(Photo Refractive Keratectomy)
Benefits:
* Bowman's layer is spared.
* No removal of the corneal surface tissue is necessary and therefore post-operative pain is substantially reduced.
* Post-operative visual acuity is restored within a few days rather than weeks.
* Less corneal scarring in the long term, less change due to healing (regression) and thus greater stability of the correction.
When comparing only the benefits of Lasik over PRK the first impression is that Lasik has the potential to be a superior procedure. There is however, a very significant list of potential complications or risks and these include:
* Failure of automated instrument to leave a hinge on the corneal flap, with the first incision.
* Loss of the corneal flap during the operation.
* Loss of the corneal flap after the operation.
* Slipping of the flap and healing off center.
* First incision too deep (perforation of the eye) or too shallow, causing a hole in the flap.
* Invasion of the surface tissue into the central tissue of the cornea.
* Infection of the cornea.
* Loss of visual acuity - from scarring or from decentration of the PRK.
* Technical problems with complex and finicky automated diamond cutting devices.
* The procedure is much more dependent upon surgeon's operating skills, than the computerized precision of the PRK procedure.
The overall complication rate for the ALK-E or LASIK in Febuary 1995 was still in the order of 10% in the hands of the world leading innovators in the technique.
Friday, November 6, 2009
Laser Manufacturers
Aesculapx- Meditec GMBH
MEL 60- This is an Argon Fluoride 193 nm excimer scanning system. The scanning beam is rectangular and measures 1mm by 10 mm. The system uses a limbal suction cup mechanism to fix centration and computer controlled rotating masks which fit into the suction cup mechanism. The mask for simple myopia is an f-stop like mechanism. There are different masks used for myopia with astigmatism, hyperopia, and for pure astigmatism. The masks rotate within the suction cup in order to control any axis of extra ablation as needed for astigmatism correction. Laser calibration is done by visual inspection of a 1um thick metal foil which requires 9 laser passes for removal. There is a layer of red under the silver foil making efficacy of removal easily monitored. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
ALCON
LADARVision® System and CustomCornea® - The LADARVision® System consists of the LADARVision® 4000 laser and the LADARWave® Aberrometer. The LADARVision excimer laser is a small-spot scanning laser with a laser radar tracking device. FDA approved for wavefront-guided ablations.
Bausch & Lomb Technolas 217 Excimer Laser with PLANOSCAN
Technolas 217 Workstation - this is an Argon Fluoride 193 nm excimer scanning system. The scanning beam is a circular spot which can be size adjusted. Centration is accomplished by an active "pupil" tracking mechanism which locks on to the pupil image and will have the laser follow any movement by the patient's eye. Active Infra-red Eye Tracker and passive monitor interrupts laser beam on movement in excess of 3 mm range (1.5 mm radius). Astigmatism, myopia and hyperopia can be treated by software adjustment of the beam scans.
LaserSight Technologies, Inc.
The new LaserScan LSX utilizes LaserSight's patented scanning delivery system integrating new leading edge technology. The LaserScan LSX uses a patented scanning system to deliver a 1-mm low energy "flying spot" in a proprietary alternating, multi-zone, multi-pass strategy. With each pass, about 2 microns of tissue are precisely removed to produce a finely polished corneal surface. Unlike older broad beam technologies, no rings or ridges are produced. Studies now show that smoother ablations may produce less haze, faster healing and more stable clinical results. Integral to each system is flexibility in treatment parameters including gently tapered transition zones.
Manufacture and sales of refractive laser systems, keratome systems, keratome blade products, and aesthetic lasers. LaserSight pioneered refractive laser systems using 193 nm, high resolution, scanning delivery. Both patient fixation and an optional automated tracking system are available. Astigmatism, hyperopia and myopia can be treated with software adjustments of the scanning mechanism. Watch this space for a future " quick-time" or "M-peg" clip of calibration, and actual treatment of myopia, astigmatism and hyperopia.
The LaserHarmonic-1 and LaserHarmonic-2 are solid state lasers still in the development stage. The former is flash lamp pumped and employs the fifth harmonic of a Nd:Yag at 213nm, and the latter is a diode pumped fifth harmonic Nd:YLF laser at 209nm.
Nidek, Inc.
EC-5000 This is an Argon Fluoride 193 nm excimer scanning system. The scanning beam is a rectangular slit which both scans, dynamically rotates, and overlaps. The rotation of the scan is designed to eliminate circular f-stop ridges and increase the smoothness of the ablation. Centration is controlled by the surgeon with a "joy" stick mechanism to follow the patient's eye. Astigmatism and myopia can be treated by software adjustment of the beam scans. At the time of writing we do not have any result data for this machine. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of myopia, and astigmatism.
Novatec LASER SYSTEMS INC
Lightblade (TM) This is an solid state c. 208nm non excimer scanning system based upon the fourth harmonic of a titanium sapphire crystal. The scanning beam is a 200-300um variable size spot. Centration is accomplished by an active tracking mechanism which locks to have the laser follow movement by the patient's eye. Astigmatism and hyperopia can also be treated by software adjustment of the spot scans. At the time of writing we do not have any result data for astigmatism of hyperopia treatment. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
Summit Technology
Excimed, Omnimed, Apogee, Apex These are Argon Fluoride 193 nm excimer wide beam systems. The 1990 version of the Eximed machine had optical zones of only 4.5 and 5.0 mm. The Omnimed and Eximed versions increased the optical zone to 6.0 and 6.5mm. (The Apex machine has an optical zone of 6.5mm blending out to 9.4mm transition zone. The mask for simple myopia is an f-stop like mechanism located internally in the beam path. Summit has chosen to use custom crafted ablatable masks in the rail or beam path for the astigmatism and hyperopic correction. These masks protect the corneal tissue under them until the tapered mask is removed by laser pulses. The area without a mask will receive the full laser ablation. We have no data at the time of writing concerning the effectiveness of the ablatable masks for the astigmatic element of myopia treatment. Laser calibration is done by an internal 2 minute beam profile test. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
VisX
20/15, 20/20, STAR (TM) These are Argon Fluoride 193 nm excimer wide beam systems, the STAR(TM) version being the most recent evolution of the machine. The STAR machine has a standard 6mm optical zone which is expandible to 8mm for future applications. The mask for simple myopia is an f-stop like mechanism located internally in the beam path. The astigmatic module masks and hyperopic module masks are located internally in the beam path. The hyperopic module has an ablation zone of 9mm. Laser calibration is performed automatically at the start of each day, and between cases. A plastic test card read on a standard lensometer verifies the calibration. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
Automated Lamellar Keratectomy (ALK) vs
ALK-E or LASIK or "FLAP and ZAP"
As a preamble to discussion of ALK (and RK) it is nessary to remark that as of January 1996 ALK is a anomaly largely confined to the USA. The reason is simple- the FDA in its "wisdom" has only approved one laser machine for PRK use, and only to -7.00 diopters correction. Mechanical surgical operations on the other hand are "approved" and thus American Ophthalmologists effectively have one hand tied behind their backs. They are allowed to perform ALK and RK but not PRK. The precision and efficacy of refractive laser technology have rendered ALK and RK essentially extinct in the rest of the world.
ALK is a purely mechanical method of changing the refractive power of the cornea. It involves removing a top layer of cornea with an automated instrument and then making a second incision (the refractive incision) in order to remove tissue for myopia or adding tissue (i.e. donor cornea) for hyperopia. The first incision is meant to remove a circular button of cornea c. 8mm in diameter, but to leave one edge hinged so that after the refractive portion of the operation is complete the hinged corneal surface flap can be repositioned. The first incision is easier to perform because the cornea which is only 0.55 mm thick can be flattened and thus held without moving so that a diamond knife can make a slice of uniform thickness from one side leaving the opposite side hinged. In the case of myopia a second incision must be made to remove a curved (lens shaped) piece of tissue from the cornea's middle tissue (stroma). This tissue can be removed from the back surface of the slice or the front surface of the remaining cornea. The first slice, which is usually hinged (i.e. not completely removed) is then replaced on the cornea and held in place with or without a contact lens until the flap can reattach itself to the rest of the cornea - i.e. heal with a change in the shape of the corneal surface equivalent to the change in lens needed to satisfy the refractive needs.
The more difficult technical problem with the mechanical ALK procedure is the (second) refractive incision which must remove an extremely thin slice of corneal tissue complete with tapered edges. There is a jelly-like consistency to the corneal tissue underneath the surface and this leads to significant limits to the precision of the procedure.
An improved method of making the refractive incision is to use the excimer laser. This method is called ALK-E OR LASIK rather than ALK (Automated Lammellar Keratectomy - Excimer laser or Laser in Situ Keratomileusis). The use of the laser to sculpt either a - (myopic) or + (hyperopic) lens in the remaining corneal tissue allows the extreme precision of the refractive laserÍs surgical ability to significantly enhance the technique. Since the first or surface incision with the microkeratome is technically easier than the second or refractive incision it makes good sense to use the extreme optical precision of the refractive laser to achieve the desired correction of the corneal refraction. This technique allows preservation of the corneal basement epithelial layer knows as Bowman's membrane and in the absence of complications from the reattachment and healing of this flap, the refractive results can be rapid and superb.
