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LASIK
LASIK or Lasik (; "laser-assisted in situ keratomileusis"), commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. LASIK surgery is performed by an ophthalmologist who uses a femtosecond laser or a microkeratome to create a corneal flap to expose the corneal stroma and then an excimer laser to reshape the corneal stroma in order to improve visual acuity. LASIK is very similar to another surgical corrective procedure, photorefractive keratectomy (PRK), and LASEK. All represent advances over radial keratotomy in the surgical treatment of refractive errors of vision. For people with moderate to high myopia or thin corneas which cannot be treated with LASIK or PRK, the phakic intraocular lens is an alternative. As of 2018, roughly 9.5 million Americans have had LASIK and, globally, between 1991 and 2016, more than 40 million procedures were performed. However, the ...
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Refractive Surgery
Refractive surgery is an optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea ( keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism. History The first theoretical work on the potential of refractive surgery was published in 1885 by Hjalmar August Schiøtz, an ophthalmologist from Norway. In 1930, the Japanese ophthalmologist Tsutomu Sato made the first attempts at performing this kind of surgery, hoping to correct the vision of military pilots. His approach was to make radial cuts in the cornea, correcting effects by up to 6 diopters. The procedure unfortunately produced a high rate of corneal degeneration, ...
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Photorefractive Keratectomy
Photorefractive keratectomy (PRK) and laser-assisted sub-epithelial keratectomy (or laser epithelial keratomileusis) (LASEK) are laser eye surgery procedures intended to correct a person's vision, reducing dependency on glasses or contact lenses. LASEK and PRK permanently change the shape of the anterior central cornea using an excimer laser to ablate (remove by vaporization) a small amount of tissue from the corneal stroma at the front of the eye, just under the corneal epithelium. The outer layer of the cornea is removed prior to the ablation. A computer system tracks the patient's eye position 60 to 4,000 times per second, depending on the specifications of the laser that is used. The computer system redirects laser pulses for precise laser placement. Most modern lasers will automatically center on the patient's visual axis and will pause if the eye moves out of range and then resume ablating at that point after the patient's eye is re-centered. The outer layer of the corne ...
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Microkeratome
A microkeratome is a precision surgical instrument with an oscillating blade designed for creating the corneal flap in LASIK or ALK surgery. The normal human cornea varies from around 500 to 600 μm in thickness; and in the LASIK procedure, the microkeratome creates an 83 to 200 μm thick flap. The microkeratome uses an oscillating blade system, which has a blade that oscillates horizontally as the blade travels vertically for a precise cut. This piece of equipment is used all around the world to cut the cornea flap. The microkeratome is also used in Descemet's stripping automated endothelial keratoplasty (DSAEK), where it is used to slice a thin layer from the back of the donor cornea, which is then transplanted into the posterior cornea of the recipient. It was invented by Jose Barraquer and Cesar Carlos Carriazo in the 1950s in Colombia. As of 2023, there are two options for cutting into the cornea, the microkeratome and the femtosecond laser. The femtosecond laser emits u ...
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Hyperopia
Far-sightedness, also known as long-sightedness, hypermetropia, and hyperopia, is a condition of the eye where distant objects are seen clearly but near objects appear blurred. This blur is due to incoming light being focused behind, instead of on, the retina due to insufficient accommodation by the lens. Minor hypermetropia in young patients is usually corrected by their accommodation, without any defects in vision. But, due to this accommodative effort for distant vision, people may complain of eye strain during prolonged reading. If the hypermetropia is high, there will be defective vision for both distance and near. People may also experience accommodative dysfunction, binocular dysfunction, amblyopia, and strabismus. Newborns are almost invariably hypermetropic, but it gradually decreases as the newborn gets older. There are many causes for this condition. It may occur when the axial length of eyeball is too short or if the lens or cornea is flatter than normal. Cha ...
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Keratoconus
Keratoconus is an eye disorder in which the cornea, the transparent front part of the eye, gradually thins and bulges outward into a cone shape. This causes distorted vision, including blurry vision, double vision, increased nearsightedness, irregular astigmatism, and light sensitivity, which can reduce Quality of life (healthcare), quality of life. Both eyes are usually affected. The cause is not fully understood but likely involves a combination of heredity, genetic, environmental, and hormonal factors. Having a parent, sibling, or child with keratoconus increases risk significantly. Environmental risk factors include frequent eye rubbing and atopy, allergies. Diagnosis is typically made with corneal topography, which maps the shape of the cornea and reveals characteristic changes. In early stages, vision is often corrected with glasses or soft contact lenses. As the condition progresses, rigid or scleral contact lenses may be needed. In 2016, the FDA approved corneal col ...
