Other extremely important `Lasik` (Laser) Eye Surgeries`
• `PRK`;
• `Custom Wave front Lasik`
• `Epée-Lasik`
• `Intra-Laze “Bladeless” Lasik
• `Pres-by Lasik
• `Corneal On lays/Inlays.
`PRK` (photorefractive keratectomy) is used in/for `Laser Eye Surgery` as it’s termed as original surgery conducted by an `Ophthalmologist` over the patients sophisticated and weakened eye due to certain dreadful diseases mentioned thereupon. It is used to be the most common refractive surgery procedure.
`What is Refractive Surgery`?
Surgery that corrects visual acuity, with the objective of reducing or eliminating the need for glasses and contacts and includes radial keratotomy, PRK, LASIK, and corneal implants.
Both are grouped under the same umbrella "laser eye surgery, and `PRK` " but each is a little different when it comes to advantages and disadvantages. There is a meager amount of discomfort but with obtainable `Good Eye Vision` of ‘Lasik Surgery’ whereas with `PRK` the improvement with the vision is gradual (over a few
days or might even months), but many surgeons prefer `PRK` for patients with larger pupils or thin corneas. `Your doctor will examine your eyes to determine exactly what kind of vision correction you need and how much laser ablation is needed. A corneal topographer will be used; this is an instrument that 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 actual steepness or flatness that the surgeon must address`. Certain conditions might disqualify while other mean a postponement of the procedure or special care afterward.
`During Surgery`
The surgery actual time could take a minute or two for diagnosing and later defines the various stages of the surgery to be conducted by a Doctor. You’re awaked the whole time when surgery is on. Most people don't feel pain during `PRK`. Your eyes are first anesthetized with special drops. The doctor will have you lie down, and then make sure your eye is positioned directly under the laser. (One eye is operated on at a time.) A kind of retainer is placed over your eye to keep your eyelids open — normally, this is not uncomfortable. It has a suction ring that keeps your eye pressurized and immobile. The doctor uses a computer to adjust the laser for your particular prescription. You will be asked to look at a target light for a short time while he or she watches your eye through a microscope to make sure it remains in the correct position while the laser sends pulses of light to your cornea that painlessly remove the tissue. It's important to keep your gaze fixed on that target light in order to get the best results. The laser machine will make a steady abnormal clicking sound while the laser pulses are undergone, and you may smell a faintly acrid odor during the tissue removal. Don’t panic! That's normal course of inspection by an expert to further analyze the entire matter. A medicine could be prescribed beforehand for any `Postoperative Pain/anxiety`! Because some have reported a “Scratchiness” inside/outside of an Eye afterwards. There’s also a facility of getting your second eye diagnosed by a Doctor after a week possible as doctor keeps an eagle eye over the operational part and can call it quits over as per his/her absolute convenience.
`After PRK Diagnosis/operation`
What occurs after the surgery can affect your vision just as much as the surgery itself. A `rest` a bit is called upon by an Eye Surgeon to let patient relax in extreme conditions at his/her home and feel at home to consult the Doctor after a stipulated time period mentioning up in the `Chart/Plan` suggested by surgeon again in due course of time (couple of hours rest only). They also recommend no strenuous exercise for up to a week, since this can traumatize the eye and affect healing. Avoid rubbing your eye (your doctor will tell you how long). In fact, you will be examined just about every day to make sure the healing is done properly. You will probably wear a special "bandage" contact lens, use antibiotic and anti-inflammatory drops for a few days or for several weeks time.
Outcome statistics: Best corrected Vision Targets`20/40 + 20/200` Vision
`Laser-assisted in situ keratomileusis` (LASIK) : Is an elective surgical procedure with some serious associated risks. And most importantly, it is an elective surgical procedure performed on an otherwise healthy eye in the presence of safe and effective non-surgical alternatives — that is, glasses and contact lenses. There are so many variables involved such as the degree and type of vision correction you need, and the experience of your eye surgeon in it for correct statistics. According to guidelines released by the Eye Surgery Education Council (ESEC), less than 1% of patients who have received LASIK up to date have experienced serious, vision-threatening problems. Most LASIK complications can be treated and usually resolve within several months of surgery. The FDA definition of adverse event includes a list of specific problems including corneal swelling, flap problems, uncontrolled intraocular pressure, and retinal Detachment. The Council for Refractive Surgery Quality Assurance (CRSQA), which certifies refractive surgeons to experience complications of `Eye` in no more then 3% in normal context and in vision-threatening situations to 0.5% respectively.
