Results
Overall, there does not seem to be a significant difference between PRK/ and LASIK in the percentage of patients achieving 6/6 [20/20] at the end of six months. Patients do extremely well with both procedures.
Thin Corneas
Sometimes, if a patient’s cornea is too thin to safely perform LASIK, then PRK is the only available option for refractive surgery.
Length of Procedure
Both are quite short. Surface PRK takes about three minutes of actual treatment time. LASIK requires about one to two minutes additional actual treatment time. There is no discomfort during either procedure. With LASIK, there is a pressure sensation and a graying out of vision for about 30 seconds while the corneal flap is created.
LASIK is definitely more complex with respect to both equipment and performance of the procedure itself. The surgeons experience and expertise is vital. Dr. Duplessie wrote the first textbook on Lasik; he is one of the best. He has performed over 30,000 procedures.
As with anything, with increased complexity, there are more possibilities that can go wrong. Although the overall percentage of complications of surface PRK and LASIK are approximately the same, the complications with LASIK are potentially more severe than with PRK.
The technology used in the Lasik Procedure has been in use for years and very safe; 31.4 million procedures have been performed worldwide to date making it the most common elective vision procedure. In the U.S. all branches of the U.S. military and NASA allow the treatment of LASIK for their servicemen and women. Dr. Duplessie feels so confident in lasik he underwent lasik 20 years ago and still has 20/20 vision in both eyes.
The LASIK Procedure
The LASIK Procedure only takes minutes. It reshapes your cornea to correct the refractive imperfections in your eye (these imperfections are essentially the reason you are nearsighted, farsighted, etc.). Computers/software are used to make an individual blueprint of your eyes; this blueprint is used to drive your laser correction and is what gives you a truly customized result
SMILE procedure from ZEISS
Dr. Duplessie was one of first American doctors to perform the SMILE procedure.
The SMILE procedure developed by ZEISS has become the third generation of laser vision correction.
The SMILE procedure developed by ZEISS for refractive surgery stands for Small Incision Lenticule Extraction and combines state-of-the-art femtosecond laser technology and precise lenticule extraction providing a micro-invasive laser vision correction method.
Unlike LASIK (Laser-Assisted in situ Keratomileusis), the SMILE procedure is performed without a flap. The ZEISS femtosecond laser VisuMax® is used to create a very thin disc of tissue (lenticule) inside the intact cornea, which can then be extracted through a small incision.
The Dry eye syndrome may be less with SMILE compared with LASIK.
Just Asking
It’s natural to have a bunch of questions when considering the LASIK Procedure. Dr. Duplessie is an expert at answering those questions and his staff are real pros who will provide plenty of support during the process.
LASIK VERSUS CONTACTS- MAYBE CONTACTS AREN’T THE LONG-TERM ANSWER?
The LASIK Procedure is safer than wearing contacts lenses.
FINANCIAL FACTS— LASIK PROCEDURE IS WITHIN YOUR REACH
Money shouldn’t be the reason you’re putting off having the LASIK Procedure. We know that the simple saying, “you can’t put a price on great vision” doesn’t change the fact that you have to find a way to pay for the procedure. Dr. Duplessie’s staff can help you with financing options.
What to Expect Before, During and After Laser Vision Correction:
What to expect before, during, and after surgery will vary from patient to patient. This section cannot replace the dialogue you should have with Dr. Duplessie, but it can help you gain a general understanding of the pre-, post– and operative stages of the procedure.
Preoperative:
If you wear contact lenses, you must stop wearing the lenses four days before your baseline evaluation and switch to wearing your glasses full-time. Contact lenses change the shape of your cornea for up to several weeks after you have stopped using them depending on the type of contact lenses you wear. Not leaving your contact lenses out long enough can result in inaccurate measurements resulting in poor vision after surgery.
If you wear:
· Soft contact lenses, you should stop wearing the lenses for 4 days before your initial evaluation.
·
Toric soft lenses or rigid gas permeable (RGP) lenses, you should stop wearing them for at least 3 weeks before your initial evaluation.
· Hard lenses, you should stop wearing them for at least 4 weeks before your initial evaluation.
You should tell Dr. Duplessie about your past and present medical and eye conditions and about all the medications you are taking, including over-the-counter medications and any medications you may be allergic to.