MEL 60- This is an Argon Fluoride 193 nm excimer scanning system. The scanning beam is rectangular and measures 1mm by 10 mm. The system uses a limbal suction cup mechanism to fix centration and computer controlled rotating masks which fit into the suction cup mechanism. The mask for simple myopia is an f-stop like mechanism. There are different masks used for myopia with astigmatism, hyperopia, and for pure astigmatism. The masks rotate within the suction cup in order to control any axis of extra ablation as needed for astigmatism correction. Laser calibration is done by visual inspection of a 1um thick metal foil which requires 9 laser passes for removal. There is a layer of red under the silver foil making efficacy of removal easily monitored. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
ALCON
LADARVision® System and CustomCornea® - The LADARVision® System consists of the LADARVision® 4000 laser and the LADARWave® Aberrometer. The LADARVision excimer laser is a small-spot scanning laser with a laser radar tracking device. FDA approved for wavefront-guided ablations.
Bausch & Lomb Technolas 217 Excimer Laser with PLANOSCAN
Technolas 217 Workstation - this is an Argon Fluoride 193 nm excimer scanning system. The scanning beam is a circular spot which can be size adjusted. Centration is accomplished by an active "pupil" tracking mechanism which locks on to the pupil image and will have the laser follow any movement by the patient's eye. Active Infra-red Eye Tracker and passive monitor interrupts laser beam on movement in excess of 3 mm range (1.5 mm radius). Astigmatism, myopia and hyperopia can be treated by software adjustment of the beam scans.
LaserSight Technologies, Inc.
The new LaserScan LSX utilizes LaserSight's patented scanning delivery system integrating new leading edge technology. The LaserScan LSX uses a patented scanning system to deliver a 1-mm low energy "flying spot" in a proprietary alternating, multi-zone, multi-pass strategy. With each pass, about 2 microns of tissue are precisely removed to produce a finely polished corneal surface. Unlike older broad beam technologies, no rings or ridges are produced. Studies now show that smoother ablations may produce less haze, faster healing and more stable clinical results. Integral to each system is flexibility in treatment parameters including gently tapered transition zones.
Manufacture and sales of refractive laser systems, keratome systems, keratome blade products, and aesthetic lasers. LaserSight pioneered refractive laser systems using 193 nm, high resolution, scanning delivery. Both patient fixation and an optional automated tracking system are available. Astigmatism, hyperopia and myopia can be treated with software adjustments of the scanning mechanism. Watch this space for a future " quick-time" or "M-peg" clip of calibration, and actual treatment of myopia, astigmatism and hyperopia.
The LaserHarmonic-1 and LaserHarmonic-2 are solid state lasers still in the development stage. The former is flash lamp pumped and employs the fifth harmonic of a Nd:Yag at 213nm, and the latter is a diode pumped fifth harmonic Nd:YLF laser at 209nm.
Nidek, Inc.
EC-5000 This is an Argon Fluoride 193 nm excimer scanning system. The scanning beam is a rectangular slit which both scans, dynamically rotates, and overlaps. The rotation of the scan is designed to eliminate circular f-stop ridges and increase the smoothness of the ablation. Centration is controlled by the surgeon with a "joy" stick mechanism to follow the patient's eye. Astigmatism and myopia can be treated by software adjustment of the beam scans. At the time of writing we do not have any result data for this machine. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of myopia, and astigmatism.
Novatec LASER SYSTEMS INC
Lightblade (TM) This is an solid state c. 208nm non excimer scanning system based upon the fourth harmonic of a titanium sapphire crystal. The scanning beam is a 200-300um variable size spot. Centration is accomplished by an active tracking mechanism which locks to have the laser follow movement by the patient's eye. Astigmatism and hyperopia can also be treated by software adjustment of the spot scans. At the time of writing we do not have any result data for astigmatism of hyperopia treatment. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
Summit Technology
Excimed, Omnimed, Apogee, Apex These are Argon Fluoride 193 nm excimer wide beam systems. The 1990 version of the Eximed machine had optical zones of only 4.5 and 5.0 mm. The Omnimed and Eximed versions increased the optical zone to 6.0 and 6.5mm. (The Apex machine has an optical zone of 6.5mm blending out to 9.4mm transition zone. The mask for simple myopia is an f-stop like mechanism located internally in the beam path. Summit has chosen to use custom crafted ablatable masks in the rail or beam path for the astigmatism and hyperopic correction. These masks protect the corneal tissue under them until the tapered mask is removed by laser pulses. The area without a mask will receive the full laser ablation. We have no data at the time of writing concerning the effectiveness of the ablatable masks for the astigmatic element of myopia treatment. Laser calibration is done by an internal 2 minute beam profile test. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
VisX
20/15, 20/20, STAR (TM) These are Argon Fluoride 193 nm excimer wide beam systems, the STAR(TM) version being the most recent evolution of the machine. The STAR machine has a standard 6mm optical zone which is expandible to 8mm for future applications. The mask for simple myopia is an f-stop like mechanism located internally in the beam path. The astigmatic module masks and hyperopic module masks are located internally in the beam path. The hyperopic module has an ablation zone of 9mm. Laser calibration is performed automatically at the start of each day, and between cases. A plastic test card read on a standard lensometer verifies the calibration. Watch this space for a future "quick-time" or "M-peg" clip of calibration, and actual treatment of hyperopia, myopia, and astigmatism.
Automated Lamellar Keratectomy (ALK) vs
ALK-E or LASIK or "FLAP and ZAP"
As a preamble to discussion of ALK (and RK) it is nessary to remark that as of January 1996 ALK is a anomaly largely confined to the USA. The reason is simple- the FDA in its "wisdom" has only approved one laser machine for PRK use, and only to -7.00 diopters correction. Mechanical surgical operations on the other hand are "approved" and thus American Ophthalmologists effectively have one hand tied behind their backs. They are allowed to perform ALK and RK but not PRK. The precision and efficacy of refractive laser technology have rendered ALK and RK essentially extinct in the rest of the world.
ALK is a purely mechanical method of changing the refractive power of the cornea. It involves removing a top layer of cornea with an automated instrument and then making a second incision (the refractive incision) in order to remove tissue for myopia or adding tissue (i.e. donor cornea) for hyperopia. The first incision is meant to remove a circular button of cornea c. 8mm in diameter, but to leave one edge hinged so that after the refractive portion of the operation is complete the hinged corneal surface flap can be repositioned. The first incision is easier to perform because the cornea which is only 0.55 mm thick can be flattened and thus held without moving so that a diamond knife can make a slice of uniform thickness from one side leaving the opposite side hinged. In the case of myopia a second incision must be made to remove a curved (lens shaped) piece of tissue from the cornea's middle tissue (stroma). This tissue can be removed from the back surface of the slice or the front surface of the remaining cornea. The first slice, which is usually hinged (i.e. not completely removed) is then replaced on the cornea and held in place with or without a contact lens until the flap can reattach itself to the rest of the cornea - i.e. heal with a change in the shape of the corneal surface equivalent to the change in lens needed to satisfy the refractive needs.
The more difficult technical problem with the mechanical ALK procedure is the (second) refractive incision which must remove an extremely thin slice of corneal tissue complete with tapered edges. There is a jelly-like consistency to the corneal tissue underneath the surface and this leads to significant limits to the precision of the procedure.
An improved method of making the refractive incision is to use the excimer laser. This method is called ALK-E OR LASIK rather than ALK (Automated Lammellar Keratectomy - Excimer laser or Laser in Situ Keratomileusis). The use of the laser to sculpt either a - (myopic) or + (hyperopic) lens in the remaining corneal tissue allows the extreme precision of the refractive laserÍs surgical ability to significantly enhance the technique. Since the first or surface incision with the microkeratome is technically easier than the second or refractive incision it makes good sense to use the extreme optical precision of the refractive laser to achieve the desired correction of the corneal refraction. This technique allows preservation of the corneal basement epithelial layer knows as Bowman's membrane and in the absence of complications from the reattachment and healing of this flap, the refractive results can be rapid and superb.
PRK Laser Types
Current PRK lasers are best classified by laser source (either Argon-Fluoride excimer lasers or solid state) and beam type (broad beam or scanning beam). Laser technology and computer control software has evolved significantly since the first normally sighted eyes were treated in 1987. Initial PRK treatments used 3.5 and 4mm optical zones so as to minimize the depth of ablation. Since many pupils dilate to 5mm it is not surprising that edge glare and light sensitivity were common complications. Ablation diameter increase with edge smoothing has been implemented to solve many edge glare problems. Wide or broad beam machines initially had problems caused by the use of nitrogen flow to disperse vaporized tissue and with the occurrence of unvaporized central islands. Stoppage of nitrogen flow and modification of computer generated treatment regimes has largely eliminated these problems.
The US Food & Drug Administration (FDA) has been cautious, rigid, and slow to approve PRK for widespread use within the USA. There has been speculation that the reason for the current caution is embarrassment over a previous premature approved of the surgical procedure of radial keratotomy (RK). Many observers have feared that the apparent bureaucratic rigidity might impede the implementation of future needed changes to equipment or procedures prior to long and inflexible testing schedules. However, recently the FDA surprised its critics when, with the final approval of the Summit Laser, they insisted upon increasing the size of the optical zone from that tested in the preapproval trials. In the US a number of other laser manufacturers are progressing or almost through FDA trials. In contrast, most other jurisdictions including Europe and Canada, have, without the "benefit" of as vigorous an approval process, had the freedom to amend and improve equipment and treatment regimes as improvements presented themselves. There is now worldwide a large and expanding experience with many varied laser machines and evolving technical improvements.
