Today there are many different procedures to correct vision. These various procedures are commonly referred to as "lasik", but lasik is really only one of the many options available to today's customer. All of these surgeries reshape the cornea so that images properly focus on the retina. The important thing to consider is which surgery is best suited to the unique contour of your eyes.

In LASIK a microthin flap of corneal tissue is created with the Intralase FS femptosecond laser for an all-laser treatment. The flap is lifted out of the laser’s path and the excimer laser is used to remove corneal tissue. The flap is placed back into position and covers the treated area. The advantages of LASIK are minimal discomfort, vision improvement within hours, reduced risk of haze, and the need to use of medicated eyedrops for only one week. Disadvantages of LASIK are associated with creation of the corneal flap and potential shifting of the corneal flap after the procedure.

During LASEK, a blade called a trephine is used to create the corneal flap rather than a microkeratome. A dilute alcohol solution is used on the eye to loosen the epithelium and then the epithelium is lifted out of position. The excimer laser is applied and the flap is replaced to cover the treated area. LASEK has fewer possible or potential complications than those associated with the microkeratome. The disadvantage of LASEK is the potential of discomfort for two to three days after surgery, delayed visual recovery and the potential for haze.

IntraLase currently is the hot news in vision correction surgery. This computer-controlled laser creates the flap on the cornea, eliminating the use of a microkeratome (a surgical blade). An all-laser procedure provides fewer post-operative problems than traditional laser surgery.

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Wavefront-guided LASIK, PRK or LASEK takes laser eye surgery to a more precise level. In Wavefront-guided Lasik, PRK, and Lasek, the entire eye is measured with a wavefront aberrometer. These measurements are much more precise than those in a traditional refractive evaluation. Wavefront measurements provide important data to the physician about how the eye focuses light and creates a personalized, one-of-a-kind prescription for surgery. Because Wavefront-guided ablations are tailored to each individual eye, these procedures have a low incidence of halo, glare and better night vision than conventional treatment. It also helps screen out patients who may not be good laser vision candidates.

Learn more about the lasers used at UT Southwestern's Laser Center for Vision Care.

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INTACS are microthin polymer ring segments. These inserts are placed under the outer edge of the cornea. INTACS reshape the cornea from within to allows better focus of light rays on the retina. If adjustments are needed prescription rings can be replaced and or removed if necessary. Advantages of INTACS include reversibility, the fact that tissue is not removed and the eye is not structurally weakened, it is not dependent on wound healing and delivers an excellent quality of vision. The disadvantages are that they are only FDA approved for low levels of myopia and do not correct astigmatism.

RK, or radial keratotomy, is a procedure more commonly performed before the use of excimer lasers. RK involves making a number of cuts in the cornea with a diamond knife thereby changing the corneal shape. The procedure is less predictable and less stable than laser vision correction. We no longer advocate its use.

PRK was the first laser vision correction procedure approved by the FDA. The corneal epithelium is actually removed and an excimer laser beam is used to remove corneal tissue until the desired correction is achieved. The epithelium will grow back over in the next several days resulting in a smooth corneal surface. PRK is quick, straight-forward, does not involve any cutting of the eye., and may be preferred in cases of certain corneal abnormalities. Disadvantages include one to two days of discomfort, slower visual recovery, the chance of developing corneal haze, and the need to use of medicated eyedrops for an extended time after surgery. Some patients may qualify for custom PRK.

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C-CAP -- Fixing issues of previous LASIK

While the vast majority of people who undergo refractive surgery have excellent results, a condition known as decentered ablation can affect a small number of those who had PRK or LASIK. This is caused by an off-center initial treatment or an eye that healed unevenly.

The Custom-Contoured Ablation Pattern (C-CAP) Method may be able to help these patients, if sufficient corneal tissue remains. C-CAP uses specialized topography software to precisely map the surface of the eye. This data allows the ophthalmologist to plan a surgery that dictates ablation depth, diameter, location and exact pattern that will eliminate the corneal irregularity.

C-CAP is also used in patients who have residual astigmatism after corneal transplants, traumatic disorders; patients with contact lens induced irregularities; and inherited or acquired eye disorders.

UT Southwestern is one of a handful of centers that offer C-CAP.

• Learn more about the lasers used at UT Southwestern's Laser Center for Vision Care.

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