The specific studies record how many people achieve 20/20 vision or better (so-called "perfect" vision) and how many achieve 20/40 vision or better (the minimum visual acuity required to obtain a driver’s license in most states of the world).
`Custom Wave front Lasik` : Patient’s Vision Correction
Introduction : `Custom LASIK surgery, also known as wave front LASIK or wave front-guided LASIK, uses 3-dimensional (3D) view/measurements of eye processing images to guide the laser in re-shaping the front part of the eye (cornea). A wave front measurement system requires some extremely precise, individualized vision correction outcomes that may achieve an impossible target as in case with traditional Lasik surgery, contact lenses, or eyeglasses it cannot be achieved. Only a qualified candidate is exposed towards `Wave front Lasik` therapy. If you have mild to moderately high degrees of common vision defects such as myopia, hyperopic symptom, and astigmatism. On your visions ability to focus a 3D map is created to demonstrate irregularities in one’s vision or how eye processes objects. Other irregularities associated with the eye's optical system could not be addressed until the advent of wave front and related technology used in custom `LASIK`.
`Wave front LASIK creates a highly individualized laser correction of your eye's surface, guided by precise analysis of vision errors that occur as light rays travel through your eye`. Wave front technology is groundbreaking because it has the potential to improve actual vision wave length or frequency of an eye to make necessary corrections. It improves the `Contrast sensitivity` that helps in the night vision! Higher-order aberrations create common refractive errors like: decreased contrast sensitivity or night vision, glare, shadows, and halos. It (reduces chance of losing virtual quality).
`Poor contrast Eye sensitivity` occurs as some of the patients complain that they are vulnerable to see in low-light or Dim. The cause of vulnerability as `High-order aberrations` can be corrected with latest sophisticated technology in hand. The sensitive ratio of Eye surgery ratio remains high as per the expertise but is always helpful in a future course of understanding. Not all refractive surgeons agree that `wave front-guided LASIK` can treat higher order aberrations but it isn’t a myth at all. According to them, artificial changes made to the natural shape of the eye's surface can be a catastrophic attempt to search upon an ultimate/absolute solution to the problem.
`Epi-lasik Eye Surgery`
This terminology of Laser therapy can only be known if one knows the difference between `Lasik` and `Lasek`! Lasik involves cutting a flap in the cornea with either a sharp blade or a laser; it also comes with a risk to have cut the `Flap` too thick whereas in case of `Lasek` the cutting is made to the outer layer, the epithelium, in a thin sheet that retains its hinge on the eye. This is done in Epée-LASIK too, but the surgeon uses a blunt, plastic oscillating blade instead of `LASEK's` finer blade. In `Lasek` surgery alcoholic influence to an eye is provided by a surgeon to loosen the epithelial sheet, but in `Epée-Lasik`, the surgeon uses the plastic blade, called an epithelial separator, to separate the sheet from the eye. This avoids the possibility of a reaction from the alcohol, which can kill epithelial cells. Because it is more difficult to create the epithelial flap in people with steeper corneas (who have higher amounts of myopia), the procedure is more appropriate for people with less steep corneas (who have low myopia). After the epithelial flap is made, it is lifted and gently folded out of the way. An excimer laser is used, as in LASIK or PRK, to sculpt the underlying corneal tissue. Then the epithelial flap is placed back on the eye with a kind of spatula. A special contact lens is placed on the eye to keep the flap in place while it re-epithelializes. Surgeons use a High Oxygen permeable contact lens for this, which means it is very oxygen-permeable. The contact lens protects the surface of the eye and allows the epithelial cells to grow back properly. The pain out of such surgery is rather manageable with `Over-the-Counter Drugs`!
