Refractive Surgery

At Gulf Coast Eye Center, our highly qualified, experienced doctors perform a variety of surgeries to help our patients see more clearly. We provide LASIK, PRK, AK and Refractive Lensectomy services depending on the patient’s need. To learn more about each procedure, see below.

One of the most popular ways to correct vision is with a procedure called LASIK (laser in-situ keratomileusis), which uses a laser to change the curvature of the cornea (outer window of the eye). LASIK has quickly become the procedure of choice for most patients because they recover quickly and have fewer side effects and complications than with other methods of vision correction. In fact, most LASIK patients notice a significant improvement in their vision soon after surgery. LASIK removes tissue within the cornea to treat low to high levels of Nearsightedness (Myopia) , Farsightedness (Hyperopia), and Astigmatism.

 

Nearsightedness

To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.

 

Farsightedness

To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.

 

 

Astigmatism

To treat astigmatism, the cornea is made more spherical–like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.

LASIK is for those:

  • Want to reduce or eliminate their dependence on glasses or contacts.
  • Are at least 18 years of age.
  • Have has a stable eye prescription for at least one year.
  • Have no health issues affecting their eyes.
  • Have no signs of glaucoma or visually significant cataract.

What to expect on surgery day:

You will arrive at the laser center about an hour prior to your procedure. Once you have been checked in, you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye. Anesthetic eye drops will be used to numb your eyes; no injections or needles will be used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

Next, an instrument called a microkeratome will create a hinged flap of thin corneal tissue, and your doctor will gently fold the flap out of the way. During this process, you may feel a little pressure but no pain. You will then be asked to look directly at a target light while the laser reshapes your cornea. The Excimer laser will be programmed with the information gathered in your preoperative exam. The laser treatment will be completed in less than a minute or two, depending on the amount of correction needed. To finish the procedure, the protective layer will be folded back into place where it will bond without the need for stitches.

Following your procedure, your eyes will be examined with a slit lamp microscope. Then you will be given additional eye drops, and your eyes may be shielded for protection. Your vision will probably be a little blurry at first, so someone will need to drive you home. You should relax for the rest of the day. You may experience some discomfort for 12 to 24 hours, but this is usually alleviated with an over-the-counter pain reliever. Some people experience sensitivity to light and watering or swelling of their eyes for a few days following their procedure.

You will be asked to come back the next day for another examination of your eyes. Most people can actually see well enough to drive the next day, but it is best not to drive until you have been examined. You should be able to resume your normal activities the day after surgery.

Vision can fluctuate for up to six months, but most people can see well enough to pass a drivers license vision exam shortly following their procedure.

Realistic expectations:

The decision to have LASIK is an important one that only you can make. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses. However, we cannot guarantee you will have the results you desire. The vast majority of our patients are extremely happy with their vision after LASIK and can do most activities without dependence on corrective lenses.

Serious complications with LASIK are extremely rare. LASIK is a safe, effective, and permanent procedure, but like any surgical procedure, it does have some risks. Many of the risks and complications associated with this procedure can be reduced or eliminated, through careful patient selection and thorough preoperative testing, using the latest diagnostic technology.

After LASIK, you may experience some visual side effects. These visual side effects are usually mild and diminish over time. But, there is a slight chance that some of these side effects won’t go away completely, such as feelings of dryness, glare, and halos.

Since everyone heals somewhat differently, some patients may overreact to the procedure, and some may under-correct resulting in over-corrections and under-corrections. Once the eye has stabilized (3 to 6 months) you and your doctor can discuss whether a re-treatment could help fine tune your vision if you are over or undercorrected.

After a thorough eye exam, you and your doctor will determine if LASIK is an option for you. If you are a good candidate, you will be given additional information about the procedure that will allow you to make an informed decision about whether or not to proceed. Be sure you have all of your questions answered to your satisfaction.

PRK was the first procedure performed using the Excimer laser. PRK was available 2-3 years before LASIK was approved in about 1998. It corrects vision by reshaping the cornea. The difference between LASIK and PRK is that with LASIK a corneal flap is created and the laser is applied to the inner tissue of the cornea. With PRK, the epithelium (or outer skin of the cornea) is removed and a laser is applied to the surface of the cornea.

PRK can be used to correct low to high levels of nearsightedness, farsightedness and astigmatism.

PRK

LASIK

To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.

To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.

To treat astigmatism, the cornea is made more spherical–like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.

PRK is for those who:

  • Want to reduce or eliminate their dependence on glasses or contacts.
  • Are over 18 years of age.
  • Have had a stable eye prescription for at least one year.
  • Have no health issues affecting their eyes.
  • Have corneas to thin for LASIK.

What to expect on surgery day:

You will arrive at the laser center about an hour prior to your procedure. Once you have been checked in, you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleansed and a sterile drape may be applied around your eye. Anesthetic eye drops will be used to numb your eyes; no injections or needles will be used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

Next, your doctor will remove the epithelium, a thin layer of protective skin that covers the cornea. You will be asked to look directly at a target light while the laser reshapes your cornea. The laser will be programmed with the information gathered in your preoperative exam. The laser treatment will be completed in less than a minute or two, depending on the amount of correction needed.

Following your procedure, your eye(s) will be examined with a slit lamp microscope. Your eyes may be shielded for protection. Your vision may be blurry or hazy for one to five days. You will experience some discomfort as the epithelium heals and covers the treated area. Eye drops, pain medication, and a protective contact lens will be used to minimize this discomfort. Most patients resume normal activities within three to five days. Vision can fluctuate for up to six months.