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Phakic Intraocular Lens
A phakic intraocular lens (PIOL) is an intraocular lens that is implanted surgically into the eye to correct refractive errors without removing the natural lens (also known as "phakos", hence the term). Intraocular lenses that are implanted into eyes after the eye's natural lens has been removed during cataract surgery are known as pseudophakic. Phakic intraocular lenses are indicated for patients with high refractive errors when the usual laser options for surgical correction (LASIK and PRK) are contraindicated. Phakic IOLs are designed to correct high myopia ranging from −5 to −20 D if the patient has enough anterior chamber depth (ACD) of at least 3 mm. Three types of phakic IOLs are available: * Angle-supported * Iris-fixated * Sulcus-supported intraocular lens Medical uses LASIK can correct myopia up to -12 to -14 D. The higher the intended correction the thinner and flatter the cornea will be post-operatively. For LASIK surgery, one has to preserve a safe ...
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Radial Keratotomy
Radial keratotomy (RK) is a refractive surgery, refractive surgical procedure to correct myopia (nearsightedness). It was developed in 1974 by Svyatoslav Fyodorov, a Russian Ophthalmology, ophthalmologist. It has been largely supplanted by newer, more accurate operations, such as photorefractive keratectomy, LASIK, Epi-LASIK and the Intraocular lens#Intraocular lenses for correcting refractive errors, phakic intraocular lens. Procedure When performing RK, incisions are made with a diamond knife. The incisions relax the steep central cornea in patients with myopia in order to achieve a decreased need for correction. The original technique – consisting of incisions from periphery to center – was called the "Russian technique", while the later advances of performing controlled incision from center to periphery was called the "American technique".Gulani AC, Fyodorov S: Future Directions in Vision course, June 1997 RK may be performed with different types, numbers, and patterns of ...
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Myopia
Myopia, also known as near-sightedness and short-sightedness, is an eye condition where light from distant objects focuses in front of, instead of on, the retina. As a result, distant objects appear blurry, while close objects appear normal. Other symptoms may include headaches and eye strain. Severe myopia is associated with an increased risk of macular degeneration, retinal detachment, cataracts, and glaucoma. Myopia results from the length of the eyeball growing too long or less commonly the lens being too strong. It is a type of refractive error. Diagnosis is by the use of cycloplegics during eye examination. Tentative evidence indicates that the risk of myopia can be decreased by having young children spend more time outside. This decrease in risk may be related to natural light exposure. Myopia can be corrected with eyeglasses, contact lenses, or by refractive surgery. Eyeglasses are the simplest and safest method of correction. Contact lenses can provide a rela ...
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Refractive Error
Refractive error is a problem with focus (optics), focusing light accurately on the retina due to the shape of the eye and/or cornea. The most common types of refractive error are myopia, near-sightedness, hyperopia, far-sightedness, astigmatism, and presbyopia. Near-sightedness results in far away objects being blurred vision, blurry, far-sightedness and presbyopia result in close objects being blurry, and astigmatism causes objects to appear stretched out or blurry. Other symptoms may include double vision, headaches, and eye strain. Near-sightedness is due to the length of the eyeball being too long; far-sightedness the eyeball too short; astigmatism the cornea being the wrong shape, while presbyopia results from aging of the lens of the eye such that it cannot change shape sufficiently. Some refractive errors occur more often among those whose parents are affected. Diagnosis is by eye examination. Refractive errors are corrected with eyeglasses, contact lenses, or surgery ...
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Excimer Laser
An excimer laser, sometimes more correctly called an exciplex laser, is a form of ultraviolet laser which is commonly used in the production of microelectronic devices, semiconductor based integrated circuits or "chips", eye surgery, and micromachining. Since the 1960s, excimer lasers have been widely used in high-resolution photolithography machines, one of the critical technologies required for microelectronic chip manufacturing. Terminology and history The term excimer is short for 'excited dimer', while 'exciplex' is short for 'excited complex'. Most excimer lasers are of the noble gas halide type, for which the term ''excimer'' is, strictly speaking, a misnomer. (Although less commonly used, the proper term for such is an exciplex laser.) Excimer laser was proposed in 1960 by Fritz Houtermans. The excimer laser development started with the observation of a nascent spectral line narrowing at 176 nm  reported in 1971 by Nikolai Basov, V. A. Danilychev and Yu. M ...
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Astigmatism (eye)
Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. The lens and cornea of an eye without astigmatism are nearly spherical, with only a single radius of curvature, and any refractive errors present can be corrected with simple glasses. In an eye with astigmatism, either the lens or the cornea is slightly egg-shaped, with higher curvature in one direction than the other. This gives distorted or blurred vision at any distance and requires corrective lenses that apply different optical powers at different rotational angles. Astigmatism can lead to symptoms that include eyestrain, headaches, and trouble driving at night. Astigmatism often is present at birth, but can change or develop later in life. If it occurs in early life and is left untreated, it may result in amblyopia. The cause of astigmatism is unclear, although it is believed to be partly related to genetic factors. The underlying mechanism involves an irregul ...
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