`After Epée-Lasik`
By about the third day after surgery, the doctor may permit you to remove the contact lenses. Vision will probably not be perfect immediately: in three days many patients do have 20/40 or even 20/20 vision, but others take longer — possibly three or six months — to reach their final result. One can drive in about a week after surgery. Follow- up of surgeon’s instructions is always exactly and absolutely needed because the quality of the final vision you achieve is affected by how well your corneas heal. Please! Follow-up the appointments with a surgeon every now and then to ensure the proper adjustment of Eye lenses. For a better result `Surgeons` around the world suggests `Epee-lasik` surgery more than a normal `Lasik` surgery as people with thin layer of `Eye Flap` do not have number of tissues available for the protection of an Eye or there is a dearth of abundance of eye tissues. The professions and hobbies of the society determine the amount of work and the nature of their work from dawn to dusk as in the case of: (soldiers, police officers, boxers, and racquet sports enthusiasts), etc may find `Epée-LASIK` safer than LASIK because there's no risk of the flap being dislodged.
`Intra-Laze` “Bladeless-Lasik” :
An extremely newly developed `Eye surgery` technology has come into limelight for various surgeons’ worldwide called “Intra-laze” technology. This technology comp lyses enhance vision correction of an eye by using laser energy instead of micro-keratome, a cutting tool with a metal blade used in traditional LASIK procedures. With Intra-Laze, a special laser is used instead of a blade to create the flap. Then the usual excimer laser does the ablation. So in the Intra-Laze procedure, two different lasers are used, which is why LASIK surgeons sometimes call it "bladeless" or "all-laser" (LASIK). The name ‘Advance Medical Optics System` is used by surgeons with new version of `Lasik’ technology` called `I-LASIK`.
`Complications: Blade Versus Bladeless`
The complications are huge in size as metal blades might create uneven flap edges, resulting in abnormal corneal surfaces and vision defects such as irregular astigmatism and causing a possibility of an Eye Infection as well. Metal blades have been associated with formation of incomplete or improperly formed "buttonhole" flaps that can cause vision-threatening scars. Many eye surgeons report these types of complications are far less likely with laser-created flaps because there are no marks relatively in and around Eyes! The Intra-Laze laser operates at extremely high speeds (pulses of one quadrillionth of a second), allowing tissue to be targeted and divided at a molecular level without heat or impact to surrounding tissue. There are significantly fewer overall `Lasik` complications rates. One postoperative complication of unusual light sensitivity such as photophobia that appears unique to the use of the Intra-Laze in LASIK had been reported by a surgeon. Surgeons have informed about the `Photophobia symptom` of an Eye as normal complication course as it can be rectified easily by “Steroid” treatment (Eye Drops). Potentially, permanent vision-threatening complications might result from defective flaps. It is a transient side effect of an eye that can be resolved very easily. The additional increased potential threat safety comes with an additional increase of the cost involved for the latest technology in hand according to the department of `Ophthalmologists Bureau` ($300). The cost can be bundled if the patient undergoes the knife with the normal course of operational procedures.
`How does it Works` :
`The LASIK surgeon uses computer software to guide the Intra-Laze laser beam, which applies a series of tiny (3-micron-diameter) bubbles within the central layer of the cornea. The resulting corneal flap is created at a precise depth and diameter pre-determined by the surgeon`. A small section of tissue at one edge of the flap is left uncut, forming a hinge that allows the surgeon to fold back the flap so that the cornea can be accessed and reshaped for vision correction. Most people have corneas that are between 500 and 600 microns thick, and most micro-keratomes cut flaps ranging between 100 and 200 microns thick. Because of its precision, the Intra-Laze appears capable of more reliably and consistently producing corneal flaps as thin as 100 microns. This projection of the thick and thin microns of an eye flap could enable the `Surgeons’ to do the operation successfully even to an eye with thin flaps availability (an advantage of a technology). The curvature of the cornea could be easily managed with vertical edges. This difference in flap structure may reduce the chance of cells growing underneath and pushing up the flap to create an irregular corneal surface with accompanying vision defects. `Eye Infection or Contamination` chances reaches to a nil. The Intra-Laze laser uses a low vacuum suction ring to hold the eye, compared with a higher vacuum used for micro-keratomes. Up to-a-minute is required to hold up the ring of the eye socket as it may cause sudden `Superficial Bleeding` on the white part/area of an Eye (sub-conjunctiva hemorrhage) but this is only a temporary bleeding of an eye rather then the permanent one.
