Refractive Surgery

The LASIK Team

At the WVU Eye Institute, we have a team approach to refractive surgery, which we feel delivers personalized care and the best outcomes. The technicians and doctor who perform your initial evaluation are also involved with your treatment and follow up.

We feel this consistency of care is important for patient confidence and satisfaction. Physician and staff involvement at every step of the refractive surgical process is our most important quality control measure.

LASIK Refractive Surgery

LASIK is the most popular refractive laser procedure. LASIK involves the creation of a thin flap of corneal tissue which has a small hinge area to aid flap realignment. This flap is hinged aside and the laser treatment applied to the exposed cornea. When the flap is replaced, it tightly adheres to the corneal surface without sutures. The flap speeds healing and visual recovery.

The WVU Eye Institute’s refractive surgery service offers:

WaveScan Wavefront Analysis: A new technology that provides a detailed evaluation of the optics of your eyes.
Orbsan topography: This device creates a detailed topographic map of the shape and thickness of your cornea. This information helps the doctor choose the safest procedure to correct your vision.
Visx S4 3D active tracking Excimer Laser: Through Wavescan custom cornea technology, and an advanced infrared tracking system that follows the movement of the eye, we can now deliver a more precise laser treatment. Visit Visx.com for more information.
Iris registration: We offer a new level of precision in treatment alignment at the WVU Eye Institute. The iris registration system identifies multiple iris reference points when the Wavescan is acquired. These reference points are used to align your custom laser treatment with a level of accuracy that is unprecedented.
Updated state-of-the-art software for custom view treatments: Software upgrades and recent FDA approvals have expanded our ability to treat patients with custom laser technology. Correction for higher degrees of nearsightedness (-6.0 D to -11.0 D with astigmatism to -3.0 D), farsightedness (+3.0 D with astigmatism to 2.0 D) and mixed astigmatism are now available with the custom view format.

We have adopted the Moria microkeratome for the creation of the Lasik flap to enhance our visual outcomes and safety. Using both the M2 and One-Use Plus SBK devices allows us to tailor the Lasik flap size, thickness, and location that is optimal for each individual case. These devices use disposable heads to eliminate assembly, sterilization, and contamination issues.

PRK Laser Surgery

PRK is a laser treatment that is applied to the surface of the cornea after gently removing the layer of surface cells that covers it. This type of laser surgery is an excellent option for lower degrees of treatment or for those with thin corneas who cannot spare the tissue for flap creation. PRK offers the advantage of no potential for flap complications because no flap is created.

Preferred by the military for resistence to trauma, advances in laser technology have also optimized PRK outcomes. The disadvantage to PRK is a slower recovery because vision remains blurry until the surface cells heal and smooth, usually within several weeks.

A variation on the PRK technique, called LASEK, uses a dilute solution of alcohol to loosen the surface cells as a sheet which can then be replaced under a bandage contact lens to speed healing.

Another advance that is pushing the frontiers of PRK is the use of an antiscarring medication called mitomycin, which allows higher degrees of correction without inducing a scarring response.

Advantages of PRK

No flap: The procedure eliminates the surgical step of flap creation and thus eliminates the possibility of flap complications. Recent reports have documented that flap creation induces a small amount of optical irregularity, which is avoided with PRK.

Greater trauma resistance: PRK may be preferable for those with occupations or avocations in which trauma to the eye is a possibility, such as law officers, military personnel, martial artists, etc. For those who suffer from recurrent breakdown of the corneal surface, PRK is a better procedure.

Better for thin corneas: If too much corneal tissue is removed, the cornea may become structurally weakened and bow forward (ectasia). By not creating a flap, more tissue is preserved for laser treatment, thus not weakening the cornea.

LASEK (Laser-Assisted Subepithelial Keratectomy)

A variation on the PRK procedure, this technique loosens the surface cells with a dilute alcohol solution allowing the sheet of cells to be displaced then repositioned over the treatment site. This method can reduce the time required for the surface cells to heal. A bandage contact lens is still used as in PRK.

Studies have verified that a substantial percentage of surface cells remain viable in the flap of epithelial tissue. It remains to be determined whether there is any less superficial haze or regression for patients with higher myopic corrections. Until more information is available, we prefer to select candidates for LASEK according to the same criteria as the PRK procedure.

Laser Surgery Q and A

LINK: http://wvuhealthcare.com/services/eye-institute/laser-surgery.aspx