

LASIK (Laser-Assisted-In-Situ-Keratomileusis) Eye Surgery:

LASIK surgery is currently the most frequently performed, and highly effective, Elective Procedure in the world and is suitable for most low, moderate and high prescriptions; LASIK surgery uses a cool beam of light from an Excimer Laser to gently reshape the front surface, cornea, of your eye, or Eyes; the entire LASIK eye treatment takes about 10 minutes and both eyes can be treated by LASIK surgery simultaneously; it is also reported that patients experience less discomfort after this procedure than with other laser correction techniques.

LASIK Preparation:

To start off the procedure anaesthetic drops are applied to the eye, or Eyes; then a protective flap is created in the cornea with a mechanical microkeratome - a blade device, or a laser keratome - a laser device; a hinge is left open at one end of the flap, which is folded back to reveal the stroma, the middle section of the cornea; then pulses of cool laser light from a computer controlled Excimer Laser are applied to the inner layers of the cornea to vaporise a portion of the stroma; as the laser pulses, it makes a ticking sound; this procedure permanently changes the shape of the cornea; the inner corneal layer is reshaped with the laser to correct Short Sightedness, Long Sightedness or Astigmatism impressions in the eye; when finished the surgeon gently replaces the flap and aligns it to its original position; the flap normally heals naturally and securely.

Apply Drops Create Flap Laser treatment Replace Flap


What Are the Disadvantages and Side Effects of LASIK Eye Surgery?

LASIK eye surgery is technically complex and despite the pluses, there are a few disadvantages to having LASIK eye surgery treatment, such as any changes made to the cornea cannot be reversed and problems, although rare, can occur when the surgeon cuts the flap, which could permanently affect the vision; this could result in a loss of 'Best Vision', which is the highest degree of vision that you achieved, before treatment, whilst wearing your contacts or eyeglasses.

Some patients experience discomfort in the first 24 to 48 hours after LASIK eye surgery and, although rare, other side effects may include Difficulty driving at night, Dry eyes, Fluctuating vision, Glare and Seeing halos around images.

LASEK (Laser-Assisted-Epithelial-Keratomileusis) Eye Surgery?

LASEK, also known as Epi-LASEK, eye surgery is an alternative laser refractive procedure to correct Short Sightedness, Long Sightedness and Astigmatism; LASEK is used mostly for people with corneas that are too thin or too steep for LASIK, when it may be too difficult to create a thicker LASIK flap; it was developed to reduce the chance of complications that occur when the flap created during LASIK does not have the ideal thickness or diameter; another variation of the LASEK procedure, known as Epi-LASIK uses a plastic blade, called an Epithelial Separator, to detach part of the Epithelial layer from the eye.

LASEK is suitable for most low, moderate and high prescriptions; LASEK surgery uses a cool beam of light from an Excimer Laser to gently reshape the front surface, cornea, of your eye, or Eyes; the entire LASIK eye treatment takes about 10 minutes and both eyes can be treated by LASIK surgery simultaneously; it is reported that patients may experience more discomfort after this procedure than with LASIK treatment.

LASEK Preparation:

To start off the procedure anaesthetic drops are applied to the eye, or Eyes; this procedure involves preserving the extremely thin Epithelial layer, the top layer of the cornea, by lifting it from the eye's surface; the surgeon covers the eye with a diluted alcohol solution for approximately 30 seconds, which loosens the edges of the Epithelium; the surgeon then sponges the alcohol solution from the eye, before gently lifting the edge of the Epithelial flap and folding it back out of the way with a special cutting tool, a bit like a tiny hoe, known as a trephine, to create an ultra thin flap-like sheet, which is folded back to reveal the stroma, the middle section of the cornea.

Once the Epithelial flap has been moved out of the way, pulses of cool laser light from a computer controlled Excimer Laser are applied to the inner layers of the cornea to vaporise a portion of the stroma; as the laser pulses, it makes a ticking sound; this procedure permanently changes the shape of the cornea; the inner corneal layer is reshaped with the laser to correct Short Sightedness, Long Sightedness or Astigmatism impressions in the eye; when finished the surgeon gently replaces the flap-like sheet using a type of spatula to place the Epithelial flap back on to the eye into its original position; the flap-like sheet normally heals naturally and securely; a bandage contact lens may be placed on to the eye, or eyes, to promote comfort.

Apply Drops Create Flap Laser treatment Replace Flap Replace Flap


What are the Differences between LASEK and LASIK Eye Surgery?

