Pop Magazine

Laser eye surgery correction: Which technique to choose?

6 October 2016
Blog post supervised and approved by Dr. Michel Pop, ophthalmologist
Michel Pop - Laser eye surgery correction

There are several techniques for performing laser eye surgery and it is not always clear what distinguishes them. From all laser Lasik, PRK, EpiLASIK and more. All this terminology can be confusing! Let us help shed light on what they all mean.

 

Eye Surgery: various types of lasers

Above all, remember that the cornea is composed of three main layers; the epithelium (upper layer), the stroma (90% of the thickness of the cornea) and the endothelium (lower layer).

The type of laser surgery chosen varies from one individual to another depending on the layer of the eye to be treated. The EpiLASIK and PRK (photorefractive keratectomy) are procedures that treat the superficial stroma, during which we must remove some of the epithelium which regenerates within 5 days after surgery. The All laser Lasik, treats the deeper layers of the corneal stroma and preserves the epithelium.

All these techniques can correct myopia, hyperopia, astigmatism or presbyopia.

EpiLasik and PKR eye surgery

For EpiLASIK surgery, the epithelium (upper layer) is first raised, then the excimer laser or exciplex laser removes surface layers of the stroma. In the case of PRK, the epithelium is removed by friction, and the Excimer laser is used in the same way as the EpiLASIK.

The epithelium is raised or removed and is replaced by a new epithelium that regenerates naturally in a few days. This process will result in the improvement of visual acuity during healing. To minimize pain, a contact lens is placed in the operated eye, and is removed as soon as the epithelium is restored.

All laser Lasik eye surgery

The all-laser Lasik operation is said to be more invasive to the eye as it affects the deeper stromal cells rather than its superficial cells. To do this, the ophthalmologist cuts a thin corneal flap with a femtosecond laser, and raises it as a “hood”. Then they use an excimer laser on the deep layers of the corneal stroma, before repositioning the corneal flap, which acts as a protective membrane. During this operation, the epithelium is preserved and does not need to regenerate. The All laser Lasik, although more invasive, allows faster visual recovery. And with all laser Lasik, the pain is almost nonexistent since the epithelium remains intact.

For information only, until the early 2000s, the most common way to cut the corneal flap was with the use of a surgical instrument called a microkeratome. This very delicate phase can now be carried out with the femtosecond laser that allows a 100% laser operation; hence the name of “all laser Lasik”.

A laser vision correction technique thats right for you

Each case of myopia, hyperopia, astigmatism or presbyopia is different and requires a specific treatment. It is also possible that a patient is more or less capable of undergoing invasive surgery, so it is important to check with an eye care professional.

Do not hesitate to ask any questions or concerns that you might have, you’ll be more comfortable and reassured about the type of laser eye surgery that is being suggested for you. That being said, here at Cliniques Michel Pop we are available for a free initial assessment. Our experts make the difference!

Learn more here.