Eye Care: Refractive surgery (LASIK, LASEK and implantable contact lenses)
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Refractive Surgery Service
Kentucky Clinic South
2400 Greatstone Point
Lexington, KY 40504
What is laser vision correction?
Laser vision correction is a relatively quick outpatient surgical procedure that uses the excimer laser to precisely reshape the cornea to minimize or eliminate dependency on corrective eyewear. Photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) are the two major types of laser vision correction. LASIK is preferred in most cases because of its rapid visual recovery and minimal discomfort. PRK and laser assisted epithelial keratomileusis (LASEK) are typically used in special cases.
LASIK offers the promise of no more fumbling for glasses at night to see, struggling to place contacts in the morning, or dealing with cumbersome eyewear for activities like swimming, skiing, biking, running or golfing.
Am I a candidate?
If you decide to be evaluated for refractive surgery, you will undergo a complete eye exam, including:
- Measurement of best uncorrected and corrected vision
- Analysis of tear film and production
- Undilated and cycloplegic refraction
- Corneal topography and pachymetry
- Intraocular pressure determination
- Dilated retinal exam
- Video and questionnaire on the LASIK procedure
(The significant information gathered from each part of your examination will be explained to you.) You must not wear contact lenses prior to the evaluation: soft lens three to five days and rigid gas permeable lens three to five weeks. This way, the cornea can return to its normal shape, allowing an accurate analysis of the corneal topography and maximizing the potential for an optimal visual outcome. If you have diabetes, an auto-immune disease (such as rheumatoid arthritis), thyroid disease, dry eyes, have had previous infectious corneal diseases (i.e. eye herpes) or trauma, or are pregnant or nursing, a detailed discussion with the surgeon will help to determine if refractive surgery is an option.
How is LASIK performed?
You should arrive approximately 30 minutes prior to the procedure. You will be placed on a comfortable bed and given numbing eye drops. The area around your eye will be cleansed by an anti-infective wash. The eyelid lashes will be taped back with sterile tape and a lid speculum will be used to retract the lids for maximal exposure of the eye.
A special instrument called a microkeratome then creates a corneal flap, which is folded back to allow precise laser reshaping of the cornea. The flap is then reseated and securely seals within two minutes. Proper flap alignment is verified and the patient is sent home to rest for a few hours. Most regain functional vision later that same day and can return to normal activities the following day. The entire procedure averages ten to fifteen minutes total time for both eyes.
The technology behind the surgery
John D. Conklin Jr., MD, Medical Director, UK HealthCare Refractive Surgery Service, uses the Bausch & Lomb excimer laser system. The laser was designed exclusively for the LASIK procedure. The UK Refractive Surgery Service is one of the first locations nationwide with access to this latest technology.
Physician chooses John Conklin, MD, for LASIK surgery (PDF, 8.8 MB)
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Although similar in spelling, LASEK and LASIK are not similar procedures. PRK or LASEK are effective alternatives to LASIK for specific cases in which corneal tissue needs to be spared (i.e. thin corneas.) Patients should be aware of the post-operative discomfort and delayed visual recovery with LASEK. During a LASEK procedure, a much thinner layer of the cornea is folded back to allow the laser to focus on cornea reshaping. The flap is then replaced.
Implantable Contact Lens
What is an implantable contact lens?
The implantable contact lens (ICL) is placed behind the iris and in front of the natural lens of the eye. The ICL provides permanent correction of moderate to severe nearsightedness (myopia). The ICL also contains an ultraviolet light filter.
Am I a candidate for the ICL? The best candidates for the ICL are between the ages of 21 and 45, with moderate to severe nearsightedness. Other aspects of candidacy are best discussed with a doctor in a consultation.
What are the advantages of an ICL?
- Expanded range of treatment. Higher levels of nearsightedness may be easily treated and managed.
- Patients who are not candidates for LASIK may be eligible for an ICL.
- FDA studies show a high level of safety and visual satisfaction with the lens.
- The ICL compares favorably with LASIK and offers a more rapid return to functional vision.
- The ICL is reversible and does not remove tissue thus permanently altering the eye's shape as LASIK does.
What does the ICL procedure involve?
The ICL is performed on an outpatient basis, meaning the patient has surgery and leaves the same day. Numbing drops are administered, assuring the patient's comfort throughout the procedure.
What if your vision changes?
The ICL is designed to give a lifetime of vision correction, but if there are major changes in one's vision, the ICL can easily be removed or replaced or another procedure can be performed.
Physicians practicing LASIK at UK HealthCare
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