The US Food & Drug Administration (FDA) has been cautious, rigid, and slow to approve PRK for widespread use within the USA. There has been speculation that the reason for the current caution is embarrassment over a previous premature approved of the surgical procedure of radial keratotomy (RK). Many observers have feared that the apparent bureaucratic rigidity might impede the implementation of future needed changes to equipment or procedures prior to long and inflexible testing schedules. However, recently the FDA surprised its critics when, with the final approval of the Summit Laser, they insisted upon increasing the size of the optical zone from that tested in the preapproval trials. In the US a number of other laser manufacturers are progressing or almost through FDA trials. In contrast, most other jurisdictions including Europe and Canada, have, without the "benefit" of as vigorous an approval process, had the freedom to amend and improve equipment and treatment regimes as improvements presented themselves. There is now worldwide a large and expanding experience with many varied laser machines and evolving technical improvements.
PRK Laser Energy
Visible light and all other forms of electromagnetic radiation carry energy. Light passes through windows, radio waves pass through buildings and x-rays pass through people, but each of these energy forms can also interact and thus release the energy. Beneficial or harmful effects will occur depending upon the wavelength of the energy source, the strength of the radiation, and what substance interacts or is struck.
Lasers are a method of producing an intense beam of energy with a precise wavelength. The first optical laser appeared in 1960 (1). The early medical lasers (2) produced visible light wavelengths which relied upon the transfer of heat energy to burn or photo coagulate tissue. Later lasers (3) used infrared (IR) wavelengths whose heat and energy was sufficient to either photo vaporize or photo disrupt (explode) tissue. Ultraviolet (UV) lasers were first suggested in 1975 (4) and subsequently a class of lasers known as Excimer lasers has evolved. The argon fluoride (ArF) version emits radiation of 193.3 nm wavelength. This is the laser which has revolutionized refractive surgery because when this laser interacts with tissue it removes only a fraction of the cell with virtually no damage to surrounding cells. A recent Ophthalmology textbook (5) has excellent comprehensive reviews showing collections of pioneering photomicrographs. We hope soon to receive permission to reproduce extraordinary photographs of grooves in a human hair (6), and laser incisions in human cornea (7). The remarkable feature is incredibly smooth incisions with no evidence of heat damage in immediately adjacent tissue. This could be called a cold laser. It turns out that wavelengths in the 200 nm range deliver just the right energy to break intermolecular bonds and simply ablate tissue without collateral damage to immediately adjacent cells. A longer wavelength such as a 248 nm (KrF Excimer) radiation burns a wide path of adjacent tissue in addition to the directly affected tissue. Since longer UV wavelengths (UV-B) are known to increase the occurrence of skin cancer a number of scientific studies have been done to study the possibility of 193 nm (UV-C) radiation causing cancer and each one has shown that 193 nm radiation does not damage DNA (8). Wavelengths shorter than 100 nm enter the X-Ray bands. X-Rays pass through cell and can also cause Cancer. Excimer 193 nm rays strike a cell surface and ablate only 0.25 (9) um of tissue. Since the distance from cell wall to nucleus in a corneal epithelial cell is 1.5 to 3.0 um (10) it is thought that the nuclei are either shielded from the radiation or destroyed with little potential for mutagenesis (cancer production).
The action of 193 nm excimer radiation is even more elegant than ablating 0.25 um of tissue. It turns out that after each laser pulse the remaining cell elements are resealed by the formation of a pseudo membrane or new layer or membrane. It is helpful to think of corneal cells as rather like grapes with a liquid center and surrounding membrane which holds the liquid center in. You can imagine each laser pulse removing 1/10 of the grape and resealing the portion of the grape (cell) not ablated or destroyed! To place the 0.25 um ablation in perspective, some corneal epithelial cells are 18 um tall and the depth of the cornea at center is 500 um.
Lasers are a method of producing an intense beam of energy with a precise wavelength. The first optical laser appeared in 1960 (1). The early medical lasers (2) produced visible light wavelengths which relied upon the transfer of heat energy to burn or photo coagulate tissue. Later lasers (3) used infrared (IR) wavelengths whose heat and energy was sufficient to either photo vaporize or photo disrupt (explode) tissue. Ultraviolet (UV) lasers were first suggested in 1975 (4) and subsequently a class of lasers known as Excimer lasers has evolved. The argon fluoride (ArF) version emits radiation of 193.3 nm wavelength. This is the laser which has revolutionized refractive surgery because when this laser interacts with tissue it removes only a fraction of the cell with virtually no damage to surrounding cells. A recent Ophthalmology textbook (5) has excellent comprehensive reviews showing collections of pioneering photomicrographs. We hope soon to receive permission to reproduce extraordinary photographs of grooves in a human hair (6), and laser incisions in human cornea (7). The remarkable feature is incredibly smooth incisions with no evidence of heat damage in immediately adjacent tissue. This could be called a cold laser. It turns out that wavelengths in the 200 nm range deliver just the right energy to break intermolecular bonds and simply ablate tissue without collateral damage to immediately adjacent cells. A longer wavelength such as a 248 nm (KrF Excimer) radiation burns a wide path of adjacent tissue in addition to the directly affected tissue. Since longer UV wavelengths (UV-B) are known to increase the occurrence of skin cancer a number of scientific studies have been done to study the possibility of 193 nm (UV-C) radiation causing cancer and each one has shown that 193 nm radiation does not damage DNA (8). Wavelengths shorter than 100 nm enter the X-Ray bands. X-Rays pass through cell and can also cause Cancer. Excimer 193 nm rays strike a cell surface and ablate only 0.25 (9) um of tissue. Since the distance from cell wall to nucleus in a corneal epithelial cell is 1.5 to 3.0 um (10) it is thought that the nuclei are either shielded from the radiation or destroyed with little potential for mutagenesis (cancer production).
The action of 193 nm excimer radiation is even more elegant than ablating 0.25 um of tissue. It turns out that after each laser pulse the remaining cell elements are resealed by the formation of a pseudo membrane or new layer or membrane. It is helpful to think of corneal cells as rather like grapes with a liquid center and surrounding membrane which holds the liquid center in. You can imagine each laser pulse removing 1/10 of the grape and resealing the portion of the grape (cell) not ablated or destroyed! To place the 0.25 um ablation in perspective, some corneal epithelial cells are 18 um tall and the depth of the cornea at center is 500 um.
The Magic of PRK
The magic of Photo Refractive Keratectomy (PRK) is a surgical precision unprecedented in human history. Excimer Laser power coupled with today's computers allows one laser pulse to remove as little as one quarter (0.25 nm) of a micrometer (or micron) of corneal tissue. This is exquisite control! In PRK the focusing power of glasses or contact lenses is sculpted directly unto the cornea or front window of the eye. The new and special laser actually cleaves individual molecular bonds to remove tissue with no damage to surrounding tissue. Computer programs control the surface sculpting to ensure the highest possible accuracy and success of the intended refractive change.
LASIK - eye surgery
Laser eye surgery was first performed to correct near-sightedness in Germany in 1988. Since then it has quickly spread throughout the world and is available in most developed countries. It has been particularly popular in Europe, Asia, and North America, especially the USA and Canada. In the USA, the FDA first approved an excimer laser to be used for laser eye surgery in 1995. The excimer laser was approved for use in LASIK in the USA in 1998.
LASIK is perhaps the most popular elective surgery available today. It is estimated that over 1,000,000 LASIK procedures are performed annually in the USA.
Availability
LASIK surgeons and clinics are available in all major cities including New York City, Los Angeles, Miami, San Francisco, Las Vegas, San Antonio, San Jose, Milwaukee, Boston, and San Diego.
There are also LASIK clinics and surgeons available in every state in the United States including
New York, California, Colorado, and New Jersey.
There are more than 5,000 LASIK surgeons who are performing LASIK eye surgery.
General Information
With increased interest in LASIK, there have been an increased number of LASIK providers as well. While LASIK eye surgery is considered to be a very safe and effective treatment in general, patients would be advised to select a LASIK surgeon with caution. Despite the increased advantage of advanced technology, the LASIK surgeon is still considered to be a vital and important part of the treatment and the selection process is vital in improving the chances of a good result.
In addition to selecting the correct LASIK surgeon, it is helpful to know the technology that is available today. LASIK technology has changed rapidly over the years and LASIK providers who have not kept up with the advancements could possibly be harming their patients. Good results with your surgery depend upon a variety of factors, including experience, skill, technology, wise decision-making, good patient selection, and good people skills. Each of the factors can affect the results of your surgery.
LASIK eye surgery has brought happiness and freedom from glasses and contact lenses to millions of people. The vast majority of LASIK patients is very satisfied with the results and would recommend their friends to have the procedure. A very small minority experience side effects or complications which leads them to regret their decision to undergo LASIK surgery. These side effects can range from mild temporary irritation to long term visual problems and possibly even loss of vision.
Please consider all the information provided before contacting your local LASIK providers. It is often wise to contact several LASIK surgeons so that you can determine which surgeon is providing the best possible service and will offer the best chance at having good LASIK results. While it is often difficult for someone outside of the business to weigh the factors in making a good decision, this web site will offer a variety of information to offer you a better opportunity for good LASIK results.
More Specific Information
LASIK articles are written periodically with respect to more specific information including information regarding clinics and surgeons in various markets, new technology, what to watch out for, and other information related to LASIK. As a service we also post articles dealing with other eye-related issues not specifically dealing with LASIK but often of interest to our readers.
