Advanced Surface Ablation (ASA)

Advanced Surface Ablation (ASA), also known as Photorefractive Keratectomy or PRK, is the preferred method for correcting nearsightedness, farsightedness and astigmatism in individuals with thin corneas and certain other eye characteristics. Though less well known than IntraLase LASIK, ASA is a proven technique that has brought freedom from glasses and contacts to thousands of people.

The original Surface Ablation techniques predate IntraLase LASIK, but just as IntraLase LASIK has improved with time, today’s Advanced Surface Ablation procedures offer extremely high levels of precision and safety. LASIK and ASA patients have access to the same technologies and customized treatments.

ASA and IntraLase LASIK: Understanding the Differences

In a IntraLase LASIK procedure, a flap is created in the cornea’s surface and moved back to allow a laser to reshape the cornea, correcting the eye’s focusing power. The flap is then replaced, where it adheres naturally.

There are a variety of ASA techniques, and Drs. Chokshi and Coluccelli will choose the method that best suits your eyes and will achieve the best result. The common element of ASA procedures is that no IntraLase LASIK flap is created.

The cornea is instead exposed via a process called surface ablation. A very thin segment of the eye’s outer epithelial layer is removed, exposing the cornea. Once the layer is removed, the cornea can be reshaped with the laser to improve your vision.

This outer layer will regenerate naturally in the weeks following surgery. Surface ablation is recommended for many patients with thin corneas because the technique does not penetrate as deeply into the eye’s surface as the IntraLase LASIK flap.

A Typical IntraLase LASIK Procedure

  • A thin corneal flap is created.
  • The cornea is reshaped to correct your vision.
  • The flap is returned to its original position where it adheres naturally.

A Typical ASA Procedure

  • A thin epithelial layer is removed.
  • The cornea is reshaped to correct your vision.
  • The epithelial layer grows back in the next week.

As you can see, the differences between ASA and IntraLase LASIK are relatively minor. The fundamental purpose of each procedure—to improve your visual acuity by reshaping the cornea—is the same. Like IntraLase LASIK, ASA is performed on an outpatient basis. The actual treatment time for each eye is very brief, lasting no more than a few minutes.

After Your Procedure

ASA has a proven history of providing great visual results. The visual results of IntraLase LASIK and ASA are identical.

ASA carries a lower risk of severe complication than IntraLase LASIK, as most IntraLase LASIK complications involve the creation and healing of the flap. However, ASA requires a longer healing process and is more likely to cause discomfort or irritation in the two to three days following surgery. You will be given special contact lenses to aid healing, provide comfort and prevent infection for the first several days, as well as medication to ease any initial discomfort you may have.

After your procedure, you should rest and protect your eyes over the next two to three days to promote rapid healing. Every patient’s healing process is different, but you should plan on limiting your activities for about five days after surgery.

As the epithelial layer grows back, most patients notice some blurring or a haze effect similar to a soft filter camera lens. This is normal, and means your eye is healing properly. You will see vast improvements in vision within the first week, but most patients will achieve a final result after a few months. You will use eye drops on a daily basis during this period to aid healing and prevent infection.

Possible side effects include mild irritation, dry eye, light sensitivity, glare, halos around bright objects and decreased contrast sensitivity. Most of these side effects diminish with time.

ASA represents a major step forward in the evolution of laser vision correction. While the procedure involves temporary drawbacks such as extended recovery time and increased post-operative discomfort, the benefits clearly make ASA an excellent choice for certain quality-conscious consumers.