Corrective Eye Surgery

Below is a brief description of the current types of corrective eye surgeries available including:

Automated Lamellar Keratoplasty (ALK) - treats high levels of nearsightedness and mild to moderate farsightedness. The surgeon cuts a flap in the stroma (the cornea's middle layer). Then, for nearsightedness, an instrument is used to remove material under the flap. For farsightedness, no removal is necessary, as eye pressure will cause the cornea to steepen, thus reducing farsightedness. ALK usually takes less than one hour. ALK is falling by the wayside nowadays, because of better results with procedures such as LASIK and PRK.

Photorefractive Keratectomy (PRK) - is a laser eye surgery that treats nearsightedness, mild to moderate farsightedness and astigmatism. The surgeon uses an excimer laser to remove tissue from the surface of the cornea. This removal (or ablation) results in a new shape, thus reducing the vision problem. PRK usually takes less than one minute per eye.

Laser-Assisted In Situ Keratomileusis (LASIK) - is currently the most popular type of eye surgery for the correction of refractive error — that is, nearsightedness, farsightedness and astigmatism. Although PRK was the corrective eye surgery first approved by the FDA, it was soon eclipsed in popularity by LASIK. ( In fact, it could be said that LASIK is a derivative of PRK, and they use the same underlying laser technology.)

In order to decide whether you're a good candidate for LASIK, your eye doctor will examine your eyes to determine their health, what kind of vision correction you need, and how much laser ablation is required. Just as in a regular eye exam, he or she will use instruments such as: a refractor (to determine your prescription); a slit lamp (to look into the back of the eye for retinal problems); and a tonometer (to determine intraocular pressure — if it's high, this may be an early sign of glaucoma).

Your doctor will also look for signs of dry eye disease, which must be treated and cleared up before LASIK can be performed.

Also, a corneal topographer is usually used; this device photographs your eye and creates a kind of "map" of your cornea. No one has a perfectly rounded cornea, and the topographer will display the corneal irregularities and the steepness or flatness that the surgeon must correct. Some doctors are also using new "wavefront" devices, which send waves through the eye to provide an even more precise map of the aberrations that are affecting your vision.

Finally, the doctor will question you about any health problems you have or medications you take. Some health conditions will disqualify you altogether for LASIK, but others may just postpone the procedure until a later date.

The LASIK surgery itself is performed with the surgeon cutting a flap in the strom (the cornea's middle layer), then using an excimer laser, removes material under the flap. LASIK usually takes less than one minute per eye.

Laser Epithelial Keratomileusis (LASEK) - is similar to LASIK, except that the surgeon cuts a flap in the epithelium (the cornea's outer layers) only, instead of through the epithelium and part of the stroma (the cornea's middle layer). He or she then loosens the edges of the flap with alcohol. LASEK is used mostly for people with thin or flat corneas who are poor candidates for LASIK, which requires more corneal tissue for success. It is a relatively new procedure; drawbacks include more discomfort afterward and a slightly longer healing time than for LASIK.

Radial Keratotomy (RK) - treats mild to moderate nearsightedness. The surgeon makes incisions in a radial (spoke-like) pattern in your cornea, which causes it to flatten, thus reducing nearsightedness. The procedure usually takes less than half an hour. Ten years ago, RK was performed fairly often. Today, surgeons prefer newer myopia correction procedures, such as LASIK and corneal ring insertion.

Astigmatic Keratotomy (AK) - treats astigmatism. The surgeon cuts the cornea in certain areas that are too bulgy, in order to flatten them to a more regular curve. Many people undergo AK in addition to other corrective eye surgery. However, AK is used less frequently now that some excimer lasers are FDA-approved to correct astigmatism.

Hexagonal Keratotomy (HK) - used to be performed to treat farsightedness. Surgeons stopped using it because of the high incidence of complications.

We currently accept the following insurance plans:

  SPECTERA (Some United Health Care Plans)
EYEMED (Some BC/BS or Humana Plans)
DAVIS (Some BC/BC Plans)

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