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What is an instrument called the microkeratome used for in corneal surgery?
The surgeon creates a flap of tissue across the cornea with an instrument called a microkeratome, ablates the cornea for about 30 seconds, and then replaces the flap.
What would you advise to someone who is going to take LASIK surgery based on your actual experience?
During SurgeryThe surgery should take less than 30 minutes. You will lie on your back in a reclining chair in an exam room containing the laser system. The laser system includes a large machine with a microscope attached to it and a computer screen. (See the animation of the LASIK procedure.) A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. Your doctor may use a mechanical microkeratome (a blade device) to cut a flap in the cornea. If a mechanical microkeratome is used, a ring will be placed on your eye and very high pressures will be applied to create suction to the cornea. Your vision will dim while the suction ring is on and you may feel the pressure and experience some discomfort during this part of the procedure. The microkeratome, a cutting instrument, is attached to the suction ring. Your doctor will use the blade of the microkeratome to cut a flap in your cornea. Microkeratome blades are meant to be used only once and then thrown out. The microkeratome and the suction ring are then removed. Your doctor may use a laser keratome (a laser device), instead of a mechanical microkeratome, to cut a flap on the cornea. If a laser keratome is used, the cornea is flattened with a clear plastic plate. Your vision will dim and you may feel the pressure and experience some discomfort during this part of the procedure. Laser energy is focused inside the cornea tissue, creating thousands of small bubbles of gas and water that expand and connect to separate the tissue underneath the cornea surface, creating a flap. The plate is then removed. You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. The doctor will then lift the flap and fold it back on its hinge, and dry the exposed tissue. The laser will be positioned over your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea. This light is to help you keep your eye fixed on one spot once the laser comes on. NOTE: If you cannot stare at a fixed object for at least 60 seconds, you may not be a good candidate for this surgery. When your eye is in the correct position, your doctor will start the laser. At this point in the surgery, you may become aware of new sounds and smells. The pulse of the laser makes a ticking sound. As the laser removes corneal tissue, some people have reported a smell similar to burning hair. A computer controls the amount of laser energy delivered to your eye. Before the start of surgery, your doctor will have programmed the computer to vaporize a particular amount of tissue based on the measurements taken at your initial evaluation. After the pulses of laser energy vaporize the corneal tissue, the flap is put back into position. A shield should be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place. It is important for you to wear this shield to prevent you from rubbing your eye and putting pressure on your eye while you sleep, and to protect your eye from accidentally being hit or poked until the flap has healed.What should I expect before, during, and after surgery?http://www.fda.gov/cdrh/lasik/expect.htm
How do you cure mixed astigmatism?
LASIK is a surgical procedure that uses a laser to correct nearsightedness, farsightedness, and/or astigmatism. In LASIK, a thin flap in the cornea is created using either a microkeratome blade or a femtosecond laser. The surgeon folds back the flap, then removes some corneal tissue underneath using an excimer laser. The flap is then laid back in place, covering the area where the corneal tissue was removed. With nearsighted people, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.
A Breakdown of the Average Lasik Surgery Cost?
