About Laser Eye Surgery

Laser Eye Surgery for the correction of nearsightedness, farsightedness and astigmatism is a term that encompasses a number of methods of Laser Vision Correction including the most common eye surgery procedures of LASIK, Custom LASIK and PRK.

 Prior to 1995, people suffering from common eye problems such as nearsightedness, farsightedness or astigmatism in the United States really had two primary vision correction options available to them. They had the choice of either wearing eyeglasses or contact lenses in order to see clearly.  In 1995, the United States Food and Drug Administration (FDA) approved the first Excimer laser (www.fda.gov/cdrh/pmaoct95.html) that could be used to perform Laser Eye Surgery to correct nearsightedness, farsightedness and astigmatism. The introduction Laser Eye Surgery with the Excimer technology to correct common eye problems allowed patients to now have yet another option for their vision correction.

  About Photorefractive Keratectomy (PRK)

The initial type of Laser Eye Surgery procedure performed was called Photorefractive Keratectomy or PRK. PRK has proven to be to be a safe, effective and predictable method of Laser Eye Surgery and enabled millions of patients to have Laser Vision Correction by the end 1998. PRK has a number of clinical advantages over other types of Laser Eye Surgery including LASIK. However, PRK has two particular disadvantages that have somewhat limited its growth and application overall.

First, in PRK, the Excimer laser is used to treat the surface of the cornea, which is the dome shaped lens on the front of the eye. In order to apply the laser treatment effectively necessitates gently removing the outermost layer of the cornea, called the epithelium. For some patients this may cause moderate discomfort during the first day or so of the healing process.

Second, the corneal epithelium serves many functions including providing a smooth optical surface. Since it is removed, it may require several days or more for some patients to achieve a good clear visual recovery.

Nonetheless, PRK is in fact the Laser Eye Surgery procedure of choice for certain patients including those who have particularly thin corneas, those who actively participate in contact sports, and those in active military duty.

The limitations of moderate discomfort and a sometimes a bit lengthy visual recovery stimulated eye surgeons to further refine the technique of Laser Eye Surgery to facilitate quicker visual recovery and make it as comfortable a procedure as possible.

  About LASIK (Laser Assisted In-Situ Keratomileusis)

Eye surgeons and researchers began developing a Laser Eye Surgery technique whereby rather than applying the Excimer laser to the surface of the cornea as in PRK, they could apply the Laser between the layers of the cornea. This was accomplished by first creating a very thin flap of corneal tissue that could be readily be replaced. This type of Laser Eye Surgery is called “lamellar eye surgery” because it is performed between the layers. The most common type of lamellar eye surgery for correcting common eye problems such as nearsightedness, farsightedness and astigmatism is called Laser Assisted In-Situ Keratomlieusis or LASIK. LASIK Eye Surgery is the most common type of Laser Eye Surgery today and one of the most common surgical procedures performed overall.

LASIK Surgery is the most advanced type of laser eye surgery used today to correct nearsightedness, farsightedness and astigmatism. LASIK is actually short for Laser Assisted In-Situ Keratomileusis, which is a term used to describe the procedure whereby a laser is used to reshape the cornea from within its layers.

In order to perform LASIK, Dr. D’Ambrosio Jr will direct the staff to place a few eye drops in your eyes to numb the surface of your eye. This will make you quite comfortable during your treatment.

You will then be escorted inside the Excimer laser suite at D’Ambrosio Eye Care and asked to position yourself comfortably on the laser system bed. Dr. D’Ambrosio Jr. will gently place a small instrument between your eyelids to help you remember to keep them open during your LASIK surgery.

Dr. D’Ambrosio Jr. will then create a very thin layer, which is a “flap” of clear tissue in the center of the cornea. He will then carefully fold the flap over and allow the inner layer of the cornea to be visible so that the laser can be applied.

The actual Laser treatment may take anywhere from a minute to a minute and a half depending on the degree of prescription to be corrected. Based on your examination, your prescription and other measurements and calculations collected at your LASIK consultation, information is programmed into a computer that will monitor and control the actual application of the laser. Upon completion of the laser application, the curvature of your cornea will be altered with the shape necessary to correct your vision.

