LASIK Surgery in Las Vegas
What is LASIK?
LASIK is a form of corneal surgery that uses an excimer laser to ablate corneal tissue in a fashion that can correct nearsightedness, farsightedness, and astigmatism. LASIK specifically involves the making of a flap on the surface of the cornea that can be lifted prior to the laser ablation.This flap can be made with a blade or with a femtosecond laser. Dr. Swanic has experience with both modalities but at this time exclusively uses all laser LASIK as he feels it provides a higher level of safety compared to blade based devices. At Las Vegas Eye Institute we are proud to be the only practice in Las Vegas that utilizes the Zeiss Visumax platform to create our LASIK flaps. The Zeizz Visumax utilizes a laser that fires 500,000 very low energy pulses per second to safely create a precise flap with an incredibly smooth bed on which to begin your customized excimer laser ablation. The main advantage that patients love about the Visumax laser compared to its competitors is that the vision does not black out during flap creation. Patients simply look at a green flashing dot while the laser works its magic. In under 20 seconds the flap creation procedure is complete. An added benefit of the Vizumax is the low suction it utilizes which allows most patients to avoid getting hemorrhages to the whites of the eyes that are commonly seen using other platforms.
Once Dr. Swanic has created the flap you will be transferred to the excimer laser to begin your custom corneal treatment. Dr. Swanic is certified on the Alcon Wavelight and the J&J Visx platform for excimer photoablation. He loves both technologies but chose to go with the Visx Platform when he established the Las Vegas Eye Institute LASIK suite in 2019. We utilize the iDesign platform which is an advanced wavefront capture device that also captures corneal topography and pupil data to create an ablation profile that is unique to your eye. The iDesign is the successor to Visx’s prior product called Customvue. The older Customvue platform is actually the platform that Dr. Swanic had performed on his own eyes in 2010 and still affords him with excellent 20/20 vision. iDesign obtained FDA approval in 2015 and brought with it 5 times the data points for its wavefront capture compared to Customvue. The iDesign also expanded wavefront guided astigmatism correction from 3 diopters up to 5 diopters which essentially covers all appropriate LASIK candidates. This iDesign capture device is housed in our clinic where it captures an image of your iris – this image is then transferred to our excimer laser where your iris image is captured again and the previously planned ablation is overlaid exactly where it should be. This is truly remarkable technology which became even more advanced in 2018 when the FDA approved it to utilize your corneal topography to further enhance the quality of ablation. We are excited to be one of only a few practices in Las Vegas to offer this advanced technology.
Some patients are not great candidates for LASIK due to a complex variety of reasons. You will find during your laser vision evaluation at Las Vegas Eye Institute that it seems as though your eyes are undergoing countless tests collecting thousands of data points (hint: because they are). This testing is being performed not only to get you the best possible results but also to ensure that laser vision correction is right for you. If abnormalities are uncovered that make you not the “ideal” LASIK candidate then Dr. Swanic will discuss your alternatives. Many patients will prove to be excellent candidates for an advanced surface ablation technique known as PRK (Photo Refractive Keratectomy) or LASEK (Laser Assisted Sub Epithelial Keratomileusis). These techniques are both quite similar. They do not involve the creation of a flap into the cornea. This allows for the preservation of corneal tissue which may lead to less Dry Eye and a lower risk of postoperative complications. Both procedures are offered at the Las Vegas Eye Institute. Do not hesitate to discuss the subtle differences between these procedures. Dr. Swanic had PRK performed on his own eyes and is a strong believer in LASIK, PRK, and LASEK for appropriate candidates.
Wavefront Guided versus Wavefront Optimized Ablations
Many patients ask about the difference between “wavefront guided” LASIK/PRK and “wavefront optimized” LASIK/PRK. The difference really comes down to whether or not a capture device, like the iDesign, is used on your eye. Other than that simple difference, it is essentially a difference in technology between the leading excimer laser manufacturers in the United States: Alcon and Johnson and Johnson. Dr. Swanic thinks they are both excellent platforms and has utilized both with outstanding outcomes. Alcon’s “wavefront optimized” ablation is not based on a capture device and is instead based on the prescription of your glasses or contacts. The laser optimizes its ablation by providing additional pulses in the peripheral cornea to decrease a phenomenon known as spherical aberration. Spherical aberration is a fancy term which means it decreases the risk of haloes after LASIK (especially after high corrections of nearsightedness.). This technology works very well and is part of the reason modern LASIK is superior to the original LASIK procedure originally approved in 1995.
“Wavefront Guided” ablations in the U.S. are nearly all done on the Visx excimer platform utilizing either the original Customvue wavefront capture device or the newer iDesign device discussed above. These devices shine an infrared light through your eye and pick it up as it exits the pupil. Abnormalities of the wavefront are captured by a device known as an aberrometer and the ablation of the cornea is altered to try to minimize any abnormalities that are unique to your particular eye. We capture these images multiple times to ensure that we have good data before we transfer this data to our excimer laser. The Visx platform also applies peripheral energy pulses to minimize spherical aberration but can also provide pulses to minimize other “higher order aberrations” known as coma or trefoil to sharpen your vision after your procedure.
As stated previously Dr. Swanic thinks both “wavefront guided” and “wavefront optimized” treatments lead to remarkable results that are definitely a cut above “conventional” treatments which do not correct abnormalities like spherical aberration.