Dr. Joseph J. K. Ma

Advanced Surface Ablation: ISA®


SMILE, ICL, Other Refractive Options

Eyes Over 40: Need for Reading Glasses

Flap Free, Blade Free: ISA® Customized Advanced Surface Ablation

ISA® Customized Advanced Surface Ablation

Advanced Surface Ablation (ASA, LASEK, A-PRK, or EPI-LASIK) is a Blade-free, Flap-free vision correction procedure that involves reshaping the surface of your corneal tissue to correct for refractive error.

Step 1: The last phase of your ISA® Customized Diagnostic Set will be completed with the final measurement of your corneal and visual system architecture. Your diagnostic representation will be validated and then finalized, which allows our Surgeon to determine the details of the ISA® Customized Technique.

Step 2: The surface of your cornea is covered in a thin layer called the epithelium. Our surgeon simply removes this outermost cell layer. The ISA® Customized 13-D Diagnostic Set is then used to guide the Excimer laser to definitively reshape the corneal tissue.

Why is ISA® Customized Advanced Surface Ablation Especially Recommended for Some Candidates?

In general, ASA is the considered the safest form of laser vision correction. Typically, this procedure is recommended for candidates who have the following conditions because advanced surface ablation leaves the cornea more structurally intact, minimizes dry eye symptoms, and allows for the correction of more severe refractive errors.

● Thinner than average corneas

● “Soft” corneas

● Dry eyes

● Severe refractive errors

● Lifestyles that place them at increased risk for eye injury

Although visual recovery takes longer, ISA® Customized Advanced Surface Ablation is the safer approach to laser vision correction in some cases and can result in and better vision than ISA® Customized LASIK in these patients.

Between the two main types of laser vision correction, and among the many other surgical options available, there is a specific customized solution that will yield the best results for you. By using the ISA® approach, our Surgeon will determine which procedure is best suited for your unique needs.

Excimer Laser Technology

Our Surgeon has had over a decade of experience with more than 7 platforms of Excimer laser technology. Our clinic currently uses two models from the more sophisticated generation of Excimer lasers that allow for various forms of customization beyond the standard treatments.

How Excimer Laser Technology Works

This technology ablates corneal tissue by disrupting molecular bonds to precisely reshape the cornea causing minimal heat and no changes to the surrounding corneal tissue. Excimer laser technology can ablate corneal tissue down to a quarter of a micron (1 micron = 1/1,000 millimetres). Excimer laser technology is so precise that corneal tissue can be remodeled to almost any architectural representation necessary to correct for an individual’s unique refractive error.

There are several different techniques that produce an optimized model of corneal architecture. Depending on your unique eyes, applying a specific model will result in superior post-operative vision. Our Surgeon will make a recommendation about which model will best suit your needs at your ISA® Customized Surgical Consultation.

Customized Subtype Techniques Include:

● Wavefront Guided

● Wavefront Optimized

● Topography Guided

● Scheimpflug Image Guided

Our Surgeon’s depth of experience allows for performing the necessary dynamic refinements to the technique for each of the chosen subtypes in every procedure.

Benefits to You

● Superior corneal modeling allows for minimal removal of corneal tissue, which is healthier and safer for the eye, particularly for patients with thinner than average corneas, larger pupils, or higher prescriptions (levels of refractive error).

● More patients achieve 20/20 vision than without the use of ISA® Customized Subtype Techniques

● Many patients can achieve vision that is superior to 20/20

● Decreases the risk of night time visual complications such as night-time glare

● Reduces shadow and halo effects

● Reduces need for post-operative re-treatments/enhancements


1. How long will it take to recover?

Recovery time depends on the individual, but most people enjoy improved vision within the next 5 days, this will continue to improve over the next several months. We suggest that every patient take 7 days off from work for a comfortable and relaxed recovery.

2. Are both eyes done on the same day?

Yes, both eyes are typically done one after the other on the same day.Yes, both eyes are typically done one after the other on the same day.

3. Is there a blade involved?

No, this is a completely blade-free, flap-free procedure!

4. Is the procedure painful?

Our surgeon will administer anesthetic eye-drops at the beginning of the procedure so you will not feel any pain; you will only feel slight pressure during the procedure.

It is important, however, to be aware that from Day 2 to Day 4 after surgery, you may experience moderate to significant eye discomfort. This is to be expected and we will provide medications to alleviate the discomfort in advance.

5. Which procedure is better, ISA® Customized LASIK or ISA® Customized Advanced Surface Ablation?

There is no “better” procedure for everyone without exception; there is only a procedure that is better suited to your own unique needs. Both procedures are safe and both procedures yield excellent results, so the optimal procedure just depends on you. Based on our rigorous proprietary in-depth ISA® assessment, our Surgeon will identify and recommend the specific option and relevant parameters that are best suited for your unique needs.

Although visual recovery takes longer, ISA® Customized Advanced Surface Ablation is the safer approach to laser vision correction in some cases and can result in better vision than ISA® Customized LASIK in these patients.