Laser Vision Correction is a special interest of this practice. Dr. Kelly and Dr. Gibralter were both FDA Investigators for the clinical research studies at Manhattan Eye, Ear & Throat Hospital for the FDA evaluation of the safety and efficacy of the excimer laser for laser vision correction. This was one of ten sites in the country for the FDA Trials and the first use of the laser in New York City as part of the FDA Clinical Trials. These clinical trials began in 1991 and the laser was approved by the FDA in 1996. It has been used on millions of patients worldwide.
Laser Vision Correction refers to a group of minimally invasive procedures that reshape the cornea with excimer laser energy to correct nearsightedness, farsightedness, and astigmatism. We are now able to do a wave-front map of a patient’s cornea and use that to guide a custom ablation. Not everyone is a candidate for Laser Vision Correction. You will need some special testing to determine whether Laser Vision Correction is right for you. Laser Vision Correction can be performed on patients who are at least 21 years of age, where the patient’s prescription has been stable. Prior to your evaluation for Laser Vision Correction and Wave-Front Exam, you will need to leave soft contact lenses out for 2 weeks and gas permeable lenses out for 3 weeks. Your doctor will discuss with you the advantages and disadvantages of LASIK vs. PRK in your case.
Laser-Assisted In Situ Keratomileusis (LASIK)
Laser-Assisted In Situ Keratomileusis (LASIK) is a safe and reliable way to improve vision by using the laser to change the curvature of the cornea. This changes the way light is bent, or refracted, as it passes through the cornea and causes the light to be focused on the retina. It is like putting your contact lens or glasses prescription into your own cornea. This change in the curvature of the cornea is generally permanent. However, myopia can still progress if the back of the eye is still elongating. That is why we like to select patients for Laser Vision Correction where the myopia is stable and not progressing. It is also always possible, however, to go back and “touch up” a correction or do additional treatment.
Laser Vision Correction is not an operating room procedure. It is done in the laser suite under topical (eye drop) anesthesia. We generally also use Valium 5 mg. to relax the patient, but the patient is fully awake and experiences no pain during the procedure. The procedure involves creating a thin flap of cornea, which is then lifted. The laser, which was programmed with the patient’s wave-front exam to give a custom ablation, is then used to reshape the cornea. The flap is then replaced to its original position. The entire procedure takes about 20 minutes for both eyes. The patient then goes home with multiple drops to use. The patient is usually able to go back to work the next day. The vision can continue to improve over the next month. It takes 3 months for the flap to fully heal down, and the patient has to be careful during this time not to participate in activities where the eye could be hit.
Photorefractive Keratectomy (PRK)
PRK is similar to LASIK in that it uses the same excimer laser to reshape the cornea. It is done in the same laser suite and with the same topical anesthesia as LASIK. The difference is that a flap of cornea is not created with PRK. Instead, the surface cells of the cornea, called epithelial cells, are gently brushed off exposing the cornea stroma. The laser is then used to reshape the surface corneal stroma instead of the corneal stroma under a flap, as in LASIK. After the completion of the PRK, a bandage contact lens (with no power) is placed in the patient’s eyes to reduce discomfort for the first three to four days after treatment. Most patients are able to return to work the day after PRK, but they don’t have the final vision that soon. The vision will continue to clear over the week after treatment, and they will be using eye drops.