Sub-Bowman's Keratomileusis (SBK)
Sub-Bowman's Keratomileusis (SBK) is an advanced vision correction procedure performed by some of the country's most progressive ophthalmologists. It offers a number of benefits over traditional LASIK:
- A more immediate improvement in vision
- Decreased treatment time
- Maintained and possibly increased corneal strength
- Increased accuracy
- Reduced risk of complications
SBK uses a laser, as opposed to a blade, to create a flap in the cornea. This brings a new level of safety and precision to the procedure. The flap for SBK is not nearly as deep as it is for LASIK. The flap is produced just below the Bowman's membrane. This method retains the original thickness of the cornea and reduces the risk of ectasia, a complication of LASIK that results in a bulging of the cornea.
In SBK, as in LASIK, a laser is used to change the curvature of the cornea (outer window of the eye). To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.

Treating nearsightedness,
the cornea is made flatter
To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.

Treating farsightedness,
the cornea is made steeper
To treat astigmatism, the cornea is made more spherical -- like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.

Treating astigmatism,
the cornea is made more spherical
SBK is for those who:
- want to reduce or eliminate thir dependence on glasses or contacts
- are at least 18 years of age
- have had a stable eye prescription for at least one year
- have no health issues affecting their eyes
- have no signs of glaucoma or cataracts
What to expect on surgery day:
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You will arrive at the laser center about an hour prior to your procedure |
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You will arrive at the laser center about an hour prior to your procedure. Once you have been checked in you may ask for a sedative if you need help relaxing. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye. Anesthetic eye drops will be used to numb your eyes; no injections or needles will be used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

The area around your eyes will be cleaned
and a sterile drape may be applied around your eye
Next, a thin corneal flap will be made with the use of an Intralase laser. You will then be asked to look directly at a target light while an Excimer laser reshapes your cornea. The laser will be programmed with the information gathered in your pre-operative exam. The laser treatment will be completed in less than a minute or two, depending on the amount of correction needed. To finish the procedure, the protective layer will be folded back into place where it will bond without the need for stitches.
Following your procedure, your eye(s) will be examined with a slit lamp microscope. Then you will be given additional eye drops, and your eyes may be shielded for protection. You will need to have someone drive you home and you should relax for the rest of the day. You may experience some discomfort for 12 to 24 hours, but this is usually alleviated with an over-the-counter pain reliever. Some people experience sensitivity to light, and watering or swelling of their eyes for a few days following their procedure.

Following your procedure, your
eye(s) will be examined with a slit lamp microscope
| You will be asked to come back the next day for another examination of your eye(s). Most people can actually see well enough to drive the next day but it's best not to drive until you have been examined. You should be able to resume your normal activities the day after surgery. |
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| Vision can fluctuate for up to six months, but most people can see well enough to pass a driver's license vision exam following their procedure. |
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Realistic expectations:
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The vast majority of our patients can do most activities without dependence on corrective lenses. |
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The decision to have SBK is an important one that only you can make. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses. However, we cannot guarantee you will have the results you desire. The vast majority of our patients are extremely happy with their vision after SBK and can do most activities without dependence on corrective lenses.
Serious complications with SBK are extremely rare. SBK 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 using the latest diagnostic technology.
After LASIK, you may experience some visual side effects. These visual side effects are usually mild and diminish over time. But there is a slight chance that some of these side effects won't go away completely, such as feelings of dryness, glare and halos.
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Everyone heals
somewhat differently |
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Since everyone heals somewhat differently, some patients may over react to the procedure and some may under react resulting in overcorrections and undercorrections. Once the eye has stablized (3 to 6 months) you and your doctor can discuss whether a re-treatment could help fine tune your vision if you are over or under corrected.
After a thorough eye exam, you and your doctor will determine if SBK is an option for you. If you are a good candidate, you will be given additional information about the procedure that will allow you to make an informed decision about whether to proceed. Be sure you have all your questions answered to your satisfaction.

Be sure you have all your questions
answered to your satisfaction
Alternatives to LASIK
LASIK is not the only surgical procedure designed to correct nearsightedness, farsightedness and astigmatism. To learn about other procedures go to the surgical and laser vision correction procedures section of our Web Site. If you would like to learn more about vision correction procedures from sources other than our practice, we encourage you to link to a number of Web sites we feel provide factual and up-to-date information. You may also choose to make an appointment, attend a seminar, view a Webcast seminar on Custom Wavefront LASIK or request additional information to learn more about this exciting procedure.
We offer a number of finance options and affordable payment plans. It is easy to apply online and receive credit approval before you schedule an appointment.
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