Even though the visual outcomes following LASEK eye surgery are similar to those produced by LASIK eye surgery, around 85% of all laser eye surgery treatments are LASIK, rather than LASEK; this is because LASIK has a more convenient, faster recovery time; however, a certain number of patients have thin corneas, have dangerous professions, or are involved in dangerous contact sports, in these cases, LASEK eye surgery is more appropriate.

It is never good to get hit in the eye, but after LASIK eye surgery, if the eye is hit at just that right angle with just the right force, there is a chance that the LASIK flap could be moved; therefore, when a prospective patient is actively involved in activities that may lead to an eye injury such as Boxing or Martial Arts, or are in occupations such as the military special forces LASEK eye surgery is more appropriate because there is no flap to be moved by a direct hit in the eye.

In another variation of LASEK, the same plastic blade an Epithelial Separator, which is used in epi-LASIK creates the thin Epithelial flap, but because alcohol is applied during the procedure as it is in straight LASEK, the procedure is called epi-LASEK with an "E" instead of an "I."

What Are the Disadvantages and Side Effects of LASEK Eye Surgery?

LASEK eye surgery is technically complex and there are a few disadvantages to having LASEK eye surgery treatment; such as any changes made to the cornea cannot be reversed and problems, although rare, can occur when the surgeon removes the flap, which could permanently affect the vision; this could result in a loss of 'Best Vision', which is the highest degree of vision that you achieved, before treatment, whilst wearing your contacts or eyeglasses.

Also LASEK eye surgery usually has a longer recovery period than LASIK though the flap edge heals in about a day, but patients usually wear a bandage contact lens for approximately four days to protect the eye and it is not unusual for LASEK patients to not have corrected vision for 1 to 2 weeks after the procedure, whilst LASIK patients may have corrected vision after only one day.

LASEK surgery patients also typically report more discomfort following the procedure than LASIK patients; however, this discomfort usually only lasts for 1 to 2 days; other disadvantages to LASEK surgery involving the recovery period include the need to wear a specially designed contact lens as a bandage for three to four days after the procedure and the need to use topical steroid drops for longer than required after LASIK surgery.

Some patients experience discomfort in the first 24 to 48 hours after LASIK eye surgery and, although rare, other side effects may include Difficulty driving at night, Dry eyes, Fluctuating vision, Glare and Seeing halos around images.

How are you Prepared for LASIK, or LASEK, Eye Surgery?

Before LASIK, or LASEK, eye surgery, you should meet with a coordinator who will discuss what to expect during and after the procedure; during this session, your medical history should be evaluated and your eyes should be fully examined; likely initial tests should include Air Pressure, Corneal Mapping, Measuring of the Corneal Thickness, Refraction and Pupil Dilation; once you have gone through the initial evaluation, you should meet the surgeon, who should be able to answer any questions you may have; afterwards, you should be able to schedule an appointment for the procedure.

If you wear rigid gas permeable contact lenses, you should not wear them for at least three weeks before your evaluation; other types of contact lenses shouldn't be worn for at least three days prior to the evaluation and you will need to take your spectacles to the surgeon so that your prescription can be reviewed; on the day of surgery, you should only eat a light meal before going to the surgery and you should take all of your prescribed medications; you should not wear any eye makeup or have any bulky accessories in your hair that could interfere with the positioning of your head under the laser; lastly, if you are not feeling well on the day of surgery, call the surgeon's office to determine whether, or not, the procedure would need to be postponed.

PRK (PhotoRefractive-Keratectomy) Eye Surgery?

PRK eye surgery is another alternative to LASIK, or LASEK, eye surgery; when PRK eye surgery is performed the eye surgeon does not cut a thin flap into the eye's surface, as occurs with LASIK, nor does the surgeon removes the ultra thin, outer layer of the eye 'Epithelium' before surgery as with LASEK, instead, the laser energy aplied with an Excimer Laser is applied directly to the eye's surface and the Epithelium is completely destroyed by the laser energy, but luckily it does eventually grow back.

The Epithelium is a soft, rapidly regrowing layer in contact with the tear film that can completely replace itself from limbal stem cells within a few days with no loss of clarity, whereas, the deeper layers of the cornea, as opposed to the outer epithelium, are laid down early in life and have very limited regenerative capacity, which is why any changes made to the cornea cannot be reversed.

What Eye Conditions Can Laser Surgery be user for?