Astigmatic Correction (Astigmatic Keratotomy – AK) is an outpatient surgical procedure to reduce or eliminate astigmatism. Astigmatism is caused by a cornea (outer window of the eye) that is shaped like a football, steep in one meridian and flat in the other. In order to reduce or eliminate astigmatism, the cornea is reshaped to make it more spherical, like a basketball.

AK can be used in combination with other laser and surgical vision correction procedures.

AK involves the placement of microscopic incisions in the steeper meridian of the cornea. The incisions cause the cornea to assume a more spherical shape, thereby decreasing the degree of astigmatism.

AK is for those who:

  • want to reduce or eliminate their dependence on glasses or contacts.
  • are over 18 years of age.
  • have a low to moderate degree of astigmatism.
  • have had a stable eye prescription for at least one year.
  • have no health issues affecting their eyes.

What to expect on surgery day:

You will arrive 30-60 minutes prior to your procedure. Once you have been checked in and settled comfortably, you will be prepared for surgery. The area around your eyes will be cleansed and a sterile drape will be applied. You may be given a sedative to help you relax. Anesthetic eye drops will be used to numb your eye; no injections or needles are used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking.

Next, a marker will be placed on your cornea. This mark is temporary and is used to guide where the surgeon will make the incisions. The marks are based upon a formula taking into account your prescription, age, and the amount of correction needed. Next, one or two microscopic incisions will be made in our cornea to make it more spherical. Finally, antibiotic drops will be applied and the eyelid holder will be removed. The actual surgery takes about five minutes, but with preoperative preparations, it can take up to an hour.

Following your procedure, you will be given additional eye drops, and your eye may be shielded for protection. Your vision will probably be a little blurry at first, so someone will need to drive you home. You should relax for the rest of the day. You may experience some discomfort, but this is usually alleviated with an over-the-counter pain reliever. Some people experience sensitivity to light and watering or swelling of their eyes for a few days following the procedure.

Most patients resume normal activities within a day or two. Some patients see a dramatic improvement in their vision within the first day. For others, vision may be blurry for several weeks.

Realistic expectations:

The decision to have AK is an important one that only you can make. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses. However, we cannot guarantee you will have the results you desire.

After AK, almost everyone experiences some visual side effects. These visual side effects are usually mild and most often diminish over time. But, there is a slight chance that some of these side effects won’t go away completely, including light sensitivity, glare and halos. Serious complications with AK are extremely rare.

The excimer laser can also be used to treat astigmatism. The PRK and LASIK procedures are the ones used that are also used for astigmatism correction

As we age, the lens inside our eye loses its ability to focus both near and far. Most vision correction procedures attempt to change the focusing power of the cornea. Refractive lensectomy, on the other hand, corrects nearsightedness Nearsightedness (Myopia) or Farsightedness (Hyperopia) by replacing the eye’s natural lens, which has the wrong power, with an artificial intraocular lens (IOL) implant that has the correct power for the eye.

Refractive lensectomy is a surgical procedure that uses the same successful techniques of modern cataract surgery. These surgical techniques have evolved and improved dramatically over the last 20 years. Cataract surgery is now the most common surgical procedure performed in medicine today.

The main difference between standard cataract surgery and refractive lensectomy is that cataract surgery is primarily performed to remove a patient’s cataract that is obstructing and clouding their vision, while refractive lensectomy is performed to reduce a person’s dependence on glasses or contact lenses. Refractive lensectomy can be combined with other procedures that treat astigmatism such as LRIs and AK.

Refractive lensectomy is for those who:

  • want to reduce or eliminate their dependence on glasses or contacts.
  • may not be a good candidate for laser vision correction.
  • are 18+ years of age.
  • have no health issues affecting their eyes.

Cataracts are a part of the normal aging process, and, if a person lives long enough, chances are they will develop cataracts. People who have refractive lensectomy now, will not require cataract surgery in the future. 

What to expect on surgery day:

The refractive lensectomy procedure is performed on an outpatient basis. Only one eye will be treated at a time. After the eye is completely numbed with topical or local anesthesia, the eye’s natural lens will be gently vacuumed out through a tiny incision, about one eighth of an inch wide.

Next, the new, intraocular lens will be folded and inserted through the same microincision. It will then be unfolded and placed into the capsular bag that originally surrounded the natural lens. This incision is self-sealing & and usually requires no stitches. It remains tightly closed by the natural outward pressure within the eye. This type of incision heals fast and provides a much more comfortable recuperation.

If your eye has pre-existing astigmatism, your surgeon may elect to make micro-incisions in the cornea to reduce your astigmatism. These are called LRIs or limbal relaxing incisions.

You will go home soon after the surgery and relax for the rest of the day. Everyone heals somewhat differently, but many patients report improvement in their vision almost immediately after the procedure. Most patients return to their normal activities within a day or two.

Realistic expectations:

he decision to have refractive lensectomy is an important one that only you can make. The goal of refractive lensectomy is to reduce or eliminate your dependence on glasses or contact lenses. However, we cannot guarantee you will have the results you desire.

Serious complications with refractive lensectomy are extremely rare. It is a safe, effective and permanent procedure, but like any surgical procedure, it does have some risks. Going to an eye specialist experienced with the procedure can significantly minimize the risks involved with refractive lensectomy.

After a thorough eye exam, you and your doctor will determine if refractive lensectomy is an option for you. If you are a good candidate, you will be given additional information about the procedure that will allow you to make an informed decision about whether or not to proceed. Be sure you have all of your questions answered to your satisfaction.