Advanced Surface Ablation vs LASIK

Nov 12, 2020

At Columbus Laser & Cataract Center, our practice is dedicated to delivering clear vision and confidence. If you are considering refractive error correction, there are several different procedures in the field of ophthalmology that may be right for you and your eyes. Learn more and discover the difference between advanced surface ablation (ASA) and LASIK in this guide.

Treatments for clearer vision

These days, LASIK is often synonymous with refractive error correction. Since the FDA first approved LASIK, 10 million Americans have chosen this popular procedure for better vision. However, there are other forms of surgery that can also deliver these improvements. In some cases, an alternative may even deliver better results for you.

At our practice, we proudly offer both LASIK and ASA, also known as advanced surface treatment (AST). During each procedure, Dr. Beran or Dr. Weber uses our state-of-the-art WaveLight® Allegretto Wave® Eye-Q Laser to correct issues like myopia, hyperopia, or astigmatism. These laser eye surgeries are optimized for precision, safety, and excellent results. Since both surgeries provide corrected vision and boast high satisfaction rates, they are highly regarded by those in the field of ophthalmology and by patients.

In addition, these procedures are also comfortable. Before the treatment, every patient receives numbing eye drops and Valium to help them relax. Each procedure takes only a few minutes per eye. During this time, patients may feel a slight sensation of pressure but will remain completely comfortable.

How advanced surface ablation (ASA) and LASIK differ

Despite their apparent similarities and identical results, the two procedures have differences. These differences include the technique behind vision correction, the length of recovery, and which patients are ideal candidates.

When performing LASIK, our surgeons create a flap in the cornea. This is lifted and the tissue underneath can carefully be reshaped with the laser to correct the refractive error. The flap is then placed back into position where it adheres over three to four minutes and is protected by a soft contact for 24 hours. With this surgery, patients enjoy a quick recovery and typically can return to most daily activities after only a day or two.

During ASA, the outer layer of the central corneal cells, known as the epithelium, is removed. Our surgeons use the exact same laser as with LASIK to reshape the cornea to correct the appropriate refractive error. A contact lens is placed on the eye to act as a bandage while the epithelial cells regrow. (At a follow-up appointment, the surgeon will remove the contact lens.) Within a few days, the epithelium will completely heal, and patients will begin to see more clearly.

Which procedure is right for you?

While discount and chain eye centers may quickly approve you for surgery, we take our time to determine if you are a good candidate. When you contact our team, we will schedule a comprehensive appointment. To provide the best possible result, we thoroughly evaluate your health and eyes—before recommending a treatment plan. Our team collects a comprehensive health history, takes precise measurements, uses advanced imaging programs, like LipiView^®, evaluates your prescription, and listens to your preferences. This detailed process ensures that the results will align with your goals, needs, and health. Between careful screenings, expert surgeons, and advanced technology, we can work to prevent subpar results, complications, and side effects.

Determining your candidacy is a highly involved process and why we feel it is important for you to see your surgeon during this evaluation and not just at the time of your surgery. There are many factors that our experts must take into consideration. Here are some reasons why our surgeons may recommend one procedure over another:

Corneal thickness: To perform LASIK, your surgeon creates a flap in your cornea. Therefore, you must have sufficient tissue to be eligible for this procedure.
Prescription: Higher prescriptions require more tissue to be removed, so they often are better treated with ASA treatment than with LASIK. Your surgeon will let you know which is best based on your eyes and visual acuity.
Dry eye: For a patient with this pre-existing condition, we may recommend ASA over LASIK treatment. ASA generally results in less damage to the corneal nerves.
Overall health: Certain pre-existing conditions, medications, or family medical histories may not make you an ideal candidate for refractive eye surgery.
Anatomy: Every eye is unique—from the size of your pupil to the shape of your cornea. These anatomical differences are important factors when determining which laser eye procedure is right for you.

Pros and cons:

There are other factors to consider besides eligibility when choosing between ASA or LASIK. Because both treatments involve different surgical processes, their recovery periods also differ. Our team will discuss these pros and cons with you to ensure you are comfortable with the proposed plan and all it entails.

Recovery time: ASA is associated with a longer recovery and more downtime. Since the epithelial cells are removed, you must regrow the epithelium, which can take several days. Most patients are back to reasonable activities after the contact is removed on the morning of day four. In contrast, a LASIK patient may only require one or two days of recovery before resuming most regular activities.
Flap complications: During LASIK, surgeons create a flap in the cornea. Though exceedingly rare, there is a slight possibility of complications that can arise from this. If this should happen, it is important to simply replace the flap without laser treatment, let it heal for several months, then come back to have ASA performed. Since ASA involves removing the top layer of epithelial cells and not a flap to shape the cornea, cases in which risk factors for a flap problem exist are best treated with ASA.
Visual improvements: Fortunately, with a skilled surgeon and advanced technology, both treatments provide excellent visual outcomes for a patient. The results of these treatments are comparable in quality. So, whether your prescription is strong or if your corneal tissue is thin, there is hope for vision correction.

Thanks to advancements in ophthalmology and refractive eye surgery, better vision is possible. If you are ready to improve your vision with laser refractive surgery or if you would like to learn about cataract surgery, please contact our Columbus Laser & Cataract Center team at 614-939-1600! And, to learn more about these treatments, feel free to browse our website for more resources and further education.