Refractive Procedures to Serve Every Need

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Refractive eye surgeries, such as LASIK and Advanced Surface Ablation (which includes PRK, LASEK, and  Epi-LASIK) are procedures that are performed to correct refractive errors including myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, as well as presbyopia (the loss of reading vision). The goal of these procedures is to reduce dependence on glasses or contact lenses.  This may result in both cosmetic as well as functional lifestyle benefits.  During each of these procedures, the cornea is precisely reshaped to correct the specific refractive error. Our refractive surgeon, Dr. Jeffrey Minkovitz has been a leader in making each of these procedures available to Delaware residents, in several cases the first to do so. Once again leading the field, Dr. Minkovitz founded Laser Vision Delaware, LLC to bring to the First State the latest refractive technology in the most up to date setting. To schedule an appointment for a careful and thorough evaluation and discussion of alternatives, we invite you to contact Eye Physicians and Surgeons, P.A. in Wilmington, Delaware today.

PRK

Photorefractive keratectomy (PRK) is an eye surgery performed to correct myopia, hyperopia, and astigmatism by reshaping the cornea. It was the original method used for laser vision correction, and it remains an ideal choice, especially among those with thin corneas or prior eye surgery.  It is also ideal for patients concerned about safety and stability in the possibility of injuries (police, military or active lifestyles).  Dr. Minkovitz was involved in the early research before FDA approval, and was the first surgeon to make PRK available to his Delaware patients.

During the PRK surgery process, Dr. Minkovitz uses anesthetic drops to numb the eyes. First, the cornea’s outermost layer - the epithelium – is gently removed so that the deeper surface can be accessed. He then uses the sophisticated excimer laser to precisely reshape the cornea to the exact specifications determined by careful preoperative testing. Once the cornea has been reshaped, a contact lens will be placed over the eye to provide comfort and protection while the epithelium grows back.

The results of PRK surgery are comparable to those achieved with LASIK, though healing takes somewhat longer. The vast majority of patients experience exceptional improvement in their vision, with many achieving 20/20 vision or better, eliminating or greatly reducing the need for corrective lenses.

LASEK

LASEK eye surgery is a variation on the original PRK treatment. The procedure differs from PRK in that an alcohol solution is used to remove the epithelium from the cornea, usually creating a thin "flap" which can be replaced. Once Dr. Minkovitz has created this flap, an excimer laser is utilized to reshape the cornea so that the eye's focusing power can be improved. After laser application, the epithelial flap is replaced. Since there is no incision made on the cornea, LASEK surgery like PRK may be ideal for patients who are not good candidates for LASIK; Again, healing may take longer than LASIK, but comparable results can be achieved in a less invasive manner.

LASIK

LASIK eye surgery is a safe, effective way to improve refractive errors such as nearsightedness, farsightedness, and astigmatism. Patients who choose to undergo custom LASIK will also be able to improve higher-order aberrations, those minute flaws in the shape of the cornea that nevertheless affect visual acuity. The vast majority of patients who undergo LASIK emerge from the procedure with dramatically improved vision, with many being achieving 20/20 vision without the need for corrective lenses. 

During the LASIK procedure,  the eyes are first numbed with anesthetic drops. A thin flap in the outermost layer of the cornea is then created with a highly precise device called a microkeratome or a laser. This allows access to the underlying corneal layers, flaws in the shape of which are responsible for visual errors. Using an excimer laser, as in PRK,  the cornea is reshaped according to preoperative measurements, a process that requires about a minute per eye. Once the laser is complete,  the flap is carefully replaced, and self-heals without the need for stitches or bandages. Improvements in vision are usually immediately noticeable, although vision will continue to improve over weeks and months. The final results are typically clear, crisp vision and, in most cases, complete independence from glasses and contact lenses. Results may be seen several days earlier than with Advanced Surface Ablation, but are ultimately comparable. 

While injuries and complications are rare, Dr. Minkovitz typically recommends advanced surface ablation over LASIK specifically to avoid LASIK flap related problems.

Epi-LASIK

Initially developed as a safer alternative for patients with thin corneas, dry eyes, or active lifestyles, the Epi-LASIK procedure is similar to PRK and LASEK in that it corrects the same visual errors and no incisions are made to cut a corneal flap.  Only the thin epithelial layer is removed, a layer which quickly regenerates.  Unlike LASEK, no irritating alcohol solution is used. Instead, Dr. Minkovitz uses an instrument called an epi-keratome to create a thin, hinged sheet of epithelial cells in the surface layer of the cornea. After moving this sheet to one side he uses the excimer laser to precisely reshape the cornea. This can be done according to preoperative refractive measurements, or using data from wavefront-guided custom measurements for the most accurate results available.  Finally, the epithelial sheet may be replaced and a special contact lens placed on the eye to facilitate healing and comfort.  As in  LASIK, visual recovery is rapid (though not as rapid as LASIK) but without any potential for intraoperative or postoperative flap-related complications or injury. 

To learn whether you are a good candidate for laser refractive surgery, or one of the other alternatives for the correction of myopia, hyperopia or astigmatism, please contact Eye Physicians and Surgeons, P.A. in Wilmington, Delaware today to schedule a consultation.

Only through a careful evaluation and a patient discussion of your options can you make the right decision about your vision correction.

Laser Vision Delaware, LLC

Having introduced laser vision correction to Delaware in 1995 (initially accompanying patients to Johns Hopkins, and subsequently performing lasers in an open access facility in Delaware, Dr. Minkovitz has now brought the newest, most advanced laser to Delaware, founding Laser Vision Delaware, LLC in 2016.  Visit www.Laser Vision Delaware.com for more information

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