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During Your Procedure

Dr. Machat meets with every patient one on one. After more than two decades and more than fifty thousand laser procedures, Dr. Machat has a very confident and comforting approach that helps instill confidence and trust in his patients. Most importantly, he has a real sensitivity to the anxiety and emotions that most patients feel and he demonstrates a warmth that seems to put every patient at ease. Dr. Machat is not only a highly experienced professional, he was a laser patient too, so his empathy and belief in this technology extends far beyond most surgeons.

Every patient must have a pre-operative consultation with Dr. Machat, some before the day of the procedure, some on the day. He will examine your eyes, review your chart with you and answer any additional questions you may have. After you have completed the surgeon consultation you will sign your informed consent. You will then be taken to prepare for your procedure. You will be offered a sedative to take prior to your procedure to further help reduce any anxiety you may be feeling and encourage you to sleep once the procedure is completed.

Before you enter the Laser Suite, the lasers are tested and internally calibrated. The customized treatment plan based upon your AMARIS Wavefront map will be programmed and confirmed. When you enter the laser room, the treatment plan is reconfirmed by both Dr. Machat and the Senior Laser Technician. There will be two lasers in the suite, the Ziemer Femtosecond Laser to create the corneal flap in the first step and the Schwind AMARIS 750S Excimer Laser to correct your prescription in the final step. The first eye is treated fully, with the creation of the flap and correction of the prescription before the second eye is treated for increased safety.

Pre-operatively, a Laser Technician will clean the area around your eyes with an antiseptic scrub, then instill antibiotic and anesthetic eye drops. Dr. Machat believes in extra anesthetic, but to avoid too many drops on the corneal epithelium the technician will use small sponges soaked with anaesthetic, which are placed beneath the upper and lower eyelids for an extra numbing effect.

Once you enter the Laser Suite, You will lie flat on the laser bed. The eye area is then protected with a surgical drape. An eyelid holder is inserted to prevent blinking. In the first step to create the corneal flap, the Ziemer ring is inserted and there will be a slow build of suction pressure to hold your eye steady. Once the Ziemer handpiece is applied, the vision may become somewhat dim. The Ziemer femtosecond laser pulses will create the corneal flap in about twenty seconds but this entire step will take a couple of minutes. There are no sounds, no smells, no discomfort with this step, aside from a small amount of pressure from the Ziemer ring itself. The handpiece is removed, but the vision will remain somewhat hazy. There are small microscopic bubbles that separate the layers of the cornea to create the corneal flap itself, and they usually remain for a brief time and blur your vision until they dissipate.

In the second LASIK step, your prescription correction is treated. Once aligned, a small flashing green target light becomes visible. The next steps involve lifting the corneal flap and activating the eye-tracking system. Dr. Machat believes that the AMARIS 750S is the safest excimer laser system in the world utilizing a six dimensional eye tracker, which not only tracks your eye in the 3 conventional axes, X, Y, Z but also in each rotational and cyclotorsional axis.

The AMARIS 750S system also has online pachymetry to measure tissue thickness, a rarity in excimer laser systems. It is not only one of the most sophisticated but fastest laser systems applying 750 laser pulses per second utilizing flying spot technology in customized proprietary patterns. The laser treatment is completely painless but occasionally patients may smell the pungent odour of the laser gases and laser by-products during this step. The laser application usually takes less than fifteen seconds. The corneal flap is then replaced, rinsed, and smoothed back into its natural alignment. Patients are usually quite comfortable throughout their entire procedure. At this point the target light becomes much sharper, and the excitement begins. Another minute or so is allowed for the flap to seal, and then attention is turned to the second eye and the process repeated. The entire procedure is usually less than twenty minutes for both eyes.