The Surgeon’s Eye View Of Laser Eye Surgery – Narrated By Professor Reinstein

Professor Dan Reinstein, a pioneering laser eye surgeon, performs LASIK Laser Eye Surgery in our most popular YouTube video and discusses the laser technology and each of his procedure steps in detail. Also, the patient in the video shares his experiences during and after his laser eye procedure.

Over 90% of patients are suitable for LASIK Laser Eye Surgery. Further, it offers the least discomfort and the fastest recovery time of any laser eye surgery –  most patients can be back at work within 24 hours.

Find out if you are a suitable candidate for LASIK Laser Eye Surgery.

Professor Dan Reinstein On The LASIK Laser Procedure

Prof Dan Reinstein: One of the innovations that this system brings is embodied in the curved contact glass, which is designed to fit onto the cornea. It has a ring of suction ports which allow attachment of the system to the patient’s cornea without raising intraocular pressure to any significant amount.

At the moment of contact between the cornea a meniscus tear film appears and suddenly the patient is able to see the green light in absolute focus, because of a pre-focusing adjustment that is made by the VisuMax according to the patient’s refraction. Suction is achieved within three or four seconds. A voice command tells you that it is ready, and then you’re able to step on the foot pedal and begin the femtosecond ablation.

So, the patient is now looking at the fixation target and the computer then tells us when it is we can apply the pedal and begin creation of the flap. And the cone automatically detaches itself at the end of the procedure, so the patient doesn’t experience a second more discomfort than is absolutely necessary. The patient is then lowered and brought over to the second microscope for inspection of the flap, while a second sterile disposal contact glass is placed onto the cone for it to be calibrated before beginning the second eye. The patient is swung from the VisuMax over to the Milady.

The Fixation Of The Patient’s Eye

Prof Dan Reinstein: I’m going to put the eye lid holder in again, nice and steady there – looking straight. Patient: I’ve got a 30% blur. I would say it’s 70% improved. Prof Dan Reinstein: And as you can see the bubbles are, for all intents and purposes, completely gone by the time the patient reaches the Milady. The fixation of the patient which is approximated by the green flashing light on the Milady can be seen to be perfectly centred within the circle of this circular flap, and you can see that the visual access for this patient is actually supranasal. Here, I’m finding the flap edge to gently pull through the interface that was created. The ablation is centred on the patient’s visual access or corneal vertex, which is the approximation that we use for the visual access. Milady takes advantage of a pupil, iris, limbus, and conjunctiva vessel eye line registration system that positions the cycler rotation of the ablation correctly onto the eye.

Professor Dan Reinstein On His Flap Technique

I use a very, very minimal flap irrigation technique, where I use a 27 gauge anterior chamber cannular to expel one centilitre of fluid in one second, so it’s a very, very high pressure stream that therefore does not hydrate the flap or bed, but rather just blows loose particles out of the interface. At the end of the case I like to see a zero gutter appearance, literally no space between the flap and the bed at the end of the procedure.

The Patient’s First Look After The Procedure

Prof Dan Reinstein: So, let’s have you sit up. Keep your eyes closed and sit yourself up. OK, how did you find that? I want you to think a little bit about what the room looked like 15/20 minutes ago before we started, without your glasses on. It’s going to be blurry when you open your eyes, but have a look and tell me what it looks like.

Patient: Wow! Yeah.

Prof Dan Reinstein: Can you see a little bit?

Patient: Yeah, a lot. I can see a lot.

Prof Dan Reinstein: OK. All right. If we said the room was 100% blurred before, how blurred is it now?

Patient: I’ve got a 30% blur. I would say it’s 70% improved.

Prof Dan Reinstein: Great, that’s fantastic. Are you feeling well enough to ask a few questions?

Patient: No, we’re good.

The Patient’s Experiences During The Procedure

Prof Dan Reinstein: OK. When we were on the laser to lid flap obviously I had to reposition your head a little bit to the side and things. Was that uncomfortable?

Patient: No, no. The bed’s fine.

Prof Dan Reinstein: And we obviously brought this thing into you very close. Did it feel claustrophobic or odd in any way?

Patient: No, that’s fine.

Prof Dan Reinstein: Was that all right. And when I put the contact lens on the eye, I increased the pressure a little bit on your eye. Were you aware of that?

Patient: No, yeah, you can feel it, you can feel it definitely, but it’s bearable.

Prof Dan Reinstein: Yeah. You were looking at a green light and I kept telling you to keep on looking at the flashing green light, does the light go down or get dim or go out at all during the procedure?

Patient: No, it was consistent.

Prof Dan Reinstein: You could always see the light?

Patient: Yeah.

Prof Dan Reinstein: OK.