Steps to the Procedure:
For the PRK procedure, no scalpels are used and no incisions are made. Prior to the procedure, an extremely detailed map of your eyes’ surface is created by a computer and then used by your surgeon to calibrate the excimer laser to your exact prescription.

The  technician will put a few anesthetic drops in to numb the eye and prevent pain.

Your  surgeon prepares the eye by gently removing the eye’s protective first layer of cells, or epithelium (this will naturally regenerate itself in a few days), with the laser, to reveal the next layer of corneal tissue known as Bowman's layer.  He/she will then smooth the area and proceed with applying computer-controlled pulses of cool laser light to precisely and delicately reshape the curvature of the eye. Deeper cell layers remain virtually untouched.

The whole PRK procedure itself is usually completed in less than five minutes and is painless. Since a layer about as slender as a human hair is typically removed, the cornea maintains its original strength.

Post-operatively, PRK patients are placed on antibiotic drops, along with anti-inflammatory agents to promote comfort and reduce swelling. Patients are also fitted with a bandage contact lens to improve their comfort while their eye is healing. Once the epithelium is healed, usually on the second or third post-operative day, the bandage contact lens is removed by your  doctor. Daily eye examinations are required during this initial healing process to ensure an infection does not develop.

To complete the healing process, PRK patients use steroid anti-inflammatory drops for typically around 2 months under the direct supervision of your eye doctor. 

INTACTS (Intracorneal rings)

Corneal rings are a recently introduced procedure for very low myopic prescriptions only. Two small plastic crescents (arcs) are inserted in the cornea following an incision. These arcs are inserted into a tunnel created between layers of stromal tissue.  A ring is formed around the cornea’s edge by the crescents which are about as thick as a contact lens.  Their slight weight flattens the cornea.   A single stitch is usually needed to close the wound.

These rings are removable, but not necessarily reversible.  In the FDA clinical trials, there were 7% that were removed, and most patients’ prescription returned to, or near their preoperative prescription.

Some 7% to 17% of patients have suffered side effects such as glare, halos, blurry vision and problems with night vision.  Low amounts of hyperopia have been reported post-operatively.  The FDA has warned that implants are only for mildly nearsighted people, whose vision is formally diagnosed as –1.00 diopters to –3.00 diopters. That roughly translates to vision ranging from about 20/40 to 20/300.  Astigmatism cannot be corrected at this time.

Every patient and prescription  is looked at individually to decide what is best for them.    Doctors are very prudent and thorough in deciding whether you are a good candidate for any vision correction procedure.  They will be happy to discuss the potential outcome and risks involved for a patient with your particular prescription. 

CLEAR LENSECTOMY
Vision correction candidates should be aware that   myopia might also be treated by removing the natural crystalline lens, also known as clear lensectomy, in a procedure similar to cataract surgery.

This procedure, recently introduced in North America, is a far more invasive procedure than LASIK as the eye itself is entered, and there are additional intraocular risks not associated with LASIK. An implant may or may not be inserted to replace the natural lens. Your eye’s ability to fine tune near images is lost, resulting in the necessity for reading glasses regardless of age.  Therefore, this is a procedure best performed to patients over 40 years of age.

This procedure may be combined with LASIK, typically after the procedure, to further improve results by treating any myopia or astigmatism to obtain very impressive results. Every patient and prescription  is looked at individually to decide what is best for them.  Doctors are very prudent and thorough in deciding whether you are a good candidate for any vision correction procedure.  They will be happy to discuss the potential outcome and risks involved for a patient with your particular prescription.

Risk factors known are infection, a much greater risk of retinal detachment, as well as other complications experienced with cataract surgery. 

ALK (Automated Lamellar Keratoplasty) is a procedure developed from older methods of vision correction.

With ALK, a microkeratome (an automated microsurgical instrument similar in design to a carpenter's plane) is used to create a corneal flap, of approximately ¼ of the cornea’s depth.  This reveals the inner corneal tissue. A thin layer of corneal tissue is then removed with a second microkeratome pass, thereby reshaping the cornea. The corneal flap is then carefully put back into place. Over the next few days, the flap edges will heal.  ALK performed in this fashion can correct myopia, and a variation of this procedure can correct hyperopia.

ALK can treat very high levels of myopia. However, the procedure lacks the accuracy of the excimer laser. It is often combined with RK/AK (link to RK page) in order to fine-tune the final visual results and to treat any accompanying astigmatism.