LASIK is an acronym for “laser in situ keratomileusis” and it has been used to
correct near-sightedness, far-sightedness, and astigmatism for over two decades. Millions
of LASIK procedures have been performed over the years and it has been shown to be very safe
and effective. It is by far the most popular refractive surgery procedure because of its rapid
visual recovery and minimal discomfort. Essentially it is a two-step procedure in which the first
step is to create a thin corneal flap. The second step is the reshaping of the cornea to correct
the refractive error. Each step is performed with a unique laser.
Femtosecond “Bladeless” LASIK Surgery
Dr. Hendricks uses “bladeless” technology to create the corneal flap, the first step
in the LASIK procedure. The device used is a femtosecond laser and is generally considered to be
safer and more precise than conventional blade microkeratomes originally used for LASIK. The corneal
flap has a uniform thickness and centration which is helpful in producing better visual outcomes.
The second step of the LASIK procedure involves folding back the corneal flap and reshaping the
underlying corneal tissue. This is done with an excimer laser and is guided by customized wavefront technology (CWT).
LASIK Surgery Experience
The procedure takes about 15-20 minutes per eye. CWT testing is done first and a small dose of
Valium is given to help relax the patient. The eyes are anesthetized with drops and the patient is positioned
under the femtosecond Intralase. A lid speculum is used to hold the eyelids open and a suction ring applied to
the eye. The vision blacks out for 20-30 seconds and the corneal flap is made. There is no pain but sometimes
the patient will feel some pressure.
The patient is then positioned under the excimer laser for corneal reshaping. The eyes kept anesthetized
with added drops. A lid speculum is reinserted and the corneal flap is loosened and folded back. As the laser is
applied, it automatically tracks the eye if there are any small movements and it is guided by CWT. There is no
pain or pressure sensation. The corneal flap is repositioned and is allowed to dry for a minute or two. Antibiotic
and anti-inflammatory drops are instilled and the procedure is complete.
Most patients notice immediate visual improvement when they leave the laser treatment room although
objects appear hazy. The vision improves almost hour by hour and by the next morning most patients are seeing
well enough to drive themselves to the office for their checkup. The vision then gradually improves over the
next few days and weeks. Medicated drops are used for about a week and artificial tears are used as necessary.
Follow up visits are tailored to individual needs.
If an under-correction or an over-correction occurs then it may be necessary to lift the flap and
re-treat for residual refractive error. Enhancements usually are not considered until eye has stabilized for
6-12 weeks. The procedure is easier from the patient’s standpoint because there are fewer steps since the flap
does not have to be re-created. With CWT guided laser treatments the enhancement rate is less than 5 percent.
Monovision is a technique used for patients with presbyopia (those who use bifocals or reading glasses
with contact lenses) that corrects one eye for distance and the other for near. Dr. Hendricks will discuss this
with you if you are a candidate.
As with any surgical procedure, risks and complications need to be considered. Potential complications
can vary widely from minimal to severe. Fortunately, severe complications are much less likely to occur and only
rarely are they vision threatening. You will receive a detailed informed consent at the time of your LASIK workup.
Who is a Candidate for LASIK?
To be eligible for LASIK the eye must be healthy and with good correctable vision. The minimal age to
qualify for LASIK is 18 years of age and a stable refraction. We perform a series of eye measurements to screen for
any hidden underlying disorders. Dr. Hendricks will then help you determine your candidacy based on the examination
results as well as your occupation, hobbies, and general lifestyle.