Dr. Paul Krawitz performs refractive surgical procedures, including Lasik and Advanced Surface Ablation. To read more about his experience,CLICK HERE.
The Excimer laser is a computer controlled ultraviolet beam of light that reshapes the cornea, or outer window of the eye, in an effort to allow light to focus more directly on the retina.
The Excimer has been used since the early 1980's and underwent numerous clinical trials since that time to refine its use and determine its safety and effectiveness. Now in its second decade of use, the Excimer laser is routinely used to treat nearsightedness, farsightedness and astigmatism.
Each pulse of the laser disrupts the molecular bonds between the corneal cells with accuracy up to 0.00004 of an inch, which makes it extremely accurate. Often, tissue measuring about 1/2 the thickness of a human hair is removed to achieve the proper amount of correction.
The Excimer laser produces a cool or non-thermal light beam. This makes it ideal for corneal surgery because it eliminates the possibility of thermal damage to surrounding tissue. Its accuracy provides surgeons with a tool that can deliver highly predictable results.
Both Advanced Surface Ablation and LASIK use the Excimer laser to reshape the cornea. There are, however, important differences between the two.
In Advanced Surface Ablation (photorefractive keratectomy), the Excimer layer is used exclusively to reshape the cornea. To accomplish this, the surface layer of the cornea, known as epithelium, is also removed. Although the Advanced Surface Ablation procedure itself is painless, patients may experience blurry or hazy vision for one to five days afterward and variable discomfort until the epithelium heals and covers the treated area. Final visual results may be realized anywhere from several days to a month or more. Anti-inflammatory eyedrops are taken for one to three months. Advanced Surface Ablation is often used to treat low to moderate amounts of nearsightedness, farsightedness and astigmatism, but because it spares more cornea tissue that Lasik, it is often used to treat higher refractive errors as well.
LASIK, or Laser in-Situ Keratomileusis differs from Advanced Surface Ablation in that it corrects vision by reshaping the corneal tissue beneath the surface of the cornea rather than on the surface. Although most surgeons use a precise cutting instrument with an oscillating metal blade, called a microkeratome to cut the initial thin flap from the cornea, Dr. Krawitz now recommends Intralase for this initial step for most patients. Intralase, which uses precisely focused laser light rather than a metal blade to create the surgical flap is desirable for two reasons. Firstly, it creates a better and more predictable surgical flap. Secondly, it removes less corneal tissue than does the microkeratome, thus preserving 33% more of the patient's corneal tissue. Dr. Krawitz is one of only a selected number of ophthalmic surgeons on Long Island that is certified in the Intralase procedure. During this process you may feel a little pressure, but no discomfort. You will be asked to look directly at a target light while the laser reshapes the cornea, usually in less than a minute. Then, the protective flap is folded back in place where it bonds securely without the need for stitches. After LASIK, some patients report a slight discomfort that usually goes away within twelve to twenty-four hours.
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