LASIK (laser in-situ keratomileusis), PRK, SMILE, FLEX, Refractive Surgery
Over 30,000 surgeries performed in LASIK (laser in-situ keratomileusis). Refractive Surgery.
Pioneer in LASIK Refractive Surgery. Dr. Duplessie was an organizer of the first and largest United States Lasik Course.
Dr. Duplessie wrote the first textbook chapter on myopic lasik surgery published worldwide.
Refractive Surgery and Corneal Pioneer and Specialist: Dr. Duplessie Editor of Advances in Refractive and Corneal Surgery
Michael Duplessie, International Ophthalmology Clinics
Dr. Duplessie wrote the first textbook chapter on Hyperopic lasik surgery published worldwide.
He organized the largest Lasik Web lab in the world.
The first United States Lasik course popularized the name lasik; at that time it was called E-IKM. Since the lasik course and textbook chapters, approximately 700,000 LASIK procedures are performed annually. Dr. Duplessie is highly skilled in all types of laser surgery, including LASIK, custom corneal correction, and all-laser procedures.
If you are considering lasik, you must decide if you want surgery performed by the person who wrote the textbook chapters or someone who may not have read them. Dr. Duplessie’s record is 100 lasik surgeries in one day. Trust your eyesight to an experienced surgeon.
Dr. Duplessie has been performing Lasik surgery longer than any surgeon in Kuwait and has performed more Lasik surgeries than any other surgeon in Kuwait.
Who is qualified for laser vision correction?
There is little more precious than the gift of sight. We process almost everything in our lives through our eyes, and yet 50 percent of people wear glasses or contacts simply to function. You will need to have a series of tests to evaluate the health of your eyes, concentrating on the health of your cornea.
What you can do after lasik
Are you tired of living in a world you cannot see without the aid of contact lenses or glasses? Are you fed up with the hassles of contact lenses or glasses? Can you imagine starting your morning able to see not only what time of day it is, but also what type of day awaits you?
What is LASIK?
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 microkeratome, is used to cut a flap in the cornea. Pulses from a computer-controlled laser change the curvature of the cornea and the flap is replaced.
Eye and Vision Errors:
The cornea is a part of the eye that helps focus light to create an image on the retina. It works in much the same way that the lens of a camera focuses light to create an image on film. The bending and focusing of light is also known as refraction. Usually the shape of the cornea and the eye are not perfect and the image on the retina is out-of-focus (blurred) or distorted. These imperfections in the focusing power of the eye are called refractive errors.
There are three primary types of refractive errors: myopia, hyperopia and astigmatism.
Myopia, or nearsightedness,
have more difficulty seeing distant objects as clearly as near objects.
Hyperopia, or farsightedness,
Eye is optically too short. Patients have difficulty seeing near objects and distant objects.
is a distortion of the image on the retina caused by irregularities in the cornea or lens of the eye.
Combinations of myopia and astigmatism or hyperopia and astigmatism are common. Glasses or contact lenses are designed to compensate for the eye’s imperfections. Surgical procedures aimed at improving the focusing power of the eye are called refractive surgery.
In LASIK surgery, precise and controlled removal of corneal tissue by a special laser reshapes the cornea changing its focusing power.
Refractive Surgery Options:
- SMILE, FLEX
Photorefractive surgery [PRK]:
PRK was the first surgical procedure developed to reshape the cornea using a laser. The exact same laser is used for the two types of surgery. Below 5.00 diopters of myopia, there is a choice between surface PRK/ and LASIK. Both procedures are approved. What are the advantages and disadvantages of each? With respect to results and expectations, PRK and LASIK are identical. LASIK has a miniscule increase in risk of complications due to creation of the flap.
Overall, there does not seem to be a significant difference between PRK/ and LASIK in the percentage of patients achieving 6/6 [20/20] at the end of six months. Patients do extremely well with both procedures.
Sometimes, if a patient’s cornea is too thin to safely perform LASIK, then PRK is the only available option for refractive surgery.