LASIK is perhaps the most popular elective surgery available today. It is estimated that over 1,000,000 LASIK procedures are performed annually in the USA.
Availability
LASIK surgeons and clinics are available in all major cities including New York City, Los Angeles, Miami, San Francisco, Las Vegas, San Antonio, San Jose, Milwaukee, Boston, and San Diego.
There are also LASIK clinics and surgeons available in every state in the United States including
New York, California, Colorado, and New Jersey.
There are more than 5,000 LASIK surgeons who are performing LASIK eye surgery.
General Information
With increased interest in LASIK, there have been an increased number of LASIK providers as well. While LASIK eye surgery is considered to be a very safe and effective treatment in general, patients would be advised to select a LASIK surgeon with caution. Despite the increased advantage of advanced technology, the LASIK surgeon is still considered to be a vital and important part of the treatment and the selection process is vital in improving the chances of a good result.
In addition to selecting the correct LASIK surgeon, it is helpful to know the technology that is available today. LASIK technology has changed rapidly over the years and LASIK providers who have not kept up with the advancements could possibly be harming their patients. Good results with your surgery depend upon a variety of factors, including experience, skill, technology, wise decision-making, good patient selection, and good people skills. Each of the factors can affect the results of your surgery.
LASIK eye surgery has brought happiness and freedom from glasses and contact lenses to millions of people. The vast majority of LASIK patients is very satisfied with the results and would recommend their friends to have the procedure. A very small minority experience side effects or complications which leads them to regret their decision to undergo LASIK surgery. These side effects can range from mild temporary irritation to long term visual problems and possibly even loss of vision.
Please consider all the information provided before contacting your local LASIK providers. It is often wise to contact several LASIK surgeons so that you can determine which surgeon is providing the best possible service and will offer the best chance at having good LASIK results. While it is often difficult for someone outside of the business to weigh the factors in making a good decision, this web site will offer a variety of information to offer you a better opportunity for good LASIK results.
More Specific Information
LASIK articles are written periodically with respect to more specific information including information regarding clinics and surgeons in various markets, new technology, what to watch out for, and other information related to LASIK. As a service we also post articles dealing with other eye-related issues not specifically dealing with LASIK but often of interest to our readers.
Laser eye surgery risks highlighted
Consumer experts have warned that patients undergoing laser eye surgery are not being told about the risks they could be taking with their sight.
Laser surgery, which can cost thousands of pounds, is increasingly popular.
But the investigation by Health Which? also reveals any doctor can carry out the treatment after just a few days of training - they do not need a specialist qualification.
The magazine also found complication rates vary between surgeons and clinics.
Around 100,000 people, tired of wearing glasses or contact lenses, undergo corrective laser eye surgery in the UK every year.
The procedure is seen as quick and simple, and has received many celebrity endorsements.
Health Which? looked at clinics offering the Lasik procedure - the most popular on offer.
But whilst some highlight a low risk of complications with the procedure, others say the risk is non-existent.
'Misleading adverts'
In very rare cases, complications can lead to corneal ectasia, where fluid pressure builds up on the eye.
Patients can need a corneal transplant to correct the condition.
Other complications, though deemed "minor" by clinics, occur "relatively frequently", according to a review by the American Academy of Ophthalmology.
Patients can experience dry eyes or night vision problems, which can affect ability to drive or work in the evening or in dim light.
Health Which? also says that the Medical Defence Union and the Medical Protection Society, both doctors' insurance companies, are raising the fees they charge doctors working in this field because of increased compensation claims by patients.
Questions
David Gartry, a consultant ophthalmologist at Moorfields Eye Hospital has helped draw up Royal College of Ophthalmologist' guidelines on who should carry out laser eye surgery.
The guidelines say that only doctors with specialist training should carry out the procedure.
Mr Gartry told BBC News Online patients should find out as much as possible about the surgeon likely to carry out their operation.
"This is a situation where patients are responding to adverts, or even incentives.
"Patients should be asking the sort of questions they would ask if they were having, say, a hernia operation.
"What are the complication rates? What will happen if something goes wrong? Will I see the surgeon again?"
Dan Reinstein, who is developing safety guidelines for the Medical Protection Society, added: "Expert surgeons are better equipped to avoid complications even if they have not previously seen them.
"And when these do occur, trained experts will have the knowledge and ability to correct them."
'Highest clinical standards'
Sue Freeman, managing editor of Health Which?, said: "Patients shouldn't be taken in by claims about the safety and success rates of laser eye surgery and in particular about so called 'minor complications'.
"While some people will be able to throw away their glasses, this won't be the case for everyone."
She added: "Patients should be fully informed of the possible risks and of the complication rates of clinics and individual surgeons.
"Until patients are able to make informed choice, they need to do a lot of research and ask a lot of hard questions of surgeons and clinics."
Here are a selection of your comments on this subject.
If my wife had known what it was going to be like she would never have had it done
G Fuller, UK
My wife had corrective laser treatment in November 2002 and all the literature she received quoted 'best case' examples of people being back at work the next day. Unfortunately she experienced massive discomfort and complete blindness for a week which failed to be controlled by the painkillers and sleeping pills prescribed by the clinic. In her own words "if she had known what it was going to be like she would never have had it done".
G Fuller, UK
Following surgery at the age of 44, I now have 20-20 vision, can use normal sunglasses (essential in Australia and at high altitude) and no longer have problems with rain or fogging. I saw a specialist surgeon in Belgium who used the latest equipment. I have had one (free) adjustment operation to correct some astigmatism in one eye.
I have experienced some minor double-vision, slight loss of night vision, and initially starbursts/haloes around strong light sources - the latter now much reduced. For me these are very minor compared with the joy of being able to see the stars with the naked eye for the first time. I was given a video recording of the operation but this is not for the squeamish, and best seen afterwards.
Charles Barran, Australia
After many years of consideration I finally took the decision to have laser treatment in December 2001. I opted for Lasek and was talked through all the possible complications and even had to take a little test to ensure I was fully aware of all possible side effects. After a thorough consultation I then had both eyes done simultaneously. I won't pretend the days following the treatment were bliss, I was in some discomfort for 3 to 4 days but after that had passed my eyes soon began to heal.
It was strange but having worn glasses for so long for a month or so afterwards I was still trying to push glasses that weren't there back up the bridge of my nose! It is now over a year since and I have perfect 20/20 vision. Just very occasionally my eyes are a little dry in the morning but I consider this a tiny inconvenience.
Edward Lacey, UK
I'd like to know if Sue Freeman would recommend micro lenses inserted into the eye as a better option than Lasik eye surgery. Would she be so kind as to find out on my behalf. I would like to lose my glasses. I did intend to have Lasik surgery but have now been scared off with the latest news regarding unsuccessful operations.
Vincent Jones, Dorset, UK
I had Lasik surgery last year and it was the best thing I ever did. I was fully informed by the company regarding any potential risks (and clear details on the procedures are on their website anyway). It was great just waking up the next day and not having to fumble around looking for glasses, and no fussing about shoving bits of plastic in my eyes each day!
Dave, UK
I had laser surgery in June 2001 and have been more than satisfied with the results and the service I received. I felt under no pressure to make a decision and that I was able to make an informed choice to go ahead with the procedure. I agree though that you do need to ask questions and be aware that there are risks - but isn't this the case for any sort of medical procedure? It is also essential to use a reputable company, unfortunately there are rouges out there, look at cosmetic surgery.
Kate Austin, England
Laser surgery, which can cost thousands of pounds, is increasingly popular.
But the investigation by Health Which? also reveals any doctor can carry out the treatment after just a few days of training - they do not need a specialist qualification.
The magazine also found complication rates vary between surgeons and clinics.
Around 100,000 people, tired of wearing glasses or contact lenses, undergo corrective laser eye surgery in the UK every year.
The procedure is seen as quick and simple, and has received many celebrity endorsements.
Health Which? looked at clinics offering the Lasik procedure - the most popular on offer.
But whilst some highlight a low risk of complications with the procedure, others say the risk is non-existent.
'Misleading adverts'
In very rare cases, complications can lead to corneal ectasia, where fluid pressure builds up on the eye.
Patients can need a corneal transplant to correct the condition.
Other complications, though deemed "minor" by clinics, occur "relatively frequently", according to a review by the American Academy of Ophthalmology.
Patients can experience dry eyes or night vision problems, which can affect ability to drive or work in the evening or in dim light.
Health Which? also says that the Medical Defence Union and the Medical Protection Society, both doctors' insurance companies, are raising the fees they charge doctors working in this field because of increased compensation claims by patients.
Questions
David Gartry, a consultant ophthalmologist at Moorfields Eye Hospital has helped draw up Royal College of Ophthalmologist' guidelines on who should carry out laser eye surgery.
The guidelines say that only doctors with specialist training should carry out the procedure.
Mr Gartry told BBC News Online patients should find out as much as possible about the surgeon likely to carry out their operation.
"This is a situation where patients are responding to adverts, or even incentives.
"Patients should be asking the sort of questions they would ask if they were having, say, a hernia operation.
"What are the complication rates? What will happen if something goes wrong? Will I see the surgeon again?"
Dan Reinstein, who is developing safety guidelines for the Medical Protection Society, added: "Expert surgeons are better equipped to avoid complications even if they have not previously seen them.
"And when these do occur, trained experts will have the knowledge and ability to correct them."
'Highest clinical standards'
Sue Freeman, managing editor of Health Which?, said: "Patients shouldn't be taken in by claims about the safety and success rates of laser eye surgery and in particular about so called 'minor complications'.
