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For most patients, a procedure called Laser In Situ Keratomileusis (LASIK) may be the best way to achieve clear and more natural vision. This procedure had its origins back in the 1960s and has evolved over the years into a popular and effective operation. In LASIK, an excimer laser is used to precisely reshape the surface of the cornea. The excimer laser is a unique type of cold laser that does not burn or cut tissue. Instead, it gently breaks the molecular bonds between cells so that controlled amounts of tissue can be literally vaporized away, one microscopic layer at a time.

LASIK has become the procedure of choice – especially with patients in high degrees of correction. The current technique involves both the use of conventional and laser surgeries to correct nearsightedness, farsightedness, and astigmatism.

In performing LASIK, the surgeon first uses a special oscillating blade to make a partial cut through 1/4 to 1/3 of the front surface of the cornea, creating a flap of clear tissue on the central part of the eye. The patient is then positioned under the excimer laser, which is programmed to vaporize away some of the internal corneal tissue under the flap.

Central tissue is removed to reduce curvature and correct nearsightedness. A donut pattern is fashioned for farsighted corrections, thereby steepening the cornea. Astigmatism can be corrected by removing selected tissue to even out the curvature of the cornea. After the laser has removed the selected tissue, the flap is closed over the eye. The cornea has extraordinary natural bonding qualities that allow effective healing without the use of stitches.

During the procedure, patients remain awake with only the designated eye anesthetized with drops. Good vision is often possible on the day following the surgery. Eye drops are used for approximately one week. Protective eye shields are recommended while sleeping during the first few nights. With few exceptions, patients can return to work the next day.

David Malitz, MD