Just as with any other surgical procedure, the typical cost of Lasik surgery is determined by a variety of factors. With Lasik, the cost is quoted per eye. Sometimes, the actual price will be more than the quoted one due to unanticipated follow-up appointments or extensive correction. Patients will also need preoperative tests, which increases the overall price. Although patients can have Lasik surgery for as little as $500 USD per eye, most surgeons will not perform this procedure for any less than $1,000 USD per eye.New Technology Influences CostsLasik surgery costs have steadily risen over the years thanks to the integration of new surgical procedures and technologies. For instance, Lasik performed with IntraLase is a lot more costly as opposed to Lasik with Microkeratome. During an IntraLase procedure, a laser is used to cut a flap in the eye and during a Microkeratome surgery, a blade is utilized for creating a flap. IntraLase procedures tend to cost $350 USD more per eye than their Microkertome counterparts.Other Factors That Dictate PriceThe cost of using testing and operating equipment will vary depending on the equipment itself. Some examples of Lasik equipment and tests include corneal thickness measurements, corneal topography, tear film analysis equipment and tracking. And of course, the Lasik laser will influence the cost of surgery.There are more fees that play a role into the price Lasik patients incur. Surgeons will pass on the price of laser lease and maintenance to the patient. If Microkeratome blades or corneal ring segments are needed, the patient will also be charged for those. In addition, the patient will also have to pay for gloves, masks, gowns and medication. Sometimes, the surgeon will charge extra to cover the costs of office overhead and staff salaries, monthly rent, office administration, malpractice insurance and office equipment, which are usually charged in the guise of a "surgeon fee."The Maximum Cost of LasikCurrently, the price of Lasik surgery can run as high as a $2,000-$2,500 USD price range per eye. The final cost will depend on each eye's condition, the included procedures for vision correction, pre-surgical tests, follow-up visits and any necessary subsequent surgeries.
What lasik is better for a army pilot?
For the majority of people who are in the military there are two options. Traditional Laser-Assisted in situ Keratomileusis (LASIK) or Photorefractive Keratectomy (PRK). The short answer is PRK. The long answer follows: LASIK is a procedure in which the cornea has a small flap cut into it using a blade called a microkeratome. The flap is then lifted, and a laser (The Excimer Laser) is used to shape the interior of the corneal flap. The advantages of LASIK are the reduced pain and healing time. The disadvantage of LASIK is that years down the road the flap may become dislodged, and you would lose your vision until the flap could be repositioned, and even then you may not be able to see clearly again. PSK is a procedure in which the cornea has the epithelial layer scrubbed off, and then the laser reshapes the surface of the cornea. After the procedure you will be required to wear a contact lens bandage over your eyes, which will be removed 3-4 days later. There is more pain over the next few days as compared to LASIK, but there is no chance of a flap coming undone. The U.S. Army's current policy is that Pilots must have PRK rather than LASIK.
How expensive is the average Lasik surgery?
The cost of laser eye surgery will greatly depend on factors such as insurance as well as the specific procedure being performed. Laser eye surgery, however, can cost anywhere from several hundred dollars up to ten thousand dollars.
What is the cost of Lasik eye surgery?
Average LASIK costs are:$2,150 for all laser-based vision correction procedures (including LASIK) in which a single price is quoted.$1,580 for non-customized LASIK using a bladed instrument (microkeratome) and excimer lasers that are not guided by wavefront analysis.$2,170 for wavefront-guided LASIK using a laser-created flap.Soroudi Advanced LASIK & eye center in Los Angeles can offer you quality service and price visit there site.http://www.soroudivision.com/
How is Lasik done?
Lasik is a two step procedure to correct eyesight by changing the shape of the cornea. In the first step a corneal flap is made where the outer layer of the cornea is separated and folded back to reveal the inner corneal tissue or stroma. This was initially performed using a vibrating razor blade device called a microkeratome and many are still performed today with this method. A newer method is to use a laser to separate this outer tissue layer with a type of laser called a femtosecond laser. The femtosecond laser uses very short length pulses to create a tissue plane that allows for this separation.The second step in Lasik is the vision correction step where an excimer laser makes pulses on the exposed stromal surface of the eye to reshape the eye into the new desired shape. There are many brands of lasers which can perform this task and are roughly divided into the large beam lasers which reshape the whole cornea by changing the size and shape of the beam, and small pulse lasers which reshape by the same size tiny pulse moving in a pattern around on the cornea. Each pulse of the laser removes a precise amount of tissue by a process known at photoablation. The sum of all these pulses changes the curvature of the cornea. When the flap is replaced, the new shape transfers to the front of the eye and the vision is corrected.One of the breakthroughs in Lasik vision correction is the use of eyetrackers which monitor and follow the eye during the treatment so that tiny eye movements do not detract from the planned correction. This is best explained in the attached link.