"While some people will be able to throw away their glasses, this won't be the case for everyone."
She added: "Patients should be fully informed of the possible risks and of the complication rates of clinics and individual surgeons.
"Until patients are able to make informed choice, they need to do a lot of research and ask a lot of hard questions of surgeons and clinics."
Here are a selection of your comments on this subject.
If my wife had known what it was going to be like she would never have had it done
G Fuller, UK
My wife had corrective laser treatment in November 2002 and all the literature she received quoted 'best case' examples of people being back at work the next day. Unfortunately she experienced massive discomfort and complete blindness for a week which failed to be controlled by the painkillers and sleeping pills prescribed by the clinic. In her own words "if she had known what it was going to be like she would never have had it done".
G Fuller, UK
Following surgery at the age of 44, I now have 20-20 vision, can use normal sunglasses (essential in Australia and at high altitude) and no longer have problems with rain or fogging. I saw a specialist surgeon in Belgium who used the latest equipment. I have had one (free) adjustment operation to correct some astigmatism in one eye.
I have experienced some minor double-vision, slight loss of night vision, and initially starbursts/haloes around strong light sources - the latter now much reduced. For me these are very minor compared with the joy of being able to see the stars with the naked eye for the first time. I was given a video recording of the operation but this is not for the squeamish, and best seen afterwards.
Charles Barran, Australia
After many years of consideration I finally took the decision to have laser treatment in December 2001. I opted for Lasek and was talked through all the possible complications and even had to take a little test to ensure I was fully aware of all possible side effects. After a thorough consultation I then had both eyes done simultaneously. I won't pretend the days following the treatment were bliss, I was in some discomfort for 3 to 4 days but after that had passed my eyes soon began to heal.
It was strange but having worn glasses for so long for a month or so afterwards I was still trying to push glasses that weren't there back up the bridge of my nose! It is now over a year since and I have perfect 20/20 vision. Just very occasionally my eyes are a little dry in the morning but I consider this a tiny inconvenience.
Edward Lacey, UK
I'd like to know if Sue Freeman would recommend micro lenses inserted into the eye as a better option than Lasik eye surgery. Would she be so kind as to find out on my behalf. I would like to lose my glasses. I did intend to have Lasik surgery but have now been scared off with the latest news regarding unsuccessful operations.
Vincent Jones, Dorset, UK
I had Lasik surgery last year and it was the best thing I ever did. I was fully informed by the company regarding any potential risks (and clear details on the procedures are on their website anyway). It was great just waking up the next day and not having to fumble around looking for glasses, and no fussing about shoving bits of plastic in my eyes each day!
Dave, UK
I had laser surgery in June 2001 and have been more than satisfied with the results and the service I received. I felt under no pressure to make a decision and that I was able to make an informed choice to go ahead with the procedure. I agree though that you do need to ask questions and be aware that there are risks - but isn't this the case for any sort of medical procedure? It is also essential to use a reputable company, unfortunately there are rouges out there, look at cosmetic surgery.
Kate Austin, England
Friday, June 26, 2009
LASIK Eye Surgery
| On May 7, I visited my local TLC Laser Eye Center for eye surgery. I began looking into eye surgery way back in December.. At that time, I wore my glasses for a week, then waltzed into my local TLC and tried to get it done the next day. I quickly found out that 1) it wasn't possible for 2 weeks and 2) I couldn't ski for a couple weeks afterward.. Since we were in the midst of a great ski season, I decided to schedule it for May. I failed the LASIK-eligibility and learned I'd have to have PRK instead. The scars on my right eyeball caused me to fail. I received these scars as a boy when a friend and I blew up a .45-70 bullet with a nail and sledgehammer. I was the one holding the nail and couldn't see for the next 3 days. In a nutshell: with LASIK they cut a flap, lift it up and shoot the laser under it. It heals quickly and is relatively painless. PRK has been around since before LASIK. With PRK, they seem to shave your eyeball and then shoot a laser into it. PRK takes a lot longer to heal, but the results are often as good or better than LASIK. Wikipedia has a more technical PRK vs. LASIK reference. The Procedure My mom flew into town for my surgery and drove me to TLC's office on that Thursday morning. It took 2 hours to prep for surgery, with most of the time spent sitting around and talking to my mom. Finally, they asked her to sit in the lobby and took me back to a waiting area. When I walked in the room, there were 2 other patients with surgery gear (funny hat and booties) and masks. They were leaning back, looking at the ceiling with their masks on and eyes closed. I quickly became the 3rd person who looked like this. Right before they started putting drops in my eyes, I remember being terrified that I might never see daylight again. At the very least, I thought I wouldn't see anything but black for the next 3 days. Right before they called me in, the previous patient walked out and muttered "Damn, that burns." Believe me, this is not what you want to hear right before it's your turn. I was led into the operating room, sat down and received numbing drops in my eyes. Less than a minute later, I was led over to the operating table. The rest of the procedure lasted less than 5 minutes. They taped my left eye shut and told me to stare at the red light with my right eye. At this point, they used some contraption to shave my eyeball. It was slightly painful, similar to the mild pain you feel when getting a cavity drilled with Novocaine. After each stroke, the world would ripple like a pebble thrown into in a lake. After 10 strokes or so, they shot a laser into my eye for around 20 seconds. You don't actually see the laser (the red light looks the same), but you can smell your eyeball burning. Each eye only took a few minutes. My mom was able to watch the entire surgery on a television on the other side of a glass wall. The Recovery I was surprised to discover I was immediately able to open my eyes and see normally. Of course, my eyes felt heavy, so I didn't open them wide nor feel like I could. I was led back to the waiting room where I was given a Valium and sent home. I put my sunglasses on when we left and kept my eyes closed for the 5-minute drive home. After arriving at my house, I immediately downed some Tylenol PM and went to bed. It was hard to fall asleep and my eyes began tearing up. There was a dull pain in my eyes that kept the tears flowing for most of the afternoon. It took me 2 hours to fall asleep and I remember my eyes causing my nose to get stuffed up from all the tears. When I woke up that evening, everything was blurry, but I was able to open my eyes and see better than I had previously w/o glasses. I didn't expect anything in the form of good vision and was mostly pre-occupied with trying to stop the pain (which wasn't terrible, but definitely present). I was prescribed Vicodin and started taking it on a regular basis. I was completely unable to watch TV at all that night. Viewing the computer screen was unthinkable. The next morning, my vision was a lot better as evidenced by the tweet from my iPhone. Shortly after, my mom drove me to my eye doctor's office for a 1-day checkup. The results were surprising. Friday night was one of the most painful. Saturday wasn't very painful, but my eyesight was very blurry. That afternoon, it was hard to keep my eyes open. Every time I tried to open them, I felt like I had to sneeze. Fortunately, I was able to watch the Nuggets game. I couldn't see players' numbers, but I was able to see Melo's last-second 3-pointer to win. On Monday, I was able to drive to TLC for my 3-day checkup. Things were definitely blurry, but I didn't feel like it was dangerous for me to be behind the wheel. I was able to work on Monday, but I also had to increase my font sizes to 36pt and used a 30" monitor all day. OS X's Universal Access -> Zoom feature came in awful handy. That night, TV was a LOT clearer than the previous night, but it was still fuzzy. What's it like now? It's been almost 4 weeks and I'm very glad that I had the surgery done. I haven't felt any pain since the Sunday after surgery and I haven't had any issues with dryness. My vision does fluctuate from day-to-day. Some days I feel like I have super-hero vision and other days there's a halo around objects beyond 10 feet. According to my doctor, fluctuations are expected to continue for 6 months. I don't mind since it never gets bad enough to seem strange.. Now I enjoy not having to worry about glasses or contacts when traveling. I love waking up every morning and not having to do anything to improve my vision. I feel like I have more freedom in my life. Getting eye surgery is definitely one of the best things I've ever done. |
Wednesday, March 25, 2009
Vancouver Laser Eye Surgery Centers
Vancouver laser eye surgery centers and clinics receive patrons from around the United States and Canada. People visiting Vancouver on vacation find it convenient to drop by one of its many laser surgery centers for a few minutes of LASIK surgery. Below are some of them.
Coal Harbour LASIK Eye Centres
Dr. Steven Kirzner, is this Vancouver laser eye surgery center's medical director. He has performed over 35,000 successful laser eye procedures since 1991.
Coal Harbour LASIK Eye Centres patients benefit from advances in 3D eye tracking so that they do not have to align their own eye to the laser, as in other procedures that predate 3D eye tracking and iris recognition technology. This technology ensures greater accuracy, alignment, and safety.
Moreover, the technology makes allowances for dilated pupils, eliminating one of the debilitating side effects of conventional laser treatment: poor night vision.
Coal Harbour LASIK Eye Centres uses Bausch & Lomb Zyoptix 100 technology for its procedures.
LASIK MD
Doctors who, together, have performed over 300,000 LASIK surgeries across Canada staff this Vancouver laser eye surgery center.
LASIK MD has pioneered in several areas, such as being the first clinic to use excimer laser in Ontario, Canada and the second in Canada in 1990. LASIK MD surgeons were also the first to use the Total Cornea technique in 1997, which eliminates visual disturbances at night.
The center uses Zero Compression Keratome (to create the corneal flap, saving corneal tissue), ZyoptixTM, and Custom Wavefront LASIK.
LASIK MD uses the Bausch & Lomb 217z laser.
