An exciter laser is a laser that works on the surface of the eye. The exciter laser refractive procedure (also called corneal sculpting) corrects refractive errors by altering the shape of the cornea. Ultraviolet light from the exciter laser hits the cornea surface and removes or ablates some corneal tissue with virtually no damage to surrounding tissue. Exciter laser is primarily used to correct myopia (minus number). It is also popularly used to correct astigmatism (compound power) and hypermetropia (plus number) with good results.

The Treatment
Exciter laser refractive procedure is performed on an outpatient basis under topical anesthesia, which means that the patient will be awake during the procedure. The surgeon will key the refractive correction into laser’s computer and will then ask the patient to fix his /her gaze on a target. The surgeon then performs one or two familiarization sessions to help the patient get used to the target, before activating the system perform the corneal sculpting which takes 15 to – 40 seconds. The total time taken, including positioning the eye under the laser, is about three to five minutes. The patient is not admitted in the hospital.

One should be able to see clearly a few days after the procedure, but the vision may be blurred for close work or reading fine print for one month after the procedure, as the eye undergoes a period of long-sightedness before stabilization.

Possible Side-effects
Common side-effects of laser treatment include susceptibility to glare, foreign body sensation and light sensitivity as the epithelium grows back over the cornea in the first two or three days.

There may also be corneal haze (clouding of the corneal tissues) which usually occurs two to four weeks after the laser treatment and usually disappears with time. Driving at night may be a problem for one or two months.

Need of Lenses or Spectacles after Laser Treatment Exciter Laser Keratotomy (PRK) is designed to reduce dependence on corrective lenses. But in the case of higher refractive errors, or if the patient is over 40 years, one may need to wear corrective lenses after treatment for driving or for fine work.

Who Qualifies for this Procedure?

The patient should be 18 years or older, mildly to moderately short-sighted, and his vision over the last year should have been stable; -4 to -10 myopia is ideal for this kind of laser therapy. The ophthalmologist conducts a complete eye examination to decide if the procedure is right for the patient.

PRK can be performed on one eye at a time or both eyes at the same time.

Is Pain Experienced?

There is no pain when the laser beam strikes the cornea during the procedure. But some discomfort may be experienced during the first 24 hours when the anesthesia wears off.

Looking after the Eye

The surgeon asks the patient to come for a follow-up examination three days after the procedure and prescribes medication to help the healing. Eye drops must be used as prescribed as they are vital to regulate healing. The medication may need to be continued for up to five months to reduce chances of regression.

Making a Decision

Be sure to discuss with your doctor the various options for correcting your short-sightedness and their advantages and side-effects before making Y0ll:’ decision. An ophthalmic surgeon having an expertise of at least five years of exciter laser is essential. Excimelaser has now been improved further by a ‘Las” procedure approved in USA and other countries. (Las therapy for myopia is advancing and changing even this book is in the process of printing.)

How to Seek the Treatment?

The patient who meets the aforementioned criteria needs to have a treatment evaluation and assessment. No p appointment is required. After the treatment evaluation is completed, the date for the exciter laser will be fixed.

If you wear contact lenses, do not wear them f least five days before your assessment and evaluation.

The argon laser machine is fully automated to deliver laser beam shots on the retina to weld the leak of blood from the blood vessels.

The leaking blood vessels are detected by a Fluroscien-Angiograpy diagnostic photograph on an automated camera.

acomplia dose font-size: small;”>The lay person has erroneous concept that laser is used in the surgical procedure of cataract. It is not so. The technique has come to be called Phako technique which uses ultrasound. Laser is never kept in the operation theatre for cataract surgery

The steps of the procedure in brief are as under:

Local eye drops are given four or six times. The person is fully conscious and needs no systemic or general anesthesia; in fact, the patient and the surgeon may be talking to each other. The procedure is painless.

The person lies on a table and the top of the table has a mounted microscope connected to a laser machine. The machine is automatically controlled by a computerized data machine. The machine has all the data of the person’s corneal thickness, error of refraction, I.e. power of the spectacle glasses to be corrected, laser depth and all the precise parameters in full to ablate the layers of the cornea.

Let us elaborate here the recent advancements in the techniques that have evolved.

Laser (PRK) is an old technique where the corneal surface is hit by laser directly and the laser is called exciter laser’ which is a unique laser beam different from others.

In the recent technique a thin corneal flap is cut by a keretome and lifted up baring the inner surface where the exciter laser beam is hit to make the centre of cornea thin to the required depth. The higher the power of myopia the greater is the corneal depth hit by the laser. This technique is termed as Lasik. It is now in vogue all over the world and in some centers of our country. It has many advantages, e.g. quick recovery, no aftereffects of glare and blurring, and full vision in few days.

There is another improved technique over the Lasik, called wave-front Lasik that hits all the points of the cornea mapped out by an aerometer. It is a marvel of modem laser technology of ophthalmic sciences. If the operation is successfully performed the person achieves above normal sight without glasses.

It suffices to state that all the procedures are fully automated by the laser surgeon who is trained and has the expertise from national and international centers. He should have performed about 500 laser procedures under the care of a master laser specialist.

The laser machine with its accessories, is expensive and costs around 3-4 cores. It is insured for maintenance by high-tech engineers of electronics and software at heavy costs. It is an outdoor procedure and does not need hospitalization. It takes ten minutes to perform the operation.

Lasik is more technically perfect than other forms of refractive surgery. It is safe and successful all over the world.

The post Lasik recovery period is about three-four days and the patient gets back to routine in seven days, the patient does not experience any pain.

Following are the prerequisite criteria for a person to be fit for Lasik?

Age 19 to 21 years is most essential for laser in myopic eyes. At this age the increase in the power of minus number stabilizes. When the height of a person stops increasing, i.e. at the age of 19-21 the myopia stops increasing.

Lasik is never performed and contraindicated in an increasing state of myopia.

Eye components must be normal, healthy and free from any diseases, e.g. glaucoma, corneal scars, retinal and vitreous diseases and cataract.

The ideal range for Lasik procedure on myopia is -3 to -15. However, the specialist decides the criteria. Lasik in plus numbered glasses hypermetropia and glasses with astigmatism compound can also be performed on +3 to + 10 in persons who wear high plus glasses. They are a minority group unlike myopias.

A hole or break in the normal layer of retina “diagram of the anatomy of eye) which is the most vital component of visual function of eye and is connect to the brain by an optic nerve. The presence of hole, not corrected, will lead to retinal detachment or retinal separation. The end result is loss of useful vision.

The warning signal appears as a flash of lightning or a dark curtain across the eye of rapid if the onset is depending on the severity of retinal separation.

Argon laser is extremely useful-either alone or combined with surgery of retina. In the presence of a threatening hole or break of retina or as a prophylactic procedure to stop the hole from extending to a detachment, the use of laser is extremely useful.

The technique requires again a high-tech, sophisticated laser machine to be handled by an expert eye specialist trained by masters par excellence in ophthalmic sciences.