LASIK and ASA

LASIK, or Laser Assisted In-Situ Keratomileusis is a surgical procedure for myopia (nearsightedness), hyperopia (farsightedness) and astigmatism correction.

LASIK eye surgery is performed using a laser to gently reshape the cornea under a protective flap of tissue. Lake Austin Eye uses only FDA approved technology for this procedure, including the Nidek and VISX laser systems.

LASIK vision correction utilizes two proven surgical procedures to correct vision errors; the creation of a corneal flap and the use of the computer-controlled excimer laser. The creation of the corneal flap was first introduced more than 30 years ago and has been successfully performed and perfected by surgeons worldwide. Using a femtosecond laser, a protective flap of corneal tissue is created which covers the area to be reshaped by the laser. This protective flap facilitates rapid vision recovery and reduces discomfort after LASIK eye surgery.

The second technique uses a computer-controlled excimer laser with a cold, ultraviolet beam to gently sculpt the cornea, removing microscopic amounts of tissue to change the shape and allow the eye to focus more clearly.

The shape or curvature of the cornea affects the eye’s focusing ability. In nearsighted patients, the laser will flatten the curvature of the cornea. In farsighted patients, the laser steepens the cornea. For patients with astigmatism, the laser will contour or make the cornea more spherical in shape.

ASA, or Advanced Surface Ablation, is when the surface cells of the cornea, or the epithelium, is removed prior to the laser treatment. This procedure is performed if your doctor decides that a flap creation is not the right choice for you. This may be because your cornea is thin, your surface is irregular, or for a variety of other reasons. After ASA, your vision will take longer to recover (1-2 weeks) but the end-result is the same.

Laser Vision Correction Technology

The Food and Drug Administration (FDA) approves lasers and devices for a range of treatment. Not all lasers and not all treatments are approved by the FDA as safe and effective. At Lake Austin Eye, we use an FDA approved laser with a full range of treatment capabilities, including wavefront optimized and customized wavefront laser vision correction.

The customized correction allows the laser to program a treatment pattern directly matched to the optical aberrations in each individual eye.

The goal of wavefront optimized or customized laser treatment is to provide a better quality of vision, to improve clarity and contrast sensitivity, and to reduce some side effects of the LASIK procedure, namely glare, halo and reduced night vision.

Not all 20/20 vision is the same. While 20/20 measures the quantity of vision, or how many lines of the Snellen chart can be read, it does not define the QUALITY of vision. The quality of vision is defined by crispness, clarity and contrast sensitivity. A wavefront aberrometer captures the distorted waves as they exit and compares them to a perfectly flat light wave indicative of a perfect optical system. This distortion is represented in a 3D map illustrating both lower order (myopia, hyperopia and astigmatism) and higher order (coma and spherical) aberrations. The wavefront device maps the unique distortions of a patient’s optical system differently for each individual. These distortions are output as a 3D map, which becomes a guide for the laser, telling it where to reshape your cornea and correct your vision. Laser treatment with a wavefront optimized or customized laser pattern can result in a reduction of common side effects of LASIK eye surgery, including degradation of night vision, glare, and halo, and an overall improved quality of vision.

LASIK Eye Surgery Procedure FAQ

  • What can I expect in my preoperative exam with my doctor?

    Your preoperative exam will last approximately 1 1/2 to 2 hours. It includes a comprehensive medical eye exam as well as two refractions, computerized corneal mapping, corneal thickness measurement, glaucoma testing, and a full medical and ophthalmic history. You will be dilated during the exam. It will make you sensitive to light and blur your near vision to a greater extent than your distance vision. Driving home after the eye exam will depend on your comfort level, but typically most patients are able to drive after the exam.

  • What can I expect during LASIK eye surgery?

    On the day of LASIK eye surgery, your eyes will be anesthetized with numbing eye drops, and you will be given a mild sedative if desired. You will be comfortably positioned on a bed beneath the laser. A small device called a lid speculum is used to keep your eyelids open and the technicians will perform a pilot-style checklist with each patient to ensure the equipment is working properly and programmed correctly with the intended correction.

    The LASIK eye surgeon uses the femtosecond laser to create the protective flap. During the flap creation, your vision will get very dim and you may feel some tightness around your eye. The flap is folded back to expose the middle layer of corneal tissue. The cold laser beam is then used to remove tissue to reshape your cornea based on your desired correction. During the treatment, you will hear a clicking sound of the laser pulses. You will be asked to look towards a blinking fixation light; however, the tracking system will follow any eye movement and allow the laser to accurately place the treatment. The use of the laser is generally about one minute. The flap is then replaced in its original position. In some cases, your doctor may elect to place a soft, thin contact lens on the cornea following eye surgery to protect the surface of the flap for the first day. Overall, the laser eye surgery takes about 10 minutes.

  • What can I expect after the LASIK procedure?

    You may be sensitive to light and have a feeling that something is in your eyes. Sunglasses may make you more comfortable. You may experience some discomfort, but the drops will help to alleviate this without the use of pain medication. If needed, you may take Tylenol, Ibuprofen or Aspirin.

    Some patients experience small fluctuations or blurriness in their vision in the first week to a few months after LASIK surgery. Some patients experience their best-corrected vision in the first week after the surgery, while others may improve over time.

  • What can I expect my results to be?

    Your doctor will discuss your expectations and the chances of success for your individual case during the preoperative consultation. We expect to not only improve vision and visual acuity but also to reduce most of the aberrations in your vision, improve clarity and contrast sensitivity, and a reduce or eliminate of the glare and halos that can be seen following LASIK eye surgery.