London Place Eye Centre
This Vancouver laser eye surgery clinic has developed a technique called No Touch, a highly safe method of reshaping the cornea in myopic, hyperopic, and astigmatic patients. No Touch uses only laser light (not the usual microkeratome's metal blade) and does not involve manual incision to create a corneal flap.
London Place Eye Centre surgeons are not only internationally recognized in the field of refractive surgery, but also take part in clinical trials to arrive at new techniques. With over 20 years of eye care experience, this Vancouver laser eye surgery center has had over 75,000 triumphant laser eye surgery operations.
London Place Eye Centre uses the VISX STAR S4-IR excimer laser for its No Touch method.
VisionMed
VisionMed's surgeons continuously participate in training and certification programs. They are leaders in refractive surgery research and development, and regularly lecture and teach at international conferences.
This Vancouver laser eye surgery center offers patients Wavefront Scan if they are vulnerable to night vision problems or have large pupils. VisionMed recommends PlanoScan LASIK for a virtually painless and quick procedure, and PlanoScanTM PRK for some patients with specific needs.
VisionMed also offers CustomScan for patients with severe to extreme prescriptions, as well as those with asymmetrical corneas that require a laser system beyond wavefront technology.
Coal Harbour LASIK Eye Centres
Dr. Steven Kirzner, is this Vancouver laser eye surgery center's medical director. He has performed over 35,000 successful laser eye procedures since 1991.
Coal Harbour LASIK Eye Centres patients benefit from advances in 3D eye tracking so that they do not have to align their own eye to the laser, as in other procedures that predate 3D eye tracking and iris recognition technology. This technology ensures greater accuracy, alignment, and safety.
Moreover, the technology makes allowances for dilated pupils, eliminating one of the debilitating side effects of conventional laser treatment: poor night vision.
Coal Harbour LASIK Eye Centres uses Bausch & Lomb Zyoptix 100 technology for its procedures.
LASIK MD
Doctors who, together, have performed over 300,000 LASIK surgeries across Canada staff this Vancouver laser eye surgery center.
LASIK MD has pioneered in several areas, such as being the first clinic to use excimer laser in Ontario, Canada and the second in Canada in 1990. LASIK MD surgeons were also the first to use the Total Cornea technique in 1997, which eliminates visual disturbances at night.
The center uses Zero Compression Keratome (to create the corneal flap, saving corneal tissue), ZyoptixTM, and Custom Wavefront LASIK.
LASIK MD uses the Bausch & Lomb 217z laser.
London Place Eye Centre
This Vancouver laser eye surgery clinic has developed a technique called No Touch, a highly safe method of reshaping the cornea in myopic, hyperopic, and astigmatic patients. No Touch uses only laser light (not the usual microkeratome's metal blade) and does not involve manual incision to create a corneal flap.
London Place Eye Centre surgeons are not only internationally recognized in the field of refractive surgery, but also take part in clinical trials to arrive at new techniques. With over 20 years of eye care experience, this Vancouver laser eye surgery center has had over 75,000 triumphant laser eye surgery operations.
London Place Eye Centre uses the VISX STAR S4-IR excimer laser for its No Touch method.
VisionMed
VisionMed's surgeons continuously participate in training and certification programs. They are leaders in refractive surgery research and development, and regularly lecture and teach at international conferences.
This Vancouver laser eye surgery center offers patients Wavefront Scan if they are vulnerable to night vision problems or have large pupils. VisionMed recommends PlanoScan LASIK for a virtually painless and quick procedure, and PlanoScanTM PRK for some patients with specific needs.
VisionMed also offers CustomScan for patients with severe to extreme prescriptions, as well as those with asymmetrical corneas that require a laser system beyond wavefront technology.
The Benefits of PRK Eye Surgery
(Photorefractive Keratectomy) precedes LASIK surgery. However, many centers still offer the procedure as an alternative to LASIK mainly due to the fact that PRK eye surgery does not invade the cornea by making an incision into the outer layer, as in LASIK.
However, just as there are LASIK eligibility exams, there are also prerequisite eye exams in PRK. Doctors will inquire into the medical history of a patient to discover any allergies or possibilities for complication. Lifestyle and expectations will also be discussed at this stage.
Also, a stable prescription is also required for at least one year.
PRK eye surgery requires that a patient undergo the following:
Corneal thickness
Corneal topography
Dilation exam
Refractive error measurement
Pupil measurements
Tear function analysis
A doctor will require that contact lenses not be used a certain period prior to the PRK eye surgery exam to ensure that refractive measurements are taken correctly. Generally, the requirements for non-use are:
Soft contact lenses = 1 week prior to the eye exam
Hard contact lenses = 2 to 3 weeks prior to the eye exam
PRK involves a longer recovery period compared to LASIK. It also involves a greater degree of discomfort.
Some surgeons and patients agree on PRK due to there being less of a risk that the inner eye pressure will push out against the thinner corneal wall (as in LASIK), causing it to bulge and contributing to ectasia or deteriorating vision over time.
Patients wary about the prospect of a metal blade creating an incision on their eye, which is the riskiest procedure in LASIK surgery, consider PRK as a better alternative.
LASEK
There are two laser eye surgery variations under PRK, one of them is LASEK (Laser Assisted Sub-Epithelial Keratomileusis).
Rather than the epithelial scraping involved in standard PRK, LASEK uses alcohol to soften the epithelium, the surface of the cornea, and remove it.
LASEK's advantage over regular PRK is the faster healing time that more closely approximates recovery from LASIK – although LASEK still avoids using a microkeratome blade to create a corneal flap (as in LASIK).
Epi-LASEK
This second type of modification on PRK uses a separator to lift the epithelium, while the laser reshapes the cornea.
Epi-LASEK reduces discomfort even more and speeds up recovery even faster than LASEK. This procedure is preferred by many who opt for PRK because, more than any other procedure, it approximates the convenience of LASIK surgery the most.
Discomfort and slight pain after PRK eye surgery is sometimes relieved by medication. However, post-op symptoms of blurry or hazy vision are normally allowed disappear naturally with no other treatment apart from regular eye drops prescribed by the doctor.
Patients who have previously undergone LASIK are sometimes advised to undergo PRK for further treatment, since PRK is less invasive.
However, just as there are LASIK eligibility exams, there are also prerequisite eye exams in PRK. Doctors will inquire into the medical history of a patient to discover any allergies or possibilities for complication. Lifestyle and expectations will also be discussed at this stage.
Also, a stable prescription is also required for at least one year.
PRK eye surgery requires that a patient undergo the following:
Corneal thickness
Corneal topography
Dilation exam
Refractive error measurement
Pupil measurements
Tear function analysis
A doctor will require that contact lenses not be used a certain period prior to the PRK eye surgery exam to ensure that refractive measurements are taken correctly. Generally, the requirements for non-use are:
Soft contact lenses = 1 week prior to the eye exam
Hard contact lenses = 2 to 3 weeks prior to the eye exam
PRK involves a longer recovery period compared to LASIK. It also involves a greater degree of discomfort.
Some surgeons and patients agree on PRK due to there being less of a risk that the inner eye pressure will push out against the thinner corneal wall (as in LASIK), causing it to bulge and contributing to ectasia or deteriorating vision over time.
Patients wary about the prospect of a metal blade creating an incision on their eye, which is the riskiest procedure in LASIK surgery, consider PRK as a better alternative.
LASEK
There are two laser eye surgery variations under PRK, one of them is LASEK (Laser Assisted Sub-Epithelial Keratomileusis).
Rather than the epithelial scraping involved in standard PRK, LASEK uses alcohol to soften the epithelium, the surface of the cornea, and remove it.
LASEK's advantage over regular PRK is the faster healing time that more closely approximates recovery from LASIK – although LASEK still avoids using a microkeratome blade to create a corneal flap (as in LASIK).
Epi-LASEK
This second type of modification on PRK uses a separator to lift the epithelium, while the laser reshapes the cornea.
Epi-LASEK reduces discomfort even more and speeds up recovery even faster than LASEK. This procedure is preferred by many who opt for PRK because, more than any other procedure, it approximates the convenience of LASIK surgery the most.
Discomfort and slight pain after PRK eye surgery is sometimes relieved by medication. However, post-op symptoms of blurry or hazy vision are normally allowed disappear naturally with no other treatment apart from regular eye drops prescribed by the doctor.
Patients who have previously undergone LASIK are sometimes advised to undergo PRK for further treatment, since PRK is less invasive.
Prevent Bad Lasik Eye Surgery
Many people with vision problems pin their hopes on Lasik eye surgery to solve their vision dilemmas. Unfortunately, many people get so excited over the anticipated positive results that they fail to seriously consider that a bad Lasik eye surgery outcome IS a serious possibility.
Any medical procedure should be considered with both the positive and negative outcomes. If you are aware of this from the start, then you can prepare better and make well-informed decisions.
Lasik Eye Surgery - A Look at Negative Results
So what can go wrong?
You can suffer from permanent vision loss. This can be caused by an inexperienced doctor who commits a mistake during surgery. This may also be the result of the use of faulty equipment.
You run the risk of actually still needing eyeglasses or contact lenses after surgery.
You may develop chronic dry eyes.
The shape of your cornea may change as a result of the surgery. This will most likely require you to purchase custom-made eyewear, which will be more expensive.
You may develop other vision problems you never had before the operation such as halos, glare, and others.
Bad Lasik Eye Surgery - Contributing Factors
Several factors can contribute to a bad Lasik eye surgery experience.
