Toronto's Laser Eye Surgery & Vision Correction Centre

LASIK (Laser-Assisted in-situ Keratomileusis) is a surgical procedure in which a corneal flap is created. A portion of the flap remains attached to the eye (as a hinge or a pivot). The thin flap is turned over, exposing the underlying cornea. The cool beam excimer laser, (Visx Star S4) then shapes the cornea, and the flap is returned to its original position. 

In PRK (Photorefractive Keratectomy), the top surface level of the cornea called the epithelium is removed. This exposes the inner cornea. The computer-assisted laser will then begin to reshape the curvature of the eye.  Over the next few days, the epithelium heals over the treated area on its own.

ln LASIK, eye drop medication is administered up to one week. You can usually resume normal activities within 3 days. Most people see 20/20 by the next morning. Yet, there may be continued improvement for up to a month or more.   No needles or incisions are required.   
  
In PRK, eye medications are used about 4 times a day and clear contact lenses are placed on each eye to promote healing and add to the comfort. These lenses are removed within 2-5 days after surgery. The epithelial layer will regenerate itself, and the healing process is usually complete by one week, though in rare instances, it can take longer. During this period eye medications will be used to promote healing and prevent infections.  Generally, most people are 20/20 within 3-5 days after the surgery.

Neither LASIK nor PRK involves any pain during the procedure itself. For LASIK patients, it takes only 5-6 hours for the surface layer to heal and you may experience some discomfort, such as feeling like a grain of sand is in the eye and the eyes may water and be difficult to keep open. Pain relievers, such as acetaminophen, ASA, etc., which do not require prescription, can be taken to ease your discomfort. PRK patients usually take pain relief medication for about 1-2 days after surgery. Most of the pain fibers in the cornea are located in the surface portion. Usually the first night is when there is the most discomfort, followed by blurred vision and light sensitivity for about 3 days.

How long will I be off work after surgery?

Most patients need to take one day off from work after LASIK surgery. But, it would be ideal to rest for a day after the surgery. With PRK, the eyes are light sensitive and vision is blurred for about 4-5 days. So patients are advised to return to work only after this period of time.

You are advised to avoid eye make-up for a few days prior to the surgery and for about a week afterwards. Dusty, dirty, smoky environments, swimming pools, hot tubs and saunas are tobe avoided for a week after the laser surgery. Do not allow anything to strike your eyes. Do not rub your eyes, which is not good for you, even if you haven't had laser eye surgery.

Custom and Wavefront-optimized LASIK programs produce better outcomes of sharper visual acuity and less nighttime glare than classic (conventional). A recent independent study conducted by the U.S. Navy demonstrated that 97% of Custom LASIK patients acquired 20/20 vision in comparison to 88% with classic (conventional) LASIK. Custom LASIK patients had fewer night vision problems compared to classic LASIK patients. For these reasons, and the fact that we have been getting outstanding results with CustomVue treatments, we are offering only custom treatment at this time.

In Traditional LASIK, the eye-surgeon creates the corneal flap with a hand-held mechanical instrument that houses a metal blade. Although LASIK complications are rare, this mechanical blade has been the cause of some complications.

In the IntraLase method, the doctor uses the accuracy and precision of a laser to create the corneal flap. This advanced technology allows doctors to customize the corneal flap for every individual patient. Earlier, patients with thin corneas were not eligible to be administered laser vision correction. IntraLase, due to its accuracy now makes it possible to treat many more people.

Some of the alternatives to LASIK laser eye surgery for myopia, hyperopia and astigmatism are:
1) Lensectomy with intraocular lens implant. Here your natural lens is removed and is replaced with an intraocular lens implant;
2) Excimer Laser PRK surface ablation;
3) Phakic IOL (Intraocular Lens) or ICL (Intraocular Contact Lens)

The laser is totally absorbed by the cornea, so no energy is applied to the lens of eye. Therefore a cataract is very unlikely to be caused by the laser.

The price of laser refractive surgery depends on where you have this procedure done, the type of procedure (LASIK, PRK, etc.), and the type of laser and/or software used. While calculating the fee, clinics have to take into account administrative costs, maintenance costs, pre and post-operative time spent with the patient, as well as post-operative medications. If a clinic updates their equipment and/or software on a frequent basis they need to recover these costs, and this may result in a higher fee, but access to the latest, safest and best technology.