KUSH TRIPATHI

LASERS IN ENT

Lasik eye surgery is a procedure that is designed to correct poor vision. It is relatively painless and takes place in a simple office setting. This technology is unique has reduced the need for millions of people to use glasses or contact lenses. In most cases, people are able to discontinue their use all together and go about living a life with perfect vision.
LASIK is a surgical procedure intended to reduce a person’s dependency on glasses or contact lenses. LASIK stands for Laser-Assisted In Situ Keratomileusis and is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. A knife, called a microkeratome, is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middlesection of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced.

Type of Lasers
The lasers that are used in Lasik eye surgery are truly unique and use exceptional technology. Excimer lasers were created specifically for Lasik. The FDA has approved each type of laser, but some lasers are better than others. The biggest difference is the way that the beam is delivered to the eye and their ability to track eye movement.
There are two broad categories of laser including broad beam and scanning. There are two categories within scanning lasers including slit scanning and spot scanning.
Broad Beam Lasers
Broad beam lasers utilize a large beam diameter, ranging from 6 to 8 millimeters, that cut the cornea. The use of these lasers shortens the amount of time that is necessary to complete the surgery. These lasers also reduce the risk of over correction due to pupil movement. The larger diameter makes the likelihood of complications more likely, but improved technique has eliminated most of this risk.
Slit Scanning Lasers
Slit scanning lasers use smaller beams. The beam is linked to a rotational device that has slit holes to enlarge the area that is being cut. Slit scanning lasers provide a more uniform beam and create a smoother cut. There is a slightly greater chance of over correction with these lasers.
Spot Scanning Lasers
Spot scanning lasers are referred to as “flying spot” lasers. These use a small beam of 0.8 to 2 millimeters. The beam is scanned across the cornea in order to create the area to be cut. Spot scanning lasers have potential to create the smoothes cut. They are also able to produce customized cuts and are able to treat irregular astigmatism.

Most lasers contain an eye tracking system. This system is linked to the position of the eye. Lasers without this system make it necessary for the patient to fixate on a distant object and to keep their eyes still. There are two different type of eye-tracking systems:
• Open Loop – monitors the pupil’s location.
• B – Tracks eye movement and makes adjustments accordingly
Some sort of tracking system is required as it can be difficult for patient’s to fixate on an object for a long period of time.
IntraLase Lasers
The IntraLase is capable of creating the flap that needs to be cut in order to reach the cornea for shaping. The laser creates a precise pattern of small, overlapping spaces. These work at a very high speed. This allows the tissue to be target and divided at a molecular level. This laser also uses a special software that helps to guide the beam. The software instructs the beam to apply a series of bubbles on the cornea. This results in a corneal flap. The technology has helped patients with thin corneas utilize Lasik.
IntraLase has far fewer complications than when microkeratomes are used. Surgeons have noticed that there is one possible complication. Some patients have a postoperative complication of being very sensitive to light after undergoing an all laser Lasik procedure. Many surgeons have also noted that this complication is only temporary and that using steroid eye drops has rectified the problem after a couple of weeks.
This system is more expensive as well. The “all laser” approach can add an additional $300 per eye. Patients are often given the option between mircrokeratome or the IntraLase system. Some surgeons use IntraLase exclusively, so the cost is already included in their fee.
Long-Term Effects
Approximately 94% of patients have improved vision immediately after the surgery is performed. Many patients will have 20/40 vision or better after receiving Lasik surgery. There are some complications that have been reported such as:
• Seeing halos around lights at nighttime
• Worsened vision
• Infections
• Poor night vision
Used for

Improved vision is not the only reason that many people turn to Lasik. There are several eye conditions that Lasik can help to correct. It has been very popular for treating conditions such as:
• Glaucoma
• Macular degeneration
• Diabetic retinopathy
• Presbyopia
• Astigmatism
• Myopia
• Hyperopia