One: Not realizing that you are a bad candidate for Lasik eye surgery. Do you have dry eyes to begin with? Are you talking any steroids that may hinder proper recovery from the eye surgery? Your condition prior the procedure should be scrutinized and if you are more adamant about having the operation rather than your qualifications for it, then you are setting yourself up for a bad experience.
Two: Your doctor may be inexperienced. You really need to do your homework when it comes to selecting the right doctor to perform Lasik eye surgery. Don't just rely on what your doctor says. Check out his/her medical records and verify if he/she is a member of any reputable medical association. Ask for referrals and call previous clients and ask about their experience. Visit the hospital or place where the doctor will carry out the eye surgery too and see if you are comfortable with the surroundings. Talk several times to your doctor and see how you feel about him/her. In short, are you confident about his/her capabilities?
Three: Last but not the least, be aware of what you should do after Lasik eye surgery. For instance, did you know what you should not, under any circumstances, rub your eyes? Did you know that you should not swim or get into a hot tub for about two to three weeks after surgery?
Talk to your doctor and ask for a list of do's and don’ts. Be sure too to ask about best and worst case scenarios so that you are always prepared in any event.
Any medical procedure should be considered with both the positive and negative outcomes. If you are aware of this from the start, then you can prepare better and make well-informed decisions.
Lasik Eye Surgery - A Look at Negative Results
So what can go wrong?
You can suffer from permanent vision loss. This can be caused by an inexperienced doctor who commits a mistake during surgery. This may also be the result of the use of faulty equipment.
You run the risk of actually still needing eyeglasses or contact lenses after surgery.
You may develop chronic dry eyes.
The shape of your cornea may change as a result of the surgery. This will most likely require you to purchase custom-made eyewear, which will be more expensive.
You may develop other vision problems you never had before the operation such as halos, glare, and others.
Bad Lasik Eye Surgery - Contributing Factors
Several factors can contribute to a bad Lasik eye surgery experience.
One: Not realizing that you are a bad candidate for Lasik eye surgery. Do you have dry eyes to begin with? Are you talking any steroids that may hinder proper recovery from the eye surgery? Your condition prior the procedure should be scrutinized and if you are more adamant about having the operation rather than your qualifications for it, then you are setting yourself up for a bad experience.
Two: Your doctor may be inexperienced. You really need to do your homework when it comes to selecting the right doctor to perform Lasik eye surgery. Don't just rely on what your doctor says. Check out his/her medical records and verify if he/she is a member of any reputable medical association. Ask for referrals and call previous clients and ask about their experience. Visit the hospital or place where the doctor will carry out the eye surgery too and see if you are comfortable with the surroundings. Talk several times to your doctor and see how you feel about him/her. In short, are you confident about his/her capabilities?
Three: Last but not the least, be aware of what you should do after Lasik eye surgery. For instance, did you know what you should not, under any circumstances, rub your eyes? Did you know that you should not swim or get into a hot tub for about two to three weeks after surgery?
Talk to your doctor and ask for a list of do's and don’ts. Be sure too to ask about best and worst case scenarios so that you are always prepared in any event.
What to Expect from Plastic Eye Surgery
Plastic eye surgery — as well as other types of cosmetic plastic surgery — corrects flaws that affect the way you feel about yourself. The enhanced looks that plastic eye surgery offers are aimed at adding to your self-confidence.
During surgery, small incisions are made around the eye with the goal of removing extra fat and muscle to create a firmer, younger-looking eye area. Using the skin's natural folds for the incisions minimizes scarring. Only fine stitches are used for plastic eye surgery.
When plastic eye surgery involves the lower eyelid, incisions are made along the line of the eyelashes and smile creases.
An unnaturally puffy eyelid can be corrected through transconjunctival blepharoplasty, by which excess fat is trimmed. In this procedure, the incision is made inside the lower eyelid. The stitches used in transconjunctival blepharoplasty cannot be seen by the naked eye and dissolve by themselves leaving no scar. This procedure can take anywhere from 1 to 2 hours.
Limits of Plastic Eye Surgery
This type of surgery does not remove fine lines and crow's feet. A separate, skin surface treatment that can enhance your skin's elasticity is an added option.
Unless plastic eye surgery involves a brow lift, it will not help the appearance of a sagging brow. Nor will it eliminate dark circles from under your eyes (for which topical applications exist in the market).
Your plastic surgeon will probably suggest added procedures to enhance your overall look.
Safety Issues
Serious complications from plastic eye surgery are rare. However, the occasional infection or allergic reaction to anesthetics has been known to happen. But the chances of this taking place are drastically minimized by pre-op examination of the patient's medical history, current medication, and preexisting allergies.
Some patients have been known to experience difficulty in closing their eyes, which condition is however generally not permanent.
Bruising, swelling, and redness are typical side effects of any type of plastic surgery, but none of these are permanent and will usually disappear within 10 days.
Plastic eye surgery is more risky for people certain conditions, such as:
Diabetes
Glaucoma and other eye diseases
Heart disease
High blood pressure
Hypothyroidism
Prices
For plastic eye surgery involving the upper eyelid, surgeons may charge in the area of $1,800 to $2,000. For procedures involving the upper and lower eyelids, prices may go as high as $4,500, or more depending on additional costs of anesthetics, medicine, facilities, staff, etc.
Health insurance does not usually cover any kind of cosmetic surgery. However, if plastic eye surgery is done to improve vision (as in the case where the area over the eye droops down to obstruct vision), then your expenses may be reimbursed in whole or in part.
During surgery, small incisions are made around the eye with the goal of removing extra fat and muscle to create a firmer, younger-looking eye area. Using the skin's natural folds for the incisions minimizes scarring. Only fine stitches are used for plastic eye surgery.
When plastic eye surgery involves the lower eyelid, incisions are made along the line of the eyelashes and smile creases.
An unnaturally puffy eyelid can be corrected through transconjunctival blepharoplasty, by which excess fat is trimmed. In this procedure, the incision is made inside the lower eyelid. The stitches used in transconjunctival blepharoplasty cannot be seen by the naked eye and dissolve by themselves leaving no scar. This procedure can take anywhere from 1 to 2 hours.
Limits of Plastic Eye Surgery
This type of surgery does not remove fine lines and crow's feet. A separate, skin surface treatment that can enhance your skin's elasticity is an added option.
Unless plastic eye surgery involves a brow lift, it will not help the appearance of a sagging brow. Nor will it eliminate dark circles from under your eyes (for which topical applications exist in the market).
Your plastic surgeon will probably suggest added procedures to enhance your overall look.
Safety Issues
Serious complications from plastic eye surgery are rare. However, the occasional infection or allergic reaction to anesthetics has been known to happen. But the chances of this taking place are drastically minimized by pre-op examination of the patient's medical history, current medication, and preexisting allergies.
Some patients have been known to experience difficulty in closing their eyes, which condition is however generally not permanent.
Bruising, swelling, and redness are typical side effects of any type of plastic surgery, but none of these are permanent and will usually disappear within 10 days.
Plastic eye surgery is more risky for people certain conditions, such as:
Diabetes
Glaucoma and other eye diseases
Heart disease
High blood pressure
Hypothyroidism
Prices
For plastic eye surgery involving the upper eyelid, surgeons may charge in the area of $1,800 to $2,000. For procedures involving the upper and lower eyelids, prices may go as high as $4,500, or more depending on additional costs of anesthetics, medicine, facilities, staff, etc.
Health insurance does not usually cover any kind of cosmetic surgery. However, if plastic eye surgery is done to improve vision (as in the case where the area over the eye droops down to obstruct vision), then your expenses may be reimbursed in whole or in part.
Risks of Having Lasik Eye Surgery Problems
The probability of LASIK eye surgery problems went from 5% in the late-90s to less than 1% today. And technology isn't necessarily the reason.
Ophthalmology experts say the main reason for this is that a surgeon's success rate has been shown to naturally rise the more LASIK procedures he performs.
Complications approach zero for many qualified surgeons now that laser eye surgery is one of the most commonplace clinic based procedures. All an experienced surgeon has to do to achieve a 100% success rate is to carefully select candidates for surgery.
IK Eye Surgery Problems - Can They Be Fixed?
Say you're one of the very, very few that do experience complications after laser vision correction surgery. Will it be hard for you to have the problem fixed?
No. Even when the unlikely happens and LASIK eye surgery problems occur, they can be fixed by re-treatment or enhancement. Almost all the best surgeons offer a guarantee that, if you experience complications within a year after surgery, any additional treatments will be given to you absolutely free.
With the expertise available in America today, it will be rare indeed for LASIK surgery to result in permanent, substantial vision loss so that you're eyesight with lenses becomes poorer than before treatment.
The only way this can happen is if the person who performs your laser eye surgery lacks the credentials to do so. To make sure that your eyes are safe, go only to a Board-certified eye surgeon.
IK Eye Surgery Problems - How Can Technology Help?
Aside from picking the right surgeon, another good way of troubleshooting laser eye surgery problems is by selecting the kind of procedure you'll have done.
One of the most common problems with LASIK a few years back had to do with the cutting of the corneal flap. In LASIK, the eye surgeon creates a flap, after which he reshapes the cornea with a laser, and then returns the flap back to sort of serve as a natural bandage.
It used to be that the only way to do this would be using a microkeratome, which is a very fine metal blade with suction. If the flap is cut too thickly or too thinly, or if the flap wrinkles when it is returned, problems occur. But today, even the cutting of the corneal flap can be done with a laser.