What is the different kinds of blade free lasik?
Originally LASIK was performed using a microkeratome which is an electric razor device to make the flap which is the first step in LASIK. Starting in 2000 several investigators began to research a new way of making flaps. This group included Lee Nordan, MD, Steve Slade, MD, and Jon Dishler, MD who performed the first cases in the United States for a company named Intralase using a femtosecond laser. This laser operated at 15 khz or 15,000 spots per second to make tiny perforations at a precise depth, thus separating the tissue and ending the requirement for the razor blade.This technology has been improved over the years and now most of these lasers operate at 60khz or four times the speed. Intralase was purchased by AMO and they have recently introduced even newer modesl of the same technology.In 2007, Dr. Dishler became an investigator for Zeiss/Meditec with a more advanced femtosecond laser called the Visumax. This laser operated at 200 khz when introduced and has been upgraded to 500kz which is a half million spots per second. Besides being very fast, this laser uses much lower energies and is more accurate than its predecessors. For this reason many doctors are moving to only offering the blade free approach for the benefit of their patients, even though this is a more expensive option.Other lasers have also entered the field including the Zeimer, which is a hybrid between the mechanical delivery system and a femtolaser to replace the blade. This laser does not have all the features of the other systems mentioned but has gained in popularity.Blade free LASIK involves using a femtosecond laser, and there are several on the market today. The most advanced system currently is offered by Zeiss/Meditec, and uses a naturally curved contact lens and a very precise focus ability. All of the blade free design lasers are an improvement over the older method of LASIK but there are still almost 50% of centers which do not offer this more modern and safer approach.
Laser Eye Surgery Offers Patients a New View on Life?
As anyone who has vision problems knows, few things are more frustrating than not being able to read the alarm clock in the morning, or tell which is the shampoo and conditioner in the shower. For these people who have lived with some level of visual impairment for years, or maybe a lifetime, laser eye surgery can be a life altering experience. In addition to being a virtual godsend for people who have lived life beyond a blurry curtain, laser eye surgery has also become incredibly accessible and affordable. The most commonly referred to type of laser eye surgery is a vision corrective procedure called laser-assisted in situ keratomileusis, or LASIK. This refractive surgery procedure is very popular because it is relatively pain free, and provides excellent vision improvement as soon as the next day. People who are nearsighted or farsighted can experience vision improvement with LASIK. For those who are nearsighted (those who can see things well up close, but have trouble with distance vision), laser eye surgery works to flatten the cornea, which is too thick and steep. For those who are farsighted (those who can see things in the distance, but have trouble reading and viewing things close up), the laser changes the corner, giving it a steeper curve. Laser eye surgery can also correct the common problem of astigmatism, by smoothing out a rough cornea and correcting the general shape. Laser surgery is, as previously mentioned, relatively painless, and pretty fast. Once the actual surgery begins, the surgeon starts by numbing the eye with drops. Then, the surgeon uses a microkeratome or an actual laser to cut a circle shaped, very thin flap in the cornea. After folding the hinged corneal flap, the eye surgeon uses an excimer laser to remove tissue from the cornea, reshaping it as necessary to fix the specific vision problem of the patient. This correctly formed cornea can now better focus light onto the retina of the eye, allowing more perfect vision. The surgeon then lays the flap of cornea back into place, and it heals relatively quickly on its own.
Laser Eye Surgery - Modern Day Miracles Of Corrected Vision ?
