Laser Vision Correction Options Available at Shiley Eye Center - La Jolla, California

» (LASEK) Laser Epithelial Keratomileusis
» Custom Lasik
» Intralase FS
» (ICRS) Intacs™ Instratromal Corneal Ring Segments
» (PRK) Photorefractive Keratectomy
» (RK) Radial Keratotomy
» (AK) Astigmatic Keratotomy

Laser Epithelial Keratomileusis (LASEK)

LASEK is a relatively new laser vision correction procedure that is similar to LASIK. The primary difference is that for LASEK the flap is created from corneal epithelium alone, while in traditional LASIK the stroma is also affected. Once the epithelium has been pulled aside, the LASEK surgeon applies the excimer laser to the surface of the cornea (as in PRK laser vision correction).

The advantages of LASEK laser vision correction include:

• Much less tissue is temporarily removed than in LASIK surgery
• A microkeratome is not needed
• Infections can be treated more readily
• Patients with dry eyes may benefit from LASEK

Please note that visual recovery is not as rapid as with LASIK and some patients endure greater discomfort.

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CustomLASIK

CustomLASIK, the next generation in laser vision correction, has recently gained FDA approval. CustomLASIK technology allows us to map the individual topographies of our patients' eyes. The experts believe this can provide superior vision quality, as compared with other methods of laser vision correction.

Wavefront technology is used to measure the way light travels through one's eye, and then compares that to the measurements for an eye with perfect vision. A precise, three-dimensional map of the eyes is then created. The laser vision correction surgeon then refers to this map to customize your treatment.

CustomLASIK Candidates

Certain types of visual imperfections, categorized as higher and lower-order aberrations, can distort one's vision. CustomLASIK can treat aberrations of the higher-order variety, such as glare and poor night vision. In the past, these visual imperfections could not be sufficiently prevented or corrected by contacts, glasses, or conventional laser vision correction techniques.

This advanced laser vision correction technology now offers:

• Vision correction for nearsightedness AND farsightedness!
   For more information, click here.
• 25 times greater precision than standard methods of measurement
• Customized treatment based on a wavefront map
• Unprecedented vision quality, including better night vision
• The greatest chance for achieving the best results

Have questions about LASIK? Check out our CustomLASIK FAQ page.

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Intralase FS

IntraLase is new technology that provides a less invasive, more precise alternative to using a microkeratome for flap creation in laser vision correction. A computer-controlled laser is utilized to create a thinner, cleaner flap. The Shiley Eye Center at UC San Diego believes that the IntraLase system is worth the extra cost to the patient. While the standard microkeratome technique has been extremely successful, we believe IntraLase provides the best standard of care for our patients. This technology can make LASIK laser vision correction more precise, less invasive, and safer.

The Intralase laser directly acts upon the stromal layer of the cornea after passing through a disposable glass lens. In this way, the outer surface of the cornea is not affected, and the procedure is pain-free. It has been demonstrated through testing that the IntraLase laser provides greater flap stability, as well as better accuracy in the size and depth of resections.

By replacing the microkeratome with an unobtrusive beam of laser light, this new technique reduces the risk of complications associated with corneal flaps. In addition, more people may qualify to have laser vision correction performed. The precision available with IntraLase makes it possible to create a flap for patients with thin corneas, who otherwise may have been inoperable.

The Shiley Eye Center is dedicated to helping you achieve your best possible vision. By combining IntraLase with CustomLASIK, we can now offer our patients totally customized laser vision correction.

To see the frequently asked questions regarding IntraLase, click here.

To learn more about IntraLase, go to: www.intralase.com

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Intacs™ Intrastromal Corneal Ring Segments (ICRS)

The Advantages of Additive Techniques: Intrastromal Corneal Rings. by Michael D. Twa, O. D.

This refractive surgery procedure involves implanting a small plastic arch-shaped device at the outer edge of the cornea. The thickness of the Intacs used depends upon the desired refractive effect.

The main advantage of Intacs over laser vision correction procedures is the potential for adjusting or reversing the procedure. The FDA granted approval for the use of the ICRS device in the United States in 1999. There are currently designs available that correct myopia, hyperopia, and astigmatism. Some designs that will increase the range of possible correction are still under investigation. The surgical implantation of Intacs is an outpatient procedure performed under topical anesthesia.

During the procedure, the geometric center of the cornea is found, and then a 1.8mm long superior radial incision of 2/3 corneal thickness is made near the superior limbus. A vacuum-centering guide is positioned around the center of the cornea to stabilize the eye during creation of the tunnel that will hold the Intacs.

The dissector, a blunt tipped device, is guided into position at the depth of the incision. The instrument is rotated 180 degrees in each direction to make the tunnel that will hold the Intacs. The ICRS is then introduced and positioned. Sometimes a suture is used to close the original incision.

Intacs are beneficial for patients with Keratoconus. For more information click here.

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Photorefractive Keratectomy (PRK)

The PRK procedure consists of using an excimer laser to ablate a thin amount of tissue from the cornea's surface. Most focusing problems can be compensated for by this slight adjustment to the shape of the cornea. Myopia, astigmatism, and myopia with astigmatism can be treated with PRK laser vision correction.

To learn more PRK laser vision correction, visit our FAQs page.

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Radial Keratotomy (RK)

Radial Keratotomy is one of the oldest refractive surgery procedures. RK involves making incisions in a radial pattern on the surface of the cornea. These incisions cause the surface of the cornea to flatten slightly, which can achieve the desired result – correcting nearsightedness. Unfortunately, the results were unpredictable and unstable. The more accurate laser vision correction procedures available today are generally preferable to RK.

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Astigmatic Keratotomy (AK)

This procedure is somewhat similar to radial keratotomy, the difference being that astigmatic keratotomy is performed to treat astigmatism. Incisions are made to flatten specific areas of the cornea. If executed correctly, AK can treat astigmatism. However, like RK, the AK procedure is somewhat unreliable and has been supplanted by modern laser vision correction techniques.

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