Dr. David Gordon Wagner, MD

Although biopsy is most often associated with cancer, it can also be used to check for other diseases, such as infections. A biopsy sample can be scraped, cut, collected with a needle, taken with a machine that punches out a tiny piece, or removed with the tiny tools in an endoscope.

In most cases, a biopsy is a simple outpatient procedure. Depending on the procedure, patients may need to stop taking certain medications beforehand, such as blood thinners. It is important for patients to tell doctors if they are pregnant, as certain biopsies require the use of x-rays to guide the needle to the right location. There is usually very little pain associated with a biopsy. Patients will have to wait a few days to hear the results.

The choice of reconstruction technique depends on the size and severity of the defect. If tissue loss is small to moderate, the wound may simply be sutured close. For larger defects, however, tissue from other parts of the body may be needed. Tissue may be taken (or harvested) from the ear, scalp, abdomen, roof of the mouth, inside of the check, or the eyelid itself.

The Hughes procedure and the Cutler-Beard procedure are reconstruction techniques that use eyelid tissue. In the Hughes procedure, a piece of neighboring tarsoconjunctival tissue is cut, slid onto the wound, and then sutured together. The tarsoconjunctiva is made up of the connective tissue that provides support to the eyelid, called tarsus, and the membrane covering the white of the eyes, called conjunctiva. This technique is suited for defects that are located on the sides of the eyelid. The Cutler-Beard procedure requires a thicker segment of tarsoconjunctival tissue and is used to repair defects in the center of the eyelid.

Eyelid reconstruction is commonly done at an outpatient facility. There will be bruising and swelling for about four to ten days following surgery. Patients should keep their heads elevated, use cold compress, and apply antibiotic cream on their eyelids for the first few days. Strenuous activities must be avoided for four weeks, but patients may be able to return to work after about a week.

LASIK is generally considered an elective procedure (not medically necessary) since patients can wear glasses or contact lenses instead of undergoing LASIK. Nevertheless, many people still elect to undergo LASIK to have better vision without having to wear corrective lenses. Certain professionals, such as pilots, military members, firefighters, and athletes, might particularly benefit from LASIK.

Ophthalmologists (eye doctors) evaluate patients before surgery, measuring the cornea and checking for any eye irregularities that would disqualify patients from LASIK. A special eye scanner is used to create a map of the cornea. This map guides the surgeon in developing an individualized LASIK treatment plan. Once approved for LASIK, contact-wearers are advised to switch to glasses for the three weeks leading up to their surgery.

LASIK is a brief procedure, lasting for about half an hour, depending on the state of a patient's eyes and the corneal reshaping required. Patients lie down on a reclining chair and have numbing eye drops applied to one or both eyes to eliminate pain and discomfort during the procedure. While the eyes are held open by a device, the eye surgeon raises a fixation light where patients direct their eyes. The surgeon uses a femtosecond laser to cut a precise circular incision in the cornea's surface. The surgeon then manually folds back the corneal flap to access the stroma (inner cornea).

An excimer laser is then used to remove certain amounts of corneal tissue. For patients with farsightedness, the laser cuts tissue on the outer regions of the cornea, making the central cornea more prominent. For patients with nearsightedness, the opposite is done; central corneal tissue is removed while the outer tissue is left alone, flattening the eye. In patients with astigmatism, the laser is used to even out the surface of the corneal tissue, making the eye more spherical. When the lasering process is complete, the ophthalmologist folds the corneal flap to its regular position. The flap quickly begins to heal and naturally reattach itself to the eye.

LASIK patients need someone to drive them home from the procedure and cannot drive for the following 24 hours. Recovery from LASIK lasts about five days. Patients typically notice improved vision within a day or two of surgery. Prescription eye drops are given to patients to alleviate discomfort and promote eye healing. During this recovery time, patients must be incredibly careful not to touch or rub their eyes. Ophthalmologists often instruct patients to wear protective glasses during the day and night to prevent potential damage from eye rubbing.

LASIK can improve the experience of certain activities such as swimming or reading, and in some cases, LASIK can be a life-changing procedure for those with severe refractive vision errors. LASIK may also save patients money by eliminating the recurring need for updated corrective lenses.