Laser eye surgery, or Lasik, (laser-assisted in situ keratomileusis), is capable of correcting astigmatism -blurred vision, myopia 'nearsightedness and hyperopia' farsightedness.The purpose of laser eye surgery, or refractive eye surgery, is to improve the refractive ability of the eye, thereby decreasing or even eliminating the need for corrective lenses in the form of glasses or contacts.In this surgical process, which is accomplished with the ultraviolet laser known as an excimer laser, the cornea is surgically reshaped. (Or in the case of cataract surgery, the individual's natural lens is removed and replaced with an artificial intraocular lens.)During laser eye surgery, the patient receives anesthetic eye drops and is awake. There are three steps to Lasik: 1. A corneal flap is incised. 2. The surgeon remodels the cornea under the flap with the laser (or the artificial intraocular lens is placed). 3. Then the corneal flap is carefully repositioned.In 1950, Jose Barraquer of Bogota, Columbia developed the microkeratome, a surgical instrument with an oscillating blade capable of cutting a 100 to 200 micrometer corneal flap.Radial kerantotomy - RK was developed in the 1970s in the USSR by Svyatoslav Fyodorov, and in 1983 photorefractive keratectomy - PKR was developed by Dr. Steven Trokel, Columbia University. Radial kerantotomy employs a procedure in which radial cuts on the cornea are made using a micrometer diamond knife.Radial kerantotomy is an entirely different procedure from Lasik, which began its development in 1968 at the University of California. Dr. Mani Bhaumik developed the carbon-dioxide laser at the Northrop Corp. Research and Technology Center with his research group. Together they developed the excimer laser.The ultraviolet excimer laser is capable of etching living tissue without thermal damage to the surrounding area. This was discovered by Rangaswamy Srinivasan working at an IBM Research Lab in 1980. He named the process Ablative Photodecomposition - APD.The first laser eye treatment on a living human was performed by Dr. Marguerite B. MacDonald in 1989 with a laser known as a VISX. The Lasik concept was introduced in the US by Dr. Pallikaris in 1992 to an FDA hand-selected group of ten surgeons.Since then, faster lasers, intraoperative pachymetry, bladeless flap incisions and other developments have further improved the ever-increasing reliability of refractive eye surgery. Thus, Lasik has become extremely popular as it provides immediate results of improved vision with virtually no pain or discomfort post surgery.
Why was LASIK invented?
This simple question is profound, because it touches on an invention that has changed the way in which the world views vision correction and has helped millions of people worldwide to see better without the aid of glasses or contact lenses.For perhaps millions of years, much of human kind has suffered with vision problems. There are the serious eye diseases such as cataracts, glaucoma and a myriad of other problems. Beyond this is the simple fact that many people are unable to see clearly at distance, near, or both. This is from the imperfections of the eyeball as a camera and this was greatly helped over that last few hundred years by glasses and more recently in the last 50 years by contact lenses. Although with the advent of lasers, there was a hope that such technology could improve vision, limitations in the nature of the eye had limited laser application to vision correction until the advent of LASIK.LASIK is a hybrid procedure, that is it involves two steps which together are able to improve vision very rapidly and predictably for patients with ametropias. The first step is to create a potential space for the laser to correct the vision and the second is to do the correction itself. In the early days of LASIK about 15-20 years ago, this potential space was made with a device called a microkeratome. This is a miniature shaver which can peel a thin layer of outer tissue from the cornea which remains attached at the edge or "hinge". Another laser, the excimer laser then focuses on the freshly cut surface, and removes tissue in a programmed manner to reshape the eye. Finally, the flap is replaced which assumes the contour of the newly shaped cornea beneath it. It is the transfer of the shape combined with covering the treated area with living tissue that makes LASIK so remarkable. Healing occurs at the edge or seam of the flap and the eye barely knows that anything has occurred beneath. The vision is rapidly restored with no significant healing response, which is key to the success of LASIK.Newer lasers, called femtosecond lasers, are able to make the flap layer more precisely without a cutting blade but fundamentally perform the same function. This all laser approach is a safer and slightly more effective way of restoring vision by LASIK.We become complacent very quickly with new technologies but it is a truly amazing and revolutionary accomplishment that in a procedure that lasts only a few minutes, a persons vision can be corrected from a lifetime of limitations.
