LASIK / Types of LASIK
Types of Laser Vision Correction
Laser vision correction changes the sharpness of the vision by using a cold laser to microscopically alter the outer curvature of the eye. With our advanced technology, the entire treatment takes less than five minutes and is painless. We perform all three of the major versions of laser vision correction:
![Happy man in casual clothes](https://www.castereye.com/wp-content/uploads/happy-man-LASIK-scaled.jpeg)
LASIK
The most common version of laser vision correction is LASIK, which has been performed in the United States since 1996. Dr. Caster was one of the twenty doctors in the United States who performed LASIK treatments as part of the original FDA approval process of LASIK. LASIK is a two-step process. The first step is the creation of a flap, which enables us to apply the second step, the laser reshaping of the eye, below the outer surface. By applying the treatment below the surface, we allow the eye to heal very quickly without any significant discomfort. We perform the LASIK version in the majority of our patients.
All-Laser LASIK Advantages and Disadvantages
Advantages
Disadvantages
PRK
Also known as LASEK or Advanced Surface Treatment. PRK is preferable for some of our patients, especially those with moderate dry eyes, thin corneas, irregularly shaped corneas, or certain hobbies such as boxing. PRK is the least invasive version of Laser Vision Correction and has been performed by Dr. Caster since 1996. In PRK, the laser reshaping of the vision is performed near the surface of the eye, rather than deeper within the eye as in LASIK or SMILE LASIK.
Because PRK is performed near the surface of the eye, there is typically one day of pain, which is treated with numbing eye drops applied at home. Although most PRK patients are driving and back to work the next day, the vision recovery is slower than with the other laser techniques.
PRK Advantages and Disadvantages
Advantages
Disadvantages
“My prescription was -10 with my astigmatism included. I love it! It’s a different world!”
Chimdi Ihezie
SMILE LASIK
SMILE LASIK, also known as ReLex SMILE, is the newest version of laser vision correction. SMILE, which stands for Small Incision Lenticule Extraction, consists of one painless laser step lasting less than 30 seconds. As with all types of laser vision correction, you are able to get up from the treatment and see an immediate improvement, though final vision (as with all types of laser vision correction) takes about three months. Over 5 million SMILE treatments have been performed world-wide.
SMILE LASIK is performed with the VisuMax laser, created by Zeiss. The VisuMax laser technology is truly amazing. The laser creates 500,000 tiny spots every second. These spots are placed very close to each other and free up a thin layer (similar to a contact lens) within the center of the cornea. The laser also creates a small tunnel connecting the thin layer to the outside of the eye. The doctor then reaches in through the tunnel, frees up the thin lens, and pulls it out. Removal of this thin lens changes the curvature of the eye, correcting the focus of the vision.
SMILE LASIK can only be achieved with the VisuMax laser by Zeiss. Only this laser has the necessary precision to perform this procedure. At the Caster Eye Center, we use the VisuMax laser not only to perform SMILE, but also to perform the first step of the all-laser LASIK procedure. Because this laser places so little pressure on the eye, treatment with this laser is pain-free. (For our engineer types, the VisuMax laser is the only femtosecond laser that is opto-electronic; all other femtosecond lasers are opto-mechanical in design.)
SMILE Advantages and Disadvantages
Advantages
Disadvantages
FAQ about SMILE LASIK
Which Laser Treatment is Best for Me?
![](https://www.castereye.com/wp-content/uploads/LASIK-types-02-scaled.jpeg)
The most popular variation of laser treatment is called LASIK. Other names include IntraLasik, Femto-LASIK, and all-laser LASIK. In this technique, the laser treatment is made within the cornea, rather than near the corneal surface. This is accomplished by using a laser to create a protective flap in the front 20% of the cornea and then applying laser treatment to the tissue beneath the flap.
The vision correction treatment can also be applied near the surface of the cornea (instead of under a protective flap), in which case the technique is referred to as Advanced Surface Treatment. This technique has several minor variations, which include PRK (for “photo-refractive keratectomy”), Lasek, and Epi-LASIK. In PRK, the thin layer of soft tissue coating the outside of the eye (the epithelium) is removed and the laser energy is applied to the firm tissue underneath. In Lasek–with an “e”–the soft tissue on the surface is replaced after the laser treatment. In Epi-LASIK, this thin layer of soft material is folded back using a machine. PRK, Lasek, and Epi-LASIK are very similar to each other. When the laser treatment is applied to the tissue deep within the cornea (as in LASIK) instead of near the surface (as in Advanced Surface Treatment), the healing is quicker with more rapid vision recovery.
SMILE LASIK is “small incision” laser correction. A laser is used to create a thin, lens-like layer within the cornea, as well as a narrow tunnel to the surface. The doctor reaches in to separate and remove the lens through the tiny tunnel.
The final visual results are the same with each of the versions of laser vision correction. The technique that is best for you depends on your very particular eye measurements, lifestyle, and visual needs. You will be able to discuss this and any other questions that you have when you meet with Dr. Caster during your personal consultation.
