LASIK surgery is one of the most common procedures performed in the United States, and it is great way for people who wear contact lenses to get out of them in a matter of minutes. Yes that is right, LASIK surgery can be done in only a few minutes. LASIK eye surgery consists of 2 parts; the first part is making a corneal flap and the second part is reshaping the cornea with an excimer laser. The short answer is that our femtosecond laser takes 20 seconds to create the flap, and our excimer laser takes under 1 minute to reshape the cornea (typically under 30 seconds.). However, if you’ve come this far you can find out a lot more about the LASIK procedure if you read on!
How long does it take to make a corneal flap?
The only LASIK procedure we perform at Las Vegas Eye Institute is femtosecond all-laser LASIK surgery. This means that we never use a blade, in fact we don’t even have one so we couldn’t do that if we wanted to. We currently use the Visumax laser by Zeiss to create the flap. This amazing device fires 500,000 very low energy pulses per second to create a smooth and uniform bed in preparation for the excimer laser treatment. It creates the entire flap in under 20 seconds.
The device uses a sterile single-use plastic cone that is calibrated before every single procedure we perform. The Visumax laser cone is curved to replicate the natural shape of your eye so that low suction can be utilized during this procedure. This low suction is why we invested in this technology (we are the only laser eye surgery center in Las Vegas to own the Visumax.). Low suction allows the procedure to be much more comfortable for the patient, and what patients really like is that the low suction is applied to the clear part of their eye (the cornea) instead of the white part of the eye that has blood vessels. Because the laser treatment is done under low suction to a part of the eye without blood vessels it is very rare for our patients to ever develop what is called a “subconjunctival hemorrhage.” This type of hemorrhage is a fairly common occurrence with high suction lasers and bladed devices called a microkeratome. These hemorrhages lead to red spots on your eye that can take 1-2 weeks to resolve. You can see why we wanted to avoid this issue if at all possible. What is great about the Visumax is that if you have a wedding to attend on a Saturday then you should be looking great in the photos after your refractive surgery procedure on a Thursday!
How long does LASIK surgery take if I’m getting the version called PRK, LASEK, or Advanced Surface Ablation?
The above laser vision correction procedures are all really the same procedure, or slight variations of the same procedure. Dr. Swanic doesn’t create a flap before performing the procedure. PRK, or Photo Refractive Keratectomy, is actually the original laser vision correction surgery that was FDA approved over 30 years ago in 1995. In this procedure, the surface layer of the cornea, called the epithelium, is removed with a weak alcohol solution so that a layer of the cornea called the stroma can be ablated with the excimer laser. This is important because laser treatments to the stroma are permanent, which is what you want in a treatment of myopia (nearsightedness) or hyperopia (farsightedness). If the epithelium was not removed and laser energy was applied to only the epithelium, then the epithelium would simply grow right back, and it would be as if nothing had ever occurred. It takes about 30 seconds of exposure of the cells to alcohol to weaken them, it then takes an experienced surgeon about 15 seconds to slide them to the side.
After the excimer laser vision correction is complete, then a contact lens is placed on the eye to help it heal and be comfortable over the next few days as the surface epithelium regrows. This bandage contact lens is usually removed about 5 days after the procedure, at which point the epithelium that was removed during the procedure should have completely grown back.
The procedure known as LASEK is rarely performed by most refractive surgeons anymore, but we will describe it here because we still get an occasional patient asking about it. LASEK is simply a procedure where you weaken the epithelial layer with alcohol (same as above for PRK) and slide it away for the excimer LASER to work. After the excimer procedure is performed, you slide those same weakened cells back over the cornea. In PRK those cells are discarded instead of put back on the cornea.
The procedure was developed to help decrease discomfort with the original PRK procedure. Unfortunately, studies showed the pain level was not statistically significantly different from conventional PRK, and thus most doctors abandoned it. Dr. Swanic completed his Cornea and Refractive surgery fellowship at UCLA Jules Stein Eye Institute in 2011, and the procedure had already been abandoned by that point. He personally feels LASEK is likely less safe than PRK as these weakened epithelial cells could increase the risk of infection during the healing process.
Advanced Surface Ablation, often abbreviated as ASA, is another way to refer to PRK. Some surgeons use this terminology to imply that they use alcohol to weaken the cells (instead of a metal instrument which was the original method) and that they place Mitomycin C (MMC) after excimer ablation to reduce the risk of haze to a minimal level. At Las Vegas Eye Institute, Dr. Swanic uses alcohol to remove the cells and Mitomycin C on all cases, so we could also refer to this procedure as ASA but we feel that makes things more confusing for patients. PRK and ASA are essentially the exact same procedure.
How long does the excimer laser portion of the surgical procedure take?
The excimer laser vision correction portion of the surgery has a variable time frame and does vary based on which model excimer laser is being used. Treatments for nearsightedness (myopia) are typically shorter than treatments for farsightedness (hyperopia), but both are typically completed in under one minute. The higher the correction the longer the treatment. Some treatments (such as under 1 diopter of myopia) can be done in under 5 seconds! The average treatment tends to be in the 20-30 second range.
About how long does the entire LASIK procedure take at Las Vegas Eye Institute?
The entire LASIK procedure usually takes about 15 minutes at LVEI. The reason for this is that the LASER bed of the Visumax will move around to align your eye to the laser before each procedure. Also, before the first procedure can take place, the sterile one-use cone needs to be calibrated which takes the Visumax about 30 seconds. This calibration process is completed again before the second eye is performed. At LVEI we are in no rush. We don’t ever want our patients to feel like they are on an assembly line. However, we do want the procedure to go quickly to minimize anxiety.
When we complete the Visumax femtosecond laser procedure we, then walk you to the excimer laser to perform the second portion of the procedure. Small marks are placed on the flap before it is lifted so that Dr. Swanic can get the flap perfectly aligned at the conclusion of the procedure. He also takes many additional steps, that in order of brevity we wont describe here, to insure an excellent outcome. You only have 2 eyes. There is no rush to get you the excellent vision that you deserve!
This sounds easy. I want to do this to get out of contacts lenses or glasses. What do I do next?
Request an appointment! We offer free LASIK evaluations and would love to match a custom LASIK procedure to your eyes!
Want to know more about LASIK? See the next Article in our LASIK series: Can LASIK Make You Go Blind?