Length of Procedure
Both are quite short. Surface PRK takes about three minutes of actual treatment time. LASIK requires about one to two minutes additional actual treatment time. There is no discomfort during either procedure. With LASIK, there is a pressure sensation and a graying out of vision for about 30 seconds while the corneal flap is created.
LASIK is definitely more complex with respect to both equipment and performance of the procedure itself. The surgeons experience and expertise is vital. Dr. Duplessie wrote the first textbook on Lasik; he is one of the best. He has performed over 30,000 procedures.
As with anything, with increased complexity, there are more possibilities that can go wrong. Although the overall percentage of complications of surface PRK and LASIK are approximately the same, the complications with LASIK are potentially more severe than with PRK.
The technology used in the Lasik Procedure has been in use for years and very safe; 31.4 million procedures have been performed worldwide to date making it the most common elective vision procedure. In the U.S. all branches of the U.S. military and NASA allow the treatment of LASIK for their servicemen and women. Dr. Duplessie feels so confident in lasik he underwent lasik 20 years ago and still has 20/20 vision in both eyes.
The LASIK Procedure-
The LASIK Procedure only takes minutes. It reshapes your cornea to correct the refractive imperfections in your eye (these imperfections are essentially the reason you are nearsighted, farsighted, etc.). Computers/software are used to make an individual blueprint of your eyes; this blueprint is used to drive your laser correction and is what gives you a truly customized result
SMILE procedure from ZEISS
Dr. Duplessie one of first doctors from the USA performing the SMILE procedure.
The SMILE procedure developed by ZEISS has become the third generation of laser vision correction.
The SMILE procedure developed by ZEISS for refractive surgery stands for Small Incision Lenticule Extraction and combines state-of-the-art femtosecond laser technology and precise lenticule extraction providing a micro-invasive laser vision correction method.
Unlike LASIK (Laser-Assisted in situ Keratomileusis), the SMILE procedure is performed without a flap. The ZEISS femtosecond laser VisuMax® is used to create a very thin disc of tissue (lenticule) inside the intact cornea, which can then be extracted through a small incision.
The Dry eye syndrome may be less with SMILE compared with LASIK..
It’s natural to have a bunch of questions when considering the LASIK Procedure. Dr. Duplessie is an expert at answering those questions and his staff are real pros who will provide plenty of support during the process.
LASIK VERSUS CONTACTS- MAYBE CONTACTS AREN’T THE LONG-TERM ANSWER?
The LASIK Procedure is safer than wearing contacts lenses.
FINANCIAL FACTS— LASIK PROCEDURE IS WITHIN YOUR REACH
Money shouldn’t be the reason you’re putting off having the LASIK Procedure. We know that the simple saying, “you can’t put a price on great vision” doesn’t change the fact that you have to find a way to pay for the procedure.
Dr. Duplessie can help you with financing
What to Expect Before, During and After Laser Vision Correction:
What to expect before, during, and after surgery will vary from patient to patient. This section cannot replace the dialogue you should have with Dr. Duplessie, but it can help you gain a general understanding of the pre-, post– and operative stages of the procedure.
If you wear contact lenses, you must stop wearing the lenses four days before your baseline evaluation and switch to wearing your glasses full-time. Contact lenses change the shape of your cornea for up to several weeks after you have stopped using them depending on the type of contact lenses you wear. Not leaving your contact lenses out long enough can result in inaccurate measurements resulting in poor vision after surgery.
If you wear:
· Soft contact lenses, you should stop wearing the lenses for 4 days before your initial evaluation.
· Toric soft lenses or rigid gas permeable (RGP) lenses, you should stop wearing them for at least 3 weeks before your initial evaluation.
· Hard lenses, you should stop wearing them for at least 4 weeks before your initial evaluation.
You should tell Dr. Duplessie about your past and present medical and eye conditions and about all the medications you are taking, including over-the-counter medications and any medications you may be allergic to.
Dr. Duplessie will perform a thorough eye exam and discuss what you should expect before, during, and after surgery, as well as your responsibilities will be before, during, and after surgery. You will have the opportunity to ask Dr. Duplessie questions during this discussion.