LASIK by Age
Teens and Young Adults (18-25 years old)
![](https://www.castereye.com/wp-content/uploads/young-woman-in-the-sun-990x657.jpeg)
As you grow, the eyes grow, too. At some point, the eyes stop growing and you reach your final level of poor vision. For many people, ocular maturity happens by age 16. For most, the vision is stable by age 18, but for some the final vision is not reached until age 25.
LASIK is best performed when your eyes have stopped changing, which is a different age for each person. If your eyes are changing only a little that will not matter, but if your eyes change a great deal after LASIK, because you are still growing, then you might want to have a second treatment later on. So we like to see only a very mild level of change in nearsightedness for a two-year period for people in this age range prior to treatment.
Adults 25-45
![](https://www.castereye.com/wp-content/uploads/family-outside-990x660.jpeg)
This is the age when your personal life and your career are expanding. The glasses and contact lenses can be irritating and hold you back in many ways, and LASIK can be very liberating. We hear from so many people that the two best days in their lives are when they had LASIK and when their first child was born! That is an incredibly strong endorsement.
Almost all people in this age group have very stable vision, which means further LASIK will probably not be needed. And the problems of reading glasses have probably not yet surfaced.
Adults 45-65
![](https://www.castereye.com/wp-content/uploads/smiling-man-orange-shirt-990x660.jpeg)
Many people have enjoyed great distance vision up to this age, and then begin to lose the close-up vision. Others first begin to lose the close-up vision in their forties and then begin to lose the distance vision as well. Others have had good distance vision using glasses or contacts, but now have trouble with close-up vision as well.
Around age 45 the problem of reading glasses typically begins. People who have always had great close-up vision, even when wearing their distance glasses or contact lenses, begin to experience some blurriness with their close-up reading vision. This vision problem is different from the vision problems that occur earlier in life, and is due to the lens deep within the eye becoming stiffer and losing its ability to change focus from far to near. This is known as presbyopia, which is the farsightedness of middle age.
Adults in the age range have a choice of correcting both eyes for distance and then using drugstore reading glasses to help with fine close-up vision. This is what a lot of people in this age group do with their contact lenses and what we can do with LASIK. Alternatively, many people use contact lenses with monovision, in which one eye is optimized for distance correction and the other is optimized for close-up. If a person enjoys vision with monovision, we can use LASIK to correct the vision this way.
Many people in this age group have never thought of monovison. Although it sounds very strange, it is surprising how many people love monovision and the more complete freedom from glasses that monovision provides. Easy-to-perform testing in our office will show you what monovision is like and you can determine whether or not it is right for you.
Adults 65 and older
![](https://www.castereye.com/wp-content/uploads/older-woman-bench-scaled.jpeg)
We are all as young or as old as our attitudes. Thanks to medical advances, glasses and contacts are not necessary at this age. There is no upper age limit for LASIK.
If we live long enough, almost all of us will develop a cataract, which is a cloudiness of the lens deep inside the eye impairing vision. If significant cataracts are present, then a cataract removal is preferable to having LASIK. However, if cataracts are not very advanced, are not impacting vision, and have not been progressing, then LASIK is an option. Also, if glasses are still necessary after cataract removal, then LASIK can be performed to improve the vision without glasses.
LASIK and the Military
![](https://www.castereye.com/wp-content/uploads/LASIK-military-scaled.jpeg)
One of the most powerful “weapons” in the United States military is laser vision correction. LASIK is widely used in all branches of the military, significantly improving the fighting ability of our troops.
The military has now performed over 600,000 laser vision correction procedures on United States military personnel. The Department of Defense carefully monitors the results of all of their laser vision treatments, and they have found that laser vision correction is highly safe and highly effective. Some interesting results of the many clinical trials conducted by the Department of Defense include:
Extensive research by the Department of Defense has repeatedly proven the extremely high level of safety and effectiveness of laser vision correction. This research has shown that patients with laser vision correction are suitable for the most visually demanding tasks in the world, in both daylight and in darkness, as well as extremely dry, wet, or dusty environments.
Troops who are treated with LASIK or PRK no longer need to worry about dirty, sweat-covered glasses, dry and irritating contact lenses, or losing their glasses or contact lenses during life-threatening combat. This applies to troops on the ground, in submarines, or aviators who fly very fast and expensive fighter jets. “Landing a jet on an aircraft carrier in the middle of the ocean at night requires amazing vision. My vision was good with contacts, but it is amazing after LASIK by Dr. Caster.”
The military provides LASIK and PRK to active service members, but there is a long waiting list. We continue to treat many men and women who are members of the United States military, and we are proud to help each one perform his or her job more effectively and safer, as well as help each service member better enjoy life free of glasses and contact lenses. Fabulous eyesight, which is so important to a high quality of life in so many ways, is critical to all aspects of the military. As one Army sergeant explains, “After LASIK, our vision is always ready for combat. No worries about dirty glasses or watery contact lenses.”