LASIK, or Laser Assisted In Situ Keratomileusis, is an exciting, precise approach to the correction of nearsightedness, farsightedness, and astigmatism. LASIK uses the same CustomWave flying spot laser as PRK but places the laser prescription within the thickness of the cornea, rather than on the surface. You will experience improved vision by the next morning and should be able to drive the next day without glasses.

To focus the laser pulses within the cornea either a laser or a microkeratome used by Dr. Hatsis since 1992 automatically creates a thin LASIK flap on the surface of the eye. The flap is then folded back, and the exposed area treated. The flap is then repositioned adhering in about one minute. Medications in the form of antibiotics and anti-inflammatory eye drops are generally used for one-week then only artificial tears.

Dr. Hatsis purchased his lasers because the Custom "Flying Spot" technology is the most advanced system in laser vision correction. We think of the Custom "Flying Spot" laser as correcting vision by painting the prescription on the eye with a small artist's pallet and brush rather than painting a room with a bucket and roller. The Custom "Flying Spot" Excimer beam corrects the vision by quickly applying small 1-millimeter treatment spots at 60 to 200 times/sec. depending on the laser used. To correctly place the treatment spots precisely the laser actually follows the quick microscopic movements of the eye by tracking the motion of the cornea and imaging its position at an incredible 4000 times/sec. This information is sent to the laser head, which accurately directs the beam to its target. The result is a treatment smoother than any other laser can create which becomes the sharpest vision possible.

The Ideal LASIK Candidate

The ideal candidate includes those who:

• Are over 18 years of age and have had a stable glasses or contact lens prescription for at least two years.
• Have sufficient corneal thickness (the cornea is the trans-parent front part of the eye). A LASIK patient should have a cornea that is thick enough to allow the surgeon to safely create a clean corneal flap of appropriate depth.
• Are affected by one of the common types of vision problems or refractive error - myopia (nearsightedness), astig-matism (blurred vision caused by an irregular shaped cornea), hyperopia (farsightedness), or a combination thereof (e.g., myopia with astigmatism). Several lasers are now approved by the U.S. Food and Drug Administration (FDA) as safe and effective for use in LASIK, but the scope of each laser's approved indication and treatment range is limited to specified degrees of refractive error.
• Do not suffer from any disease, vision-related or otherwise, that may reduce the effectiveness of the surgery or the patient's ability to heal properly and quickly.
• Are adequately informed about the benefits and risks of the procedure. Candidates should thoroughly discuss the procedure with their physicians and understand that for most people, the goal of refractive surgery should be the reduction of dependency on glasses and contact lenses, not their complete elimination.

PRK

PRK, or Photorefractive Keratectomy, is a highly accurate, thoroughly investigated, FDA approved method for correcting nearsightedness, farsightedness, and astigmatism. It uses the precision of the CustomWave Excimer laser to sculpt a permanent prescription onto the surface of the eye.

Since prescriptions are corrected by removing only a microscopic amount of cornea, less than the thickness of a hair, the strength of the eye remains completely intact. For this reason governmental agencies including branches of the military and civil law enforcement accept candidates who have had PRK. The "Flying Spot" laser quickly delivers a pulse of highly concentrated cool light energy that disrupts the molecular structure of the cornea without generating any heat. Each 1-millimeter diameter pulse removes precisely ¼ micron of corneal tissue which is less than 1/5,000 of an inch. The relationship of these numbers is appreciated when you consider that a human hair is about 60 microns thick and the normal cornea is about 550 microns thick.

Since Dr. Hatsis had been studying the healing effects of laser surgery on the human eye during the United States FDA clinical trials, he felt comfortable performing the first PRK on Long Island only three weeks after the FDA approved the laser in 1995.

PRK is always performed under topical eye drop anesthesia, which completely numbs the cornea so patients feel nothing during the 30 to 60 seconds it takes to apply the laser prescription to the eye. The complete procedure from beginning to end usually takes about ten minutes per eye. After the treatment, antibiotic and anti-inflammatory drops are applied prior to discharge home. The vision returns as the surface heals over two to four days. The eye drop antibiotics are usually discontinued by one week and anti-inflammatories are reduced and stopped over a three month period.

Alcon Custom LADARWave®

The LADARWave® CustomCornea® Wavefront System is a unique stand-alone-system that uses wavefront measurement technology. A narrow beam of light is pulsed into the eye and onto the retina. The light bounces off the retina in a diffused wavefront that travels back through the optical system gathering the exact individual properties of the optical path in a single pass. The data captured in the reflected wave is instantly analyzed by the LADARWave® and a 3-dimensional-map is created - unique to each eye. This CustomCornea® Wavefront System will allow Dr. Hatsis to adjust his method of setting up the laser for the best visual outcome possible.

CustomCornea® is the first laser vision correction procedure to go beyond reshaping your cornea based on your prescription for eyeglasses or contacts. The procedure is completely customized to your eyes and your eyes alone. Secondly, CustomCornea® can help with other vision problems that could not be detected previously known as higher order aberrations. Experts believe these aberrations could be responsible for vision problems such as glare and halos in low light conditions and nighttime.

LADARVision® combines both eye tracking and small beam corneal shaping. The built-in eye tracker automatically follows any eye movements during the laser procedure. This allows the system to more accurately aim the laser beam and correct for any movement of the eye during the procedure. The expertise in the area of eye tracking had its origins in many years of research and development for the Strategic Defense Initiative and the National Aeronautic and Space Administration (NASA).

"The LADARVision® System is the only system that combines this laser radar eye tracker with narrow-beam shaping technology for the correction of near-sightedness and astigmatism. It is the only FDA-approved laser system to incorporate this type of advanced eye tracker technology during surgery."

For more information on the LADARVision® system, click here.