`People who have had previous corneal surgery often are candidates for LASIK with Intra-Laze` surgical operation`. `
`After side effects of Intra-Laze procedure`
Recovery is similar to that of traditional `LASIK`. Study results have shown that LASIK with Intra-Laze may produce a lower incidence of post-operative dry eye. Fewer enhancement ("touch-up") procedures appear to be required when LASIK is performed with Intra-Laze. Only sense of two day eye irritation is recorded by a surgeon as soon as the operation ends itself! While achieving the best 20/20 vision of an eye. According to `Ophthalmologists` laser-made flaps appear to adhere more tightly to the corneal bed at the end of the procedure and demonstrate a more aggressive healing response at the edges compared with micro-keratome-made flaps.
`Presby Lasik` (Multi-focal LASIK, Bifocal LASIK, or LASIK for Presbyopia) : Presby LASIK, also known as multi-focal `LASIK`, is an experimental type of laser vision surgery that changes the shape of the eye's clear surface (cornea) to establish different zones for seeing at near to far distances. The surgery corrects the cause of “presbyopia” which causes near vision to blur as the eye's natural lens begins to stiffen, usually at around age 40. If you are nearsighted and have presbyopia, you may be able to see up close without your usual eyeglasses or contact lenses but not when you are wearing them.
`What is Presbyopia`?
It is an experience of a blurred vision of an individuals Eye who is unable to see nearby objects or requires near vision corrections such as when reading, sewing or working at the computer. It is mandatory for every individual to suffer from such vision problem in some stage of their lives but this is generating huge revenue towards the government as there’s an increase demand of Contact Lenses, Eye Glasses, and other Eye wears. The demand will certainly increase by 2015.
`Presbyopia Symptoms and Signs`
The sign or symptom of having `Presbyopia` develop a sense to hold up newspapers, magazines, tabloids, news-letters, menus and other reading materials, etc at arm's length in order to focus properly. When they perform near work, such as embroidery or handwriting, they may have headaches or eyestrain, or feel fatigued.
`Cause of Presbyopia`
`The eye's lens stiffens with age, so it is less able to focus when you view something up close. The result is blurred near vision. Presbyopia is caused due to age-related complexities. This is different from astigmatism, nearsightedness and farsightedness, which are related to the shape of the eyeball and caused by genetic factors, disease, or trauma. Presbyopia is generally believed to stem from a gradual loss of flexibility in the natural lens inside your eye. These age-related changes occur within the proteins in the lens, making the lens harder and less elastic with the years passing by. It substantially affects the muscle fibers surrounding the lens as well. With less elasticity, the eye has a harder time focusing up close. Eyeglasses with bifocal or progressive additional Lenses (PALs) are the most common correction for presbyopia. Bifocal means two points of focus: the main part of the spectacle lens contains a prescription for nearsightedness or farsightedness, while the lower portion of the lens holds the stronger near prescription for close work.
`What are Progressive Additional Lenses`?
` Multi focal lenses whose corrective powers change progressively throughout the lens are called `Progressive Additional Lenses. A wearer looks through one portion of the lens for distance vision, another for intermediate vision, and a third portion for reading or close work. Each area is blended invisibly into the next, without the lines that traditional bifocals or trifocals have. They offer a more gradual visual transition between the two prescriptions, with no visible lines between them.
`Reading glasses`: `Reading glasses are more stylish and functional than ever, with fashionable, colorful frames`. Reading glasses come in two main styles: full frames, in which the entire lens is made in the reading prescription, and half-eyes, the smaller "Ben Franklin" style glasses that sit lower down on the nose.
