An Overview on Performance Characteristics of Laser In-Situ Keratomileusis Using Lasers and Identification of Challenges

Salman      Nasir Khan; Panos      Shiakolas; Mohsin      Rizwan

doi:10.2174/1876402911204040284

Abstract

Laser in-situ keratomileusis (LASIK) is a prominent surgical procedure employed to rectify refractive errors in human eyes using lasers. The LASIK procedure and the issues related to it can only be better understood through better understanding of the operation of the human eye. Therefore, this paper revisits the anatomy of the human eye followed by an explanation on the operation of LASIK and the role of lasers/microkeratomes. It continues by explaining the physics behind laser-tissue interaction when a femtosecond laser is used to create the corneal flap and when an excimer laser is used to remodel the human cornea. It discusses the characteristics of both femtosecond lasers and mechanical microkeratomes in flap creation and introduces the parameters that affect the post LASIK visual acuity of the patients. Subsequently, it discusses innovations being introduced in the LASIK procedure and how these innovations are affecting its final outcome. It elaborates on the parameters that affect laser-tissue interaction and suggests approaches by which these parameters could be optimized for enhanced incision quality. Aspects of the LASIK procedure which lead to post LASIK side effects are introduced and the role of lasers in alleviating them is discussed. This paper will highlight issues presently encountered in LASIK and recent developments in addressing these issues. Further it highlights open research questions which are yet to be answered.

Keywords: Corneal ablation, Dry eye, Femtosecond laser, LASIK, Laser in-situ keratomileusis, Post LASIK complications, Ultrafast lasers, In-Situ Keratomileusis, refraction, retina, corneal flaps, photo-chemical effect, plasma, femtosecond lasers, micro-cavitation