The word LASIK stands for Laser-Assisted In Situ Keratomileusis. It is a form of refractive laser eye surgery procedure carried out by ophthalmologists to help the patients in restoring their eyesight. It becomes an alternative to the traditional photorefractive keratectomy since the procedure requires lesser time and is not so painful.
LASIK was started by Dr Jose Barraquer from Colombia. He developed the first microkeratome in 1960. This method involves cutting thin flaps in the cornea and alter its shape.
Gradually, it was developed by Dr Lucio Buratto and Ioannis Pallikaris as a bonding of 2 major methods as in keratomileusis and photorefractive keratectomy. Due to its greater precision and lesser complications, this method became very popular in the short space of time after it was announced to the world.
To ensure that the surgery goes smoothly, patients are advised to stop wearing soft contact lenses for 7 to 10 days as safe precaution. If they are wearing hard ones, they should refrain from using for at least 6 weeks.
Before the operation starts, the doctor will examine the patient’s corneas with a computer-controlled scanning device just to determine his or her exact shapes. Using low-powered lasers, it creates a topographic map of the cornea.
This checkup also helps to detects any signs of astigmatism and other irregularities within the cornea. Using this information, the surgeon will calculate the amount and locations of corneal tissue to be removed during the operation.
To minimize the risk of infection after surgery, the patient will be prescribed an antibiotic beforehand.
The surgery is performed with the patient awake as the doctor needs his or her eyes to be open. But if the patient is scared of pain the doctor will prescribe some mild sedatives such as Valium or diazepam and anesthetic eye drops.
LASIK is carried out in 2 steps.
The initial step is to create a flap of corneal tissue. This process is achieved with the use of a metal blade or femtosecond laser microkeratome. They create a series of tiny closely arranged bubbles within the cornea.
A hinge is left at one end of this flap. The flap is folded back to reveal the stroma - the middle section of the cornea. The process of lifting and folding back the flap can be uncomfortable.
The second step of the procedure is to use a excimer laser to modify the corneal stroma. The laser vaporizes tissue in a finely controlled manner without damaging adjacent stroma by releasing the molecular bonds that hold the cells together. No burning with heat or actual cutting is required to ablate the tissue. The layers of tissue removed are tens of micrometers thick.
At this point, the patient's vision will be blurr once the flap is lifted. He or she will be able to see only white light surrounding the orange light of the laser. This can be disorienting.
Currently manufactured excimer lasers use a computer system that tracks the patient's eye position up to 4,000 times per second. This redirects laser pulses for precise placement.
After the laser has reshaped the cornea, the LASIK flap is repositioned over the treatment area by the surgeon. The flap remains in position by natural adhesion until healing is completed.
Performing the laser ablation in the deeper corneal stroma typically provides for more rapid visual recovery and less pain.
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