Lasik was introduced in refractive surgery by Prof. Pallikaris of Crete. LASIK combines the precision of the excimer laser delivery system with the benefits of Lamellar Keratoplasty (LK), proven to treat a wide range of refractive errors. For some eyes it will become necessary to fine tune the initial procedure with additional refractive procedures to obtain the best final result.

First, a thin layer of the cornea, or corneal cap, is lifted up with an instrument, called a microkeratome, which glides across the cornea.

Then, in less than 3 minutes, ultraviolet light and high energy pulses from the excimer laser reshape the cornea with an accuracy up to 0.25 microns. By adjusting the pattern of the laser beam, it is possible to treat high levels of nearsightedness, and moderate amounts of farsightedness and astigmatism. After the tissue has been reshaped, the flap is replaced in its original position. Because of the cornea's extraordinary natural bonding qualities, healing is extremely rapid and does not require stitches.

LASIK is performed as an outpatient procedure in the comfort and convenience of an excimer surgical suite. The entire procedure takes less than 10 minutes.
The procedure is performed using "eye drop" anaesthesia. Some patients report a slight, post-operative discomfort that can usually be alleviated with medications. Many patients see a dramatic improvement in their vision within the first day.In exceptional cases, vision may be blurry and fluctuate for several weeks or more. Most patients return to their normal activities within a day or two.
The goal of LASIK is to reduce dependence on corrective lenses. LASIK does not always create 20/20 vision.

Lasik is the "Gold Standard" for refractive surgery with more than 2 million treatments planned in tge USA in the year 2003.

Risks of Lasik

Each intervention has his own, although very limited, risks.
Now we would like to discuss with you the different techniques.
We want to differentiate between inconveniences of the technique and real risks.

Under imperfections and limitations we consider the fact that the surgeon cannot guarantee a 100% result or a 0 deviation in all the cases.
Refractive surgery is often a stepwise approach. In 6 to 10%, according to the degree of the refractive anomaly, a second treatment of an enhancement becomes necessary. An enhancement will then be unavoidable in order to obtain a maximal and optimal result.
There will be of course no fee for this second treatment: only the examens have to be paid.

In a limited number of cases the patient may, after the first treatment, have some glare or night driving problems. This condition improves mostly after a few weeks or months and it is very seldon that it remains. In these cases also, a second treatment may eliminate the problem.

Amelioration of the visual acuity is very fast after Lasik. Nearly in most of the circumstances an improvement between 60 and 90% is already there the next day: after while, there is stabilisation after a few days to weeks.

When an enhancement after Lasik becomes necessary then this enhancement will be a different approach. No new keratotomy or no new section with the blade will be necessary but the originally made flap will be lifted with a very delicate instrument and a very limited doses of laser energy will again be applied.

Retreatments are also possible, even 3 to 5 years after the original treatment.
In cases of Lasik it is very seldom (less than 1 out of 1000) that for one another reason the treatment cannot be executed or can only be partially be executed. In these cases the full treatment will be done after a few months.

Exceptionally, infections or inflammations (DLK, diffuse lamellar keratitis) may occur after Lasik.
In these circumstances the healing process will be bad and supplementary medication will become necessary. However, almost all of these eyes obtain a result as planned.

Flap problems (folds, striae, irregularities, epithelial invasion, slippage) may happen after Lasik in 1 to 2% of the cases. Mostly the diagnosis is made at the occasion of the first control examination, the day after Lasik. In these cases a limited retreatment takes care of the problem in most of the cases.

It is also very important to realise that refractive surgery will solve the refractive problem of the eye in cases of myopia (the deviation in cases of myopia, hyperopia and so on) but this myopic eyes will continue to carry the myopic disease: the fragility and the sensitivity of the retina for a number of refraction diseases as retinal holes, retinal detachment.

It is a fact that, even after a 100% succesfull refractive surgery for myopia, the patient will need a regular eye examination yearly by his private ophthalmologist.

In cases where the surgeon enters the eye for refractive surgery as for clear lens extraction and exchange implantation of the own natural lens by an artificial lens, or the implantation of a mini contactlens, the Artisan lens, which has the refractive power of the glasses or contactlenses and is placed in front of the natural lens, complications as after cataract surgery may happen.

Infections, however very seldom, (<1/2000) will never be excluded. However in cases of early detection, there may be a retardation of the healing, but the result will be satisfactory or even excellent.

Complications during the treatment are also, although very seldom, not to be excluded 100%. In some cases it might happen that the surgeon will not, because of anatomical reasons, be able to implant the artificial lens. In these cases also a second intervention or an enhancement will solve the problem.

After Refractive Lensectomy it may happen, as after cataract surgery, that the posterior capsule of the original lens becomes cloudy and that a yag laser capsulotomy becomes necessary.
The risks of these capsulotomies are practically zero after hyperopia. After myopia there is a risk of retinal detachment in 1% of the cases. Of course surgery may cure this retinal detachment.