A number of eye conditions can be treated with the help of Laser surgery, including Astigmatism, which is an optical defect in which the vision is blurred due to the inability of the optics of the eye to focus an object into a sharp focused image on to the Retina; this may be due to an irregular, or toric, curvature of the Cornea or lens; Hyperopia, Long Sightedness, when you find it difficult to see things up close and Myopia, Short Sightedness, when you find it difficult to see things at a distance.
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Astigmatism is an eye condition that can affect the clarity of your vision and make it more difficult for you to focus on objects; it is most commonly found in eyes where the cornea is oval shaped like a rugby ball, rather than being spherical shaped like a football; most astigmatic corneas have two curves, a steeper curve and a flatter curve, which causes light to focus at more than one point in the eye, resulting in blurred vision.

There are 2 types of Astigmatism Irregular and Regular; Irregular Astigmatism is often caused by a Corneal scar or scattering in the crystalline lens and cannot be corrected by standard spectacle lenses, but can be corrected by contact lenses; Regular Astigmatism is caused by an uneven, or toric, shape of the Cornea; a toric surface is like a section of the suface of an American football, or a doughnut, where there are 2 regular radii, one smaller than the other; it can be corrected with the use of a toric lens or lasr treatment to smooth the Cornea into a more regular shape.

It can be a mild or fairly serious eye condition, with symptoms ranging from very mild blurred vision to severe blurriness resulting in squinting, fatigue and headaches; many Long Sighted and Short Sighted people also suffer from some degree of Astigmatism.
 
Hyperopia is an eye condition that is often better known as Long Sightedness; if you have difficulty focusing on things that are close by, but find it easy to see things that are far away, there's a chance you could be Long Sighted.

The blurring of vision associated with Hyperopia is caused by the shape of the eyeball, it is an optical defect in which incoming rays of light reach the Retina before they converge into a focussed image, meaning the distance between the Cornea and the Retina is too short and the Focal Point falls behind the Retina, instead of on it; it can be corrected with the use of a Convex lens, or laser surgery.

It is caused when the eyeball is too short, or when the lens is not round enough, which makes it difficult for the eye to focus on near objects; some Long Sighted people find that their symptoms become more pronounced as they age, with some finding that they end up having difficulty focusing on distant objects too.
 
Myopia is an eye condition that is often better known as Short Sightedness; if you have difficulty focusing on things that are far away, but find it easy to see things that are close by, there's a chance you could be Short Sighted.

The blurring of vision associated with Myopia is caused by the shape of the eyeball; it is an optical defect in which incoming rays of light do not reach the Retina before they converge into a focussed image, meaning the distance between the Cornea and the Retina is too long and the Focal Point falls in front of the Retina, instead of on it; it can be corrected with the use of a Concave lens, or laser surgery.

It is caused when the eyeball is too long, or when the cornea is too steep, which causes images to focus inside the eye rather than on the retina at the back of the eye, which in turn makes it difficult for the eye to focus on far objects.

The degree to which Astigmatism, Hyperopia and Myopia affects the vision is unique to each person, so choosing the best treatment should be the result of a consultation with an optometrist.


The Benefits of Laser Eye Surgery:

Before surgery the simple act of having to wear glasses or contact lenses may well have hampered your life in ways that you hadn't really considered, due to the fact that wearing these aids was what you would have considered a normal way of life; however, wearing glasses, or contact lenses, is not a normal way of life, they are an annoyance and inconvenience created by you having had eye problems that required their use, before having had laser eye surgery.

Undergoing laser eye surgery could mean that from then on you would be able to open your eyes in the morning, or in the middle of the night, and see your alarm clock without having to fumble for your glasses, or contact lenses first; you would be able to check on your child, or go to the toilet, in the middle of the night without having to find your glasses.

You would be able to enjoy playing with your children without the fear of breaking your glasses, or losing a contact lens; you would be able to go to work without the worry of having your contact lenses having a drying effect on your eyes, due to air conditioning systems or sitting in front of a computer screen all day.

It would even minimise the hassle of packing when going on a holiday abroad; you would no longer have to worry about forgetting your glasses, contact lenses or prescription sunglasses; you would be able to go to the beach and not worry about getting sand or sun cream on your glasses, or in your eyes and not have to worry about losing a contact lens or breaking your glasses, whilst taking a dip in the sea.

You would be able to lead an active lifestyle, without the annoyance, or inconvenience, of having to wear glasses, or contact lenses, which means that you wouldn't have to worry about breaking your glasses, or losing a contact lens whilst playing football or rugby, or going swimming.

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