Dr. D’Ambrosio will then gently and carefully place the “flap” back into its proper position. Since the cornea is able to bond to itself, replacing the “flap” requires no sutures be used to hold it in place. LASIK surgery has the desirable characteristics of allowing the healing and visual recover process to be very quick for most patients. For a few days after your LASIK Eye Surgery, be careful not to rub or bump your eyes too much. It is expected that you will have a mild “sandy” or “gritty” sensation during the first day or so after your LASIK surgery.

Dr. D’Ambrosio Jr. and his staff will give you complete instructions regarding eye drops to use to facilitate the healing and visual recovery process.

 YOU NEED TO FOLLOW THESE INSTRUCTIONS CAREFULLY

 Even if you think that you are doing well, it is necessary for you to return for your scheduled follow-up visits to check the healing process. Most LASIK patients at D’Ambrosio Eye Care are able to pass the Massachusetts driver’s eye test without eyeglasses or contacts within a day or so after their LASIK Surgery.

You should feel free to discuss all of your concerns and ask all of your questions about LASIK or any Laser Eye Surgery with staff at D’Ambrosio Eye Care. The staff and Refractive Surgery Coordinator will be pleased to spend whatever time is necessary to review any information about the LASIK procedure, what to expect on LASIK surgery day, follow-up care, fees and affordable payment plans that will fit into your budget.

The only way to really be sure that you are a good candidate for LASIK is to schedule a free LASIK consultation at D’Ambrosio Eye Care. When you schedule your LASIK consultation, begin to think about all the things in your life that would be more convenient or more comfortable if you didn’t have to depend on eyeglasses or contact lenses to do them. Then, at your LASIK consultation tell our Refractive Surgery Coordinator about what you would like to be able to do without eyeglasses and contacts staff so that together you can set realistic expectations for your LASIK surgery.

   About Custom Wavefront Guided Laser Eye Surgery

Many people do not realize that their eyes are really a living optical system made up of a number of optical components, that together, produce the optical characteristics of your eyes. The two main optical components of your eye are the cornea and the crystalline lens. As with any optical component, the cornea and crystalline lens may have distortions. These distortions are called aberrations. Everyone who wears eyeglasses or contact lenses is familiar with the most common aberrations which are called myopia, hyperopia and astigmatism. These aberrations are relatively simple aberrations and are thus are called ‘low order’ aberrations. Since they are relatively simple, low order aberrations can usually be corrected with eyeglasses and contact lenses. However, there are some optical aberrations that cannot be fully corrected with eyeglass or contact lens prescriptions because they are too complex. These aberrations are probably unfamiliar to most patients but include spherical aberration, coma and trefoil. Since these aberrations are much more complex, they are called “high order” aberrations. High order aberrations are not corrected with eyeglasses or contact lenses. Until a few years ago we were not able to measure high order aberrations in everyday clinical practice in an eye care office because the necessary instrumentation was only found in research laboratories.

Today, at D’Ambrosio Eye Care we use a clinical eye care instrument called and aberrometer at each and every LASIK consultation to fully understand the complexity of the prescription we are trying to correct. By measuring aberrations at your LASIK consultation we can apply them to any visual symptoms or complaints that you might have. If you are found to have considerable high order aberrations that make your vision uncomfortable, Dr. D’Ambrosio Jr. may recommend using a Custom Wavefront Laser Eye Surgery procedure to achieve the best possible results.

At your LASIK consultation we will be taking careful aberrometry measurements along with a thorough eye examination including measuring your prescription, measuring your pupil size, performing a retinal and optic nerve exam through a dilated pupil and measuring your corneal thickness and corneal shape to confirm that you are a good candidate for LASIK. Further, we will have an in depth discussion exploring the vision correction goals you have and the specific things that you wish to achieve by having LASIK surgery.

If you are considering having LASIK in Massachusetts, and especially LASIK in Boston or any type of specialized LASIK Eye Surgery in Boston, please fee free to contact D’Ambrosio Eye Care at 1.800.325.EYES for a Free LASIK Surgery Consultation in Boston.