About Laser Eye Surgery

LASIK, Custom LASIK, Epi-LASIK, LASEK and PRK are all different types of Corneal Laser Eye Surgery that Dr. Brass performs for the correction of nearsightedness, farsightedness and astigmatism. Laser Eye Surgery is the general term used to describe these various types of Laser Vision Correction procedures for correction of the most common vision problems of myopia, hyperopia and astigmatism. 

Until 1995, people who were nearsighted, farsighted or who had astigmatism really only had two options readily available for seeing clearly. They could either wear eyeglasses or contact lenses. Other surgical methods of vision correction such as Radial Keratotomy (RK) have not proven to meet the broad acceptance of eye surgeons and eye care patients due to variability in safety, efficacy and predictability.

In 1995, the United States Food and Drug Administration (FDA) approved the first Excimer Laser (www.fda.gov/cdrh/pmaoct95.html) for performing Laser Eye Surgery to correct nearsightedness, farsightedness and astigmatism. Dr. Brass has been performing laser eye surgery since it was approved. The introduction of Laser Eye Surgery with the Excimer Laser technology to correct common eye problems marked the opportunity for millions of eye care patients to decrease or even eliminate their dependence of eyeglasses or contact lenses.

About Photorefractive Keratectomy (PRK)

The first Laser Eye Surgery procedure performed using the Excimer Laser was called Photorefractive Keratectomy or PRK. Over the years PRK has withstood the test of time and has proven to be to be a safe, effective and predictable method of Laser Eye Surgery for millions of eye care patients.

PRK is a class of Laser Eye Surgery called “surface ablation”. Simply, this means that the Excimer Laser energy is used to reshape the surface of the cornea by applying laser energy to the layer of the cornea beneath the epithelium, or “skin of the eye”. 

The cornea is the clear, dome shaped layer on the front of the eye.   In order to apply the laser energy Dr. Brass must remove the outermost layer of the epithelium. As a Corneal Surgeon, this is quite a routine procedure for Dr. Brass.  While the procedure is painless, some patients may experience mild discomfort during the first day or so of the healing process.  The Laser vision correction portion of the surgery for PRK is identical to that for LASIK.  The main difference is that in PRK the epithelium is removed while in Lasik a flap of tissue is created. The corneal epithelium serves many functions including providing a smooth optical surface. Once the corneal epithelium is removed, it requires several days or more to heal.  Most patients see well out of the operated eye right away, but it takes a few weeks to achieve the best and clearest visual recovery.

Dr. Brass may recommend PRK as the Laser Eye Surgery procedure of choice for certain patients including those who have particularly thin corneas, those who actively participate in contact sports, and those in active military duty.

Today, Dr. Brass uses advanced “scanning-tracking” laser technology to provide a smoother corneal surface and markedly improved eye drop medications, both of which make the visual recovery and overall comfort considerably better than the early PRK procedures.

About LASIK (Laser Assisted In-Situ Keratomileusis)

Eye surgeons and researchers began developing a technique whereby instead of applying the laser energy directly to the surface of the cornea as in PRK, they could apply it between the layers of the cornea.

This can be achieved by creating a very thin flap of corneal tissue that could readily be replaced. This type of Laser Eye Surgery is called “lamellar eye surgery” because it is performed between the layers. The most common type of lamellar eye surgery for correcting common eye problems such as nearsightedness, farsightedness and astigmatism is called Laser Assisted In-Situ Keratomileusis or LASIK, which literally means, “to reshape the cornea from within”. LASIK Eye Surgery is the most common type of Laser Eye Surgery performed today and is one of the most frequently performed surgeries of any type.

The LASIK Procedure

In order to perform LASIK, Dr. Brass will direct the staff to place a few eye drops in your eyes to numb the surface of your eye. This will make you quite comfortable during your treatment.

You will then be escorted into the Excimer Laser suite and asked to position yourself comfortably on the reclining “bedlike” chair adjacent to the laser system. Dr. Brass will gently place a small instrument between your eyelids to help you remember to keep them open during your LASIK surgery.

Dr. Brass will then create a very thin layer, which is a “flap” of clear tissue in the center of the cornea. He will then carefully fold the flap over and allow the inner layer of the cornea to be visible so that the laser energy can be applied. The actual application can take from 30-90 seconds depending on the amount of correction that you require. Based on your examination, your prescription and other measurements and calculations collected at your LASIK consultation, Dr. Brass will instruct the staff to program certain information into a computer that will monitor and control the actual application of the laser. Upon completion of the laser application, Dr. Brass will have changed the curvature of your cornea so that it will be the shape necessary to correct your vision.

Dr.Brass will then gently replace the “flap” back into its proper position. Since the cornea is able to “stick” to itself, Dr. Brass will not need to use sutures to hold it in place.

LASIK surgery has the desirable characteristics of allowing the healing and visual recover process to be very quick for most patients. For a few days after your LASIK Eye Surgery, you will need to be careful not to rub or bump your eyes too much.

It is expected that you will have a mild “sandy” or “gritty” sensation during the first day or so after your LASIK surgery.

Dr. Brass and his staff will give you complete instructions regarding eye drops to use to facilitate the healing and visual recovery process.

YOU NEED TO FOLLOW THESE INSTRUCTIONS CAREFULLY

 Dr. Brass requires that you return for your scheduled follow-up visits to check the healing process, regardless of how well you are doing. Most LASIK patients at Brass Eye Center are able to pass the New York Motor Vehicle Driver’s Eye Test without eyeglasses or contacts within a day or so after their LASIK Surgery with Dr. Brass.

You should feel free to discuss any concerns, questions or thoughts about LASIK or any Laser Eye Surgery with Dr. Brass or the staff at Brass Eye Center. The Refractive Surgery Coordinator will be pleased to spend whatever time is necessary to review any information about the LASIK procedure, what to expect on LASIK surgery day, follow-up care, fees and affordable easy monthly payment plans that will fit into your budget.

About LASEK (Laser Epithelial Keratomileusis)

LASEK, which is known medically as Laser Epithelial Keratomileusis, a type of “surface ablation”, is a method of Laser Eye Surgery that attempts to blend the positive features of LASIK and PRK.

In the LASEK procedure, rather than creating a “flap”, Dr. Brass applies a dilute solution of alcohol to loosen and remove only the very surface of the epithelium. In this way, it is similar to PRK and can be used for patients who have thin corneas. Once the epithelial layer has been removed, Dr. Brass uses the Excimer Laser to reshape the cornea, as in both LASIK and PRK. Upon completion of the laser application, the epithelial layer is then returned to its original position.

If, after your consultation, Dr. Brass feels that LASEK will provide you the best possible results, he will fully discuss the risks, benefits and complications with you in order to answer all of your questions.

About Epi-LASIK
(Epithelial Laser Assisted In-Situ Keratomileusis)

Epi-LASIK, which is known medically as Epithelial Laser In-Situ Keratomileusis, a type of advanced “surface ablation” is a method of Laser Eye Surgery that attempts to further blend the positive features of LASIK, LASEK and PRK.

In the Epi-LASIK procedure, Dr. Brass uses a specially designed “non-cutting” instrument to create a thin “flap” of corneal epithelium. He achieves this by gently separating the epithelium from the underlying corneal layer without cutting any tissue. In Epi-LASIK, no alcohol solution is applied to loosen and remove the surface of the epithelium as in LASEK. Epi-LASIK is appropriate for patients who have thin corneas, participate in contact sports or are on active military duty and might not otherwise be good candidates for LASIK.

Once, Dr. Brass has created and lifted the epithelial “flap”, he can then apply the laser energy to reshape your cornea to correct your optical prescription, just as with LASIK, PRK and LASEK. After applying the Excimer Laser, Dr. Brass will return the epithelial “flap” to its position and place a thin soft “bandage” contact lens in place to protect the “flap”.

If, after your consultation, Dr. Brass feels that Epi-LASIK will provide you the best possible results, he will fully discuss the risks, benefits and complications with you in order to answer all of your questions.

About Custom Wavefront Guided Laser Eye Surgery

Custom Wavefront Guided Laser Eye Surgery is a specialized Laser Eye Surgery technique that Dr. Brass uses to provide patients with more complex eyeglass and contact lens prescriptions. This technique provides the possibility of achieving a more precise visual outcome.

Many people do not realize that their eyes are really a living optical system made up of a number of optical components that together, produce the optical characteristics of your vision. The two main optical components of your eye are the cornea and the crystalline lens. As with any optical component, the cornea and crystalline lens may have distortions. These distortions are called aberrations.

Everyone who wears eyeglasses or contact lenses is familiar with the most common aberrations, which are called myopia, hyperopia and astigmatism. These aberrations are relatively simple aberrations and thus are called ‘low order’ aberrations. Since they are relatively simple, low order aberrations can usually be corrected with eyeglasses and contact lenses. However, there are some optical aberrations that cannot be fully corrected with eyeglass or contact lens prescriptions because they are too complex. These aberrations are probably unfamiliar to most patients but include spherical aberration, coma and trefoil. Since these aberrations are much more complex, they are called “high order” aberrations. High order aberrations are not corrected with eyeglasses or contact lenses. Until a few years ago we were not able to measure high order aberrations in everyday clinical practice in an eye care office because the necessary instrumentation was only found in research laboratories. Today, Dr. Brass is able to use a clinical eye care instrument called an aberrometer to fully understand the complexity of the prescription he is trying to correct. If Dr. Brass finds that you have considerable high order aberrations that make your vision uncomfortable, or might otherwise benefit, he may recommend using a Custom Wavefront Laser Eye Surgery procedure to achieve the best possible results.

Am I A Laser Eye Surgery Candidate?

The only way to really be sure that you are a good candidate for LASIK or any type of Laser Eye Surgery is to schedule a free consultation at Brass Eye Center. When you schedule your consultation, begin thinking about all the things in your life that would be more convenient or more comfortable if you didn’t have to depend on eyeglasses or contact lenses to do them. Then, at your consultation tell our Refractive Surgery Coordinator what you would like to be able to do without eyeglasses and contacts so that together you can set realistic expectations for your Laser Eye Surgery.

At your consultation we will be conducting a thorough eye examination including measuring your prescription for laser treatment, measuring your pupil size, performing a retinal and optic nerve exam through a dilated pupil and measuring your corneal thickness and corneal shape to confirm that you are a good candidate for Laser Eye Surgery. Further, we will have an in depth discussion exploring the vision correction goals you have and the specific things that you wish to achieve by having LASIK in New York at Brass Eye Center surgery or any type of Laser Eye Surgery.

Please feel free to contact Brass Eye Center at 1.518.782.7827 or e-mail to schedule a Free Laser Eye Surgery Consultation.