Dr. Duplessie will perform a thorough eye exam and discuss what you should expect before, during, and after surgery, as well as your responsibilities will be before, during, and after surgery. You will have the opportunity to ask Dr. Duplessie questions during this discussion.
The day before surgery, you should stop using creams, lotions, makeup and perfumes. These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. Dr. Duplessie may ask you to scrub your eyelashes for a period of time before surgery to get rid of residues and debris along the lashes.
During the procedure:
The procedure should take less than 20 minutes. You will lie on your back in a reclining chair in an exam room containing the laser system. The laser system includes a large machine with a microscope attached to it and a computer screen.
A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. A ring will be placed on your eye and your vision may dim. The microkeratome, an instrument, is attached to the ring. Dr. Duplessie will use the microkeratome to make a flap in your cornea.
The microkeratome and the ring are then removed. You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. Dr. Duplessie will then lift the flap to dry the exposed tissue.
The laser will be positioned over your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea; it is a light to help you keep your eye fixed on one spot once the laser comes on.
When your eye is in the correct position, Dr. Duplessie will start the laser. A computer controls the amount of laser delivered to your eye.. After the pulses of laser energy shape the corneal tissue, the flap is put back into position.
A shield will be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place.
Postoperative:
Immediately after the procedure, your eye may feel like there is something in it. You will instinctively want to rub your eye, but don’t! Rubbing your eye could dislodge the flap, requiring further treatment. In addition, you may experience sensitivity to light, glare, starbursts or haloes around lights, or the whites of your eye may look red or bloodshot. These symptoms should improve considerably within the first few days after surgery.
Post-Operative Course
The post op result is similar in both procedures except LASIK is more comfortable than surface PRK. Vision becomes crisper quicker and patients feel more comfortable during the early post-operative period. It is just a fraction risker.
Post-Operative Care
· LASIK: A clear plastic shield is worn over the eye for the first 24 hours, and then nightly for 2 nights to prevent inadvertent rubbing of the eye. Eye drops are started immediately and are used for only 4 days.
· Surface PRK: A therapeutic soft bandage contact lens is worn for around four days (depending upon your rate of healing) to reduce discomfort. Antibiotic, anti-inflammatory, and cortisone eye drops are used four times a day while the lens is on. After removal, the topical cortisone is used four times a day for a week. Artificial tears are used as needed.
You will see Dr. Duplessie at regular intervals.
Strenuous contact sports such as boxing, and karate, etc. should not be attempted for at least 3 months after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped.
Visual Recovery
Most patients notice an improvement in their vision immediately upon completion of their surgery.
By the next day vision is often dramatically improved. It can take several months before some patients achieve their final vision after LASIK. Several studies demonstrate that the vision of a number of patients continued to improve up to six months post-operatively. During that time, patients may experience slight fluctuations in vision throughout the day. These symptoms generally diminish with time.
Dry Eyes
Some patients experience dry eyes post-operatively. The symptoms can vary widely. When the dry eye is treated, those symptoms diminish.
Clinical dry eye is comparatively easy to diagnose and the great majority of patients respond well to treatment options ranging from use of preservative-free eye drops to insertion of punctal plugs, depending on the severity of the case. For almost all patients, dry eye symptoms gradually subside over the first few weeks or months after LASIK surgery. If you suspect that you may have post-operative dry eye, you should contact Dr. Duplessie for an evaluation.
Glare/Halos/Starbursts
Many LASIK patients notice a temporary decrease in night vision with symptoms that include glare, halos, and starbursts.
These symptoms usually subside within six weeks; however, some will continue to experience them for a greater length of time.
Enhancement procedures:
May be an option, but not everyone is eligible for an additional procedure.
Overcorrection, under correction & Regression
About 10-15% of LASIK or PRK/ patients may require a re-treatment (enhancement or touch-up) for under correction or regression back towards myopia. Retreatment is more common in patients who are more myopic or hyperopic and have higher amounts of astigmatism.
Regression can occur quickly, within the first few weeks after surgery, but it also can occur slowly over time. Patients who experience regression will notice their vision changing progressively. Dr. Duplessie asks patients to wait 3 months prior to performing an enhancement so the eye has stabilized. As that point, a LASIK procedure can be performed to correct the residual error, if the patient and Dr. Duplessie believe it is appropriate.