The technology for flap creation via laser is marketed under the brand name IntraLase. Although a skilled surgeon can achieve an almost 100% success rate with a microkeratome, studies show that using a laser to create the flap has nearly eliminated complaints among LASIK patients.
Using a laser on the corneal flap increases accuracy so that defects, such as nighttime haloes, are pretty much eliminated. This option is, of course, more expensive.
Ophthalmology experts say the main reason for this is that a surgeon's success rate has been shown to naturally rise the more LASIK procedures he performs.
Complications approach zero for many qualified surgeons now that laser eye surgery is one of the most commonplace clinic based procedures. All an experienced surgeon has to do to achieve a 100% success rate is to carefully select candidates for surgery.
IK Eye Surgery Problems - Can They Be Fixed?
Say you're one of the very, very few that do experience complications after laser vision correction surgery. Will it be hard for you to have the problem fixed?
No. Even when the unlikely happens and LASIK eye surgery problems occur, they can be fixed by re-treatment or enhancement. Almost all the best surgeons offer a guarantee that, if you experience complications within a year after surgery, any additional treatments will be given to you absolutely free.
With the expertise available in America today, it will be rare indeed for LASIK surgery to result in permanent, substantial vision loss so that you're eyesight with lenses becomes poorer than before treatment.
The only way this can happen is if the person who performs your laser eye surgery lacks the credentials to do so. To make sure that your eyes are safe, go only to a Board-certified eye surgeon.
IK Eye Surgery Problems - How Can Technology Help?
Aside from picking the right surgeon, another good way of troubleshooting laser eye surgery problems is by selecting the kind of procedure you'll have done.
One of the most common problems with LASIK a few years back had to do with the cutting of the corneal flap. In LASIK, the eye surgeon creates a flap, after which he reshapes the cornea with a laser, and then returns the flap back to sort of serve as a natural bandage.
It used to be that the only way to do this would be using a microkeratome, which is a very fine metal blade with suction. If the flap is cut too thickly or too thinly, or if the flap wrinkles when it is returned, problems occur. But today, even the cutting of the corneal flap can be done with a laser.
The technology for flap creation via laser is marketed under the brand name IntraLase. Although a skilled surgeon can achieve an almost 100% success rate with a microkeratome, studies show that using a laser to create the flap has nearly eliminated complaints among LASIK patients.
Using a laser on the corneal flap increases accuracy so that defects, such as nighttime haloes, are pretty much eliminated. This option is, of course, more expensive.
Creating the Corneal Flap
LASIK is a two step procedure. In the first step, an instrument called a microkeratome lifts a thin surface layer of the cornea away from underlying layers in a process known as making a corneal flap.
Flap creation begins with the instillation of anesthetic eye drops. A suction ring is then centered around the cornea and a vacuum is generated to hold the ring on the eye. During the few seconds the vacuum is on, the vision grows dim and a mild pressure sensation is felt.
The microkeratome is then attached to the suction ring and passed across the surface of the cornea to create the flap.
Flap creation begins with the instillation of anesthetic eye drops. A suction ring is then centered around the cornea and a vacuum is generated to hold the ring on the eye. During the few seconds the vacuum is on, the vision grows dim and a mild pressure sensation is felt.
The microkeratome is then attached to the suction ring and passed across the surface of the cornea to create the flap.
LASIK - Price
LASIK (Laser-Assisted In Situ Keratomileusis) for $499? Too good to be true? Yes, according to Robert Maloney, M.D., a spokesman for the American Academy of Ophthalmology, and also director at Maloney Vision Center in LA. When the LASIK eye surgery price falls as low as $499 to $999 an eye, Maloney says that the clinic is probably cutting corners just to cut the price.
In exchange for their bargain basement prices, Maloney says the patient may be getting inferior equipment, a neophyte surgeon, faulty eye measurements, and deficient sterilization techniques.
What You Are Paying For?
An extremely low LASIK eye surgery price can mean ineffective surgery that will end up with you spending more to have a better surgeon repeat the procedure.
At worst, an insufficient LASIK eye surgery price can mean damage to your eye due to complications, such as infection, scarring, and serious injury to your cornea.
When you pay an amount within the LASIK eye surgery price range of a reputable clinic or surgeon, $1,500 to $2,500 per eye, you pay, first of all, for the surgeon’s experience. A surgeon's LASIK eye surgery experience generally decreases complications.
Although complications have been observed in less than 1% of LASIK cases, one study reports that complications are likely to be less after a surgeon has performed 1,000 LASIK procedures.
Aside from your surgeon’s skill, the LASIK eye surgery price also includes:
Purchase/lease/maintenance of laser equipment
Purchase of microkeratome, corneal ring segments, and other gadgets
Royalties to laser manufacturer (to recoup high cost of developing cutting-edge technology)
$100 to $150 an eye, for regular excimer laser
$145 to $250 an eye, for custom procedures
Cost of keeping the LASIK eye surgery sterile
Gloves, gowns, masks
Surgical solutions, medications
Overhead costs of the center or clinic
Rent
Utilities
Office equipment, supplies
Office and staff salaries, benefits
Marketing costs
Website fees
Advertisements
Seminars
Insurance
Professional fees
Co-management fees for other practitioners
Surgeon’s fee (especially if not on staff)
Evaluation, follow-up exams
Comprehensive eye exams
Technician
Equipment
Medications
Financing
Rather than settling for a rock bottom LASIK eye surgery price and putting your vision in jeopardy, it is wiser to pick a reputable surgeon and find a way to help finance your surgery.
Many good LASIK eye surgery centers offer financing plans to their patients. And although insurance plans normally do not cover LASIK eye surgery since it is regarded as a cosmetic procedure, employers can make an arrangement with a LASIK center for a special price for employees.
In exchange for their bargain basement prices, Maloney says the patient may be getting inferior equipment, a neophyte surgeon, faulty eye measurements, and deficient sterilization techniques.
What You Are Paying For?
An extremely low LASIK eye surgery price can mean ineffective surgery that will end up with you spending more to have a better surgeon repeat the procedure.
At worst, an insufficient LASIK eye surgery price can mean damage to your eye due to complications, such as infection, scarring, and serious injury to your cornea.
When you pay an amount within the LASIK eye surgery price range of a reputable clinic or surgeon, $1,500 to $2,500 per eye, you pay, first of all, for the surgeon’s experience. A surgeon's LASIK eye surgery experience generally decreases complications.
Although complications have been observed in less than 1% of LASIK cases, one study reports that complications are likely to be less after a surgeon has performed 1,000 LASIK procedures.
Aside from your surgeon’s skill, the LASIK eye surgery price also includes:
Purchase/lease/maintenance of laser equipment
Purchase of microkeratome, corneal ring segments, and other gadgets
Royalties to laser manufacturer (to recoup high cost of developing cutting-edge technology)
$100 to $150 an eye, for regular excimer laser
$145 to $250 an eye, for custom procedures
Cost of keeping the LASIK eye surgery sterile
Gloves, gowns, masks
Surgical solutions, medications
Overhead costs of the center or clinic
Rent
Utilities
Office equipment, supplies
Office and staff salaries, benefits
Marketing costs
Website fees
Advertisements
Seminars
Insurance
Professional fees
Co-management fees for other practitioners
Surgeon’s fee (especially if not on staff)
Evaluation, follow-up exams
Comprehensive eye exams
Technician
Equipment
Medications
Financing
Rather than settling for a rock bottom LASIK eye surgery price and putting your vision in jeopardy, it is wiser to pick a reputable surgeon and find a way to help finance your surgery.
Many good LASIK eye surgery centers offer financing plans to their patients. And although insurance plans normally do not cover LASIK eye surgery since it is regarded as a cosmetic procedure, employers can make an arrangement with a LASIK center for a special price for employees.
Astigmatism
Astigmatism causes light entering the eye at different axes to be focused different amounts. For example, light entering vertically (from 12 o'clock to 6 o'clock) may be focused more than light entering horizontally (from 9 o'clock to 3 o'clock). In an eye without astigmatism, light is focused the same amount in each axis.
The net result of astigmatism is blurred vision. Often letters appear slanted or with "tails" coming off of them. Sometimes the affected eye sees double.
When LASIK is performed for astigmatism, the cornea is reshaped by the laser to allow proper focusing, regardless of the axis light enters the eye. In practical terms, astigmatism is treated similar to nearsightedness and farsightedness, but with different amounts of treatment to each axis.
yperopia
Farsightedness
With hyperopia, the cornea does not bend incoming light enough, so light focuses behind the retina.
Hyperopia causes blurry vision up close and at distance. Hyperopia must be distinguished from presbyopia, which is clear vision at distance with a need for reading glasses up close.
When LASIK is performed for hyperopia, the corneal surface is gently steepened by the laser, resulting in more bending of incoming light and proper focusing on the retina.
With hyperopia, the cornea does not bend incoming light enough, so light focuses behind the retina.
Hyperopia causes blurry vision up close and at distance. Hyperopia must be distinguished from presbyopia, which is clear vision at distance with a need for reading glasses up close.
When LASIK is performed for hyperopia, the corneal surface is gently steepened by the laser, resulting in more bending of incoming light and proper focusing on the retina.
Myopia
Nearsightedness
With myopia, the cornea is too steeply curved and too much focusing power is produced. This makes distant objects blurry, because light is focused in front of the retina. Near objects remain clear.
When LASIK is performed for myopia, the laser gently flