Advanced Surface Ablation (ASA)
For patients with conditions such as thin corneas and loose skin of the cornea that make LASIK less than ideal, advanced surface ablation (ASA) is an excellent alternative for treating nearsightedness, farsightedness and astigmatism. In an ASA procedure, the vision correction is performed on the surface of the eye instead of under a flap in the cornea. This makes it a more extensive procedure than LASIK with a longer recovery time, but the results are very similar.
Usually, patients see well within several days after ASA treatment and only use medicated drops for the first several weeks after the procedure.
About ASA
Before the development of LASIK, laser vision correction was first performed on the surface of the eye and was called photorefractive keratectomy (PRK). PRK has been shown to have identical long-term visual results as LASIK, but it has the disadvantage of slower visual recovery, sometimes as long as six weeks, and more discomfort. Traditional PRK also required the use of medicated eye drops usually for three or more months.
ASA has a faster visual recovery timeframe than PRK and is more comfortable for the patient. This is due to improved surgical methods that were not available when PRK was first developed.
How ASA Works
ASA treats the surface of the cornea: no flap is made. ASA uses excimer lasers capable of eye tracking and wavefront customized treatment to reshape the front surface of the cornea to correct vision. A temporary soft contact lens is placed on the eye for a few days following surgery to assist in the healing process.
The Procedure
The actual treatment time for each eye is very brief, lasting just a few minutes.
- In ASA, anesthetic drops are applied to the eye for comfort.
- The epithelium, or surface layer of the cornea, is then gently removed by a soft automated brush.
- Laser treatment is then performed to reshape the eye to the appropriate prescription.
- Immediately after the laser treatment, a chilled physiologically balanced solution is used to rinse the cornea.
- Finally, a clear bandage contact lens is placed on the eye for several days until the epithelium regenerates.
Following your procedure, your eye(s) may be shielded for protection. Your vision will probably be a little blurry at first, so someone will need to drive you home. You should relax for the rest of the day. You may experience mild to moderate discomfort for two or three days. You will be given instructions on how to manage this discomfort before you leave.
Usually patients see well within several days after ASA treatment and use medicated drops for only the first several weeks after the procedure. Most patients resume normal activities within two to three days. Vision can fluctuate for up to six months.
Are You a Candidate?
You may be a candidate for ASA if you:
- Want to reduce or eliminate your dependence on glasses or contacts.
- Are over 18 years of age.
- Have had a stable eye prescription for at least one year.
- Have no health issues affecting your eyes.
- Have wide pupils.
- Have corneas too thin for LASIK.
- Want to avoid LASIK flap complications.
- Cannot have LASIK because of eye pressure problems (glaucoma) or corneal dystrophy.
Realistic Expectations
ASA has enhanced the lives of many people. However, it is important that your expectations be realistic and your decision to have ASA is based on fact. To determine if you are a good candidate, your doctor will perform special tests using state-of-the-art technology. Most of our patients are extremely happy with their vision after ASA and can do the majority of their normal activities without dependence on corrective lenses.
Serious complications with ASA are extremely rare. ASA is a safe, effective and permanent procedure, but like any surgical procedure, it does have some risks. Many of the risks and complications associated with this procedure can be reduced or eliminated through careful patient selection and thorough pre-operative testing.