The day before surgery, you should stop using creams, lotions, makeup and perfumes. These products as well as debris along the eyelashes may increase the risk of infection during and after surgery. Dr. Duplessie may ask you to scrub your eyelashes for a period of time before surgery to get rid of residues and debris along the lashes.
During the procedure:
The procedure should take less than 20 minutes. You will lie on your back in a reclining chair in an exam room containing the laser system. The laser system includes a large machine with a microscope attached to it and a computer screen.
A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. A ring will be placed on your eye and your vision may dim. The microkeratome, an instrument, is attached to the ring. Dr. Duplessie will use the microkeratome to make a flap in your cornea.
The microkeratome and the ring are then removed. You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. Dr. Duplessie will then lift the flap to dry the exposed tissue.
The laser will be positioned over your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea; it is a light to help you keep your eye fixed on one spot once the laser comes on.
When your eye is in the correct position, Dr. Duplessie will start the laser. A computer controls the amount of laser delivered to your eye.. After the pulses of laser energy shape the corneal tissue, the flap is put back into position.
A shield will be placed over your eye at the end of the procedure as protection, since no stitches are used to hold the flap in place.
Immediately after the procedure, your eye may feel like there is something in it. You will instinctively want to rub your eye, but don’t! Rubbing your eye could dislodge the flap, requiring further treatment. In addition, you may experience sensitivity to light, glare, starbursts or haloes around lights, or the whites of your eye may look red or bloodshot. These symptoms should improve considerably within the first few days after surgery.
The post op result is similar in both procedures except LASIK is more comfortable than surface PRK. Vision becomes crisper quicker and patients feel more comfortable during the early post-operative period. It is just a fraction risker.
· LASIK: A clear plastic shield is worn over the eye for the first 24 hours, and then nightly for 2 nights to prevent inadvertent rubbing of the eye. Eye drops are started immediately and are used for only 4 days.
· Surface PRK: A therapeutic soft bandage contact lens is worn for around four days (depending upon your rate of healing) to reduce discomfort. Antibiotic, anti-inflammatory, and cortisone eye drops are used four times a day while the lens is on. After removal, the topical cortisone is used four times a day for a week. Artificial tears are used as needed.
You will see Dr. Duplessie at regular intervals.
Strenuous contact sports such as boxing, and karate, etc. should not be attempted for at least 3 months after surgery. It is important to protect your eyes from anything that might get in them and from being hit or bumped.
Most patients notice an improvement in their vision immediately upon completion of their surgery.
By the next day vision is often dramatically improved. It can take several months before some patients achieve their final vision after LASIK. Several studies demonstrate that the vision of a number of patients continued to improve up to six months post-operatively. During that time, patients may experience slight fluctuations in vision throughout the day. These symptoms generally diminish with time.
Some patients experience dry eyes post-operatively. The symptoms can vary widely. When the dry eye is treated, those symptoms diminish.
Clinical dry eye is comparatively easy to diagnose and the great majority of patients respond well to treatment options ranging from use of preservative-free eye drops to insertion of punctal plugs, depending on the severity of the case. For almost all patients, dry eye symptoms gradually subside over the first few weeks or months after LASIK surgery. If you suspect that you may have post-operative dry eye, you should contact Dr. Duplessie for an evaluation.
Many LASIK patients notice a temporary decrease in night vision with symptoms that include glare, halos, and starbursts.
These symptoms usually subside within six weeks; however, some will continue to experience them for a greater length of time.
May be an option, but not everyone is eligible for an additional procedure.
Overcorrection, under correction & Regression
About 10-15% of LASIK or PRK/ patients may require a re-treatment (enhancement or touch-up) for under correction or regression back towards myopia. Retreatment is more common in patients who are more myopic or hyperopic and have higher amounts of astigmatism.
Regression can occur quickly, within the first few weeks after surgery, but it also can occur slowly over time. Patients who experience regression will notice their vision changing progressively. Dr. Duplessie asks patients to wait 3 months prior to performing an enhancement so the eye has stabilized. As that point, a LASIK procedure can be performed to correct the residual error, if the patient and Dr. Duplessie believe it is appropriate.