10/10/2021
One of the most promising and exciting developments in the world of refractive surgery has been the advent of laser in situ keratomileusis (LASIK). The surgical technique involves the creation of a hinged lamellar corneal flap, after which an excimer laser is used to make a refractive cut on the underlying stromal bed. LASIK is a fusion of old and new technologies, with its roots in keratomileusis and automated lamellar keratectomy (ALK). However, as currently practiced, it is perhaps best thought of as photorefractive keratectomy (PRK) performed under a flap instead of on the corneal surface.
Postoperative details
A complete eye examination, including manifest and cycloplegic refraction, slit lamp examination, dilated fundus examination, and corneal topography, is recommended. Wavefront measurements can also be taken as part of the initial screening examination and are helpful in determining if the patient is a candidate for custom treatment and as a comparison to the current glasses prescription and refraction.
Intraoperative Details
The procedure usually is performed under topical anesthesia, but it can be supplemented by intravenous or oral conscious sedation.
A sterile drape and lid speculum is placed carefully to maximize exposure and to isolate the lashes. The patient is positioned underneath the microscope of the laser so that the flap can be cut under direct visualization.The cornea is marked. A radial keratotomy marker and optic zone marker (placed eccentrically) dipped in methylene blue or gentian violet can be used. The marks allow replacement and alignment of the flap in the event that a nonhinged free flap is cut by the microkeratome.