Full reading glasses are suitable for people who spend a great deal of time concentrating on material close-up. If you try to look up and across the room through the reading lenses, everything appears blurry.
`Presbyopia Treatment: Surgery`
The surgery namely, ‘Refractec Inc.'s conductive keratoplasty`, or `Near- Vision CK treatment`, which uses radio waves to create more curvature in the cornea for a higher "plus" prescription to improve near vision help improve visionary sites. The method was FDA-approved for the temporary reduction of presbyopia! A highly experimental treatment is a soft, elastic polymer gel that researchers say would be injected into the capsular bag, the cavity that contains the natural lens. The gel would replace the natural lens and serve as a new, more elastic lens. Experiments also have centered on laser treatment of the eye's hardened lens to increase flexibility and improve focus.
'What are the ways for Presby LASIK Procedure`
Presby LASIK is also called multi-focal LASIK because it works on principles virtually identical to artificial multi-focal Lens used to provide vision correction for presbyopes. With presby LASIK, laser energy reshapes your eye's clear surface into different zones, such that light is bent or refracted differently in each zone. In this way, both near and distance vision can be achieved simultaneously. There is a problem to define the term in a broader prospective because `Presby Lasik Surgery of Eye` is still in its investigational phases. Different approaches are being studied to determine how the eye should be shaped to achieve the best possible vision correction for presbyopes. In one presby LASIK method, it is said that the cornea's center is altered to enhance near vision while the outer periphery provides zones for distance vision. This configuration currently appears to be the preferred method for providing multi-focal LASIK vision correction for individuals who are presbyopic, or `farsighted and presbyopic`. In some cases, near vision correction is provided in the central zone of the cornea, and in others, near vision correction is established in the peripheral area. `Aspheric corrections of an eye’ is being done by the surgeon to ensure the protection of the Lens of an Eye. Aspheric shapes are not perfectly round and are thought to help reduce vision distortions or aberrations that generally can be associated with vision correction.
`This study involved 82 eyes of 49 farsighted and presbyopic patients; the mean age was 56. Results after 12 months (statistics apply to use of both eyes and binocular vision):
J3 represent the ability to read newspaper print; J1 indicate even finer print.
One re-treatment was required in the study group.
Half of patients still require eyeglasses some of the time for certain types of activities such as reading or computer work; (Reading capacity 10 (minutes) of `Presby-Lasik Surgery`)!
Contrast sensitivity was reduced immediately after the procedure, but returned to normal levels for this age group.
`Corneal Inlays and Corneal On lays`
`Corneal Inlays and on lays` are made of biocompatible materials that closely resemble the clear surface of the eye itself. A new form of vision correction surgery should pave its way to new future clinical trials that will definitely prove successful in a long term terminology of understanding the type of surgery conducted.
` A corneal in lay or on lay is designed to seamlessly "merge" with the eye's surface and no laser light therapy is required to seemingly do the operation of an eye as with corneal inlays or on lays inserted just beneath the eye's surface, laser energy some day could be used to sculpt this artificial material instead of the eye itself. In other words, they may work as in a form of `Contact Lenses` which will be placed just beneath the Eye surface permanently near the cornea of the Eye. These devices will never demand a regular removal of the contact Lenses or ongoing care at specific place availability. And they will also differ from surgically implanted Lenses because they are not placed behind the cornea. In a general parlance, these devices are being somehow neglected by an `Eye Surgeon` because in order to avoid complications associated with procedures the eye's natural surface tissue is left virtually undisturbed just in the case of `PRK`, `LASIK`, or `Implantable Lenses`, etc.
The procedure takes less than 15 minutes and can be performed in the eye surgeon's office. Sutures are not required, and only topical anesthesia in the form of eye drops is used. According to Bausch & Lomb, the inlay is designed to block certain light rays reflecting from near objects that ordinarily would not be focused correctly by the presbyopic eye.
"Its optical principle is the pinhole phenomenon, which when used in photography (in terms of a small aperture), allows depth-of-focus and thus allows clear vision at all distances — near, intermediate, and distance” objects viewed crystal clearly by a soft and delicate `Eye`!
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