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There have been marked advances in refractive surgery since earlier attempts at reshaping the cornea using a special keratome (corneal knife) were first described in the 1970s (radial keratotomy- RK). Ophthalmologists have long known that the cornea (outer layer of the eye) could be surgically reshaped to change a person’s refractive states (need for glasses); however, using a knife to manually incise the cornea lacked the precision we think of today.
The advent of the excimer laser changed the refractive surgery dramatically as the accuracy, precision, and safety of this newer technology was quickly appreciated by many patients. Soon, a microkeratome was specially developed to make a flap of tissue that could be repositioned after the excimer laser was performed, and the boom of laser-assisted in situ keratomileusis (LASIK) ensued. This provided for a faster recovery and a near painless experience for many people.
Since then, there continues to be marked advances in refractive surgery. The microkeratome (semi-automated knife) has largely been replaced by a femtosecond laser leading to “bladeless/all laser” refractive surgery. Further, there has been a resurgence of advanced surface ablation also known as “flapless” refractive surgery.
All refractive surgeries have the same goals of reduced dependence on glasses and/or contact lenses. There are numerous ways to accomplish this, and there is no single solution for each individual patient. The surgeries can be divided into three main categories: corneal surgeries, implantable intraocular (inside the eye) lenses, or refractive lens/cataract exchange (removal of the natural crystalline lens and replacement with an artificial lens).
Corneal surgeries typically involve reshaping the surface of the cornea to reduce the refractive error of the eye. This can be accomplished with a laser (LASIK, epi-LASIK, LASEK, PRK, etc), heat (e.g. conductive keratoplasty), or manually incising (e.g. radial keratotomy, limbal relaxing incisions, etc). Each technique has inherent advantages and disadvantages. Newer corneal surgeries involve implanting special devices within the actual cornea for improved visual acuity.
During your refractive surgery evaluation at Eye Physicians Inc, we will perform a detailed examination of your eyes to determine whether refractive surgery is an option for you and, if appropriate, discuss which surgery may be best for you. This examination is much more detailed than a standard eye examination and includes measurements such as your corneal thickness (pachymetry) and corneal shape (topography).
Drs. Wild, Dinn, and Swindler have years of experience performing various refractive surgeries; however, we mainly have transitioned to advanced surface ablation (e.g. PRK/LASEK/epi-LASIK) over the last few years because of the safety of the surgery and significant advances in the post-operative regimen that has enhanced patient comfort and hastened healing. All of our surgeons have extensive training in intraocular surgery and perform multifocal intraocular lens and astigmatism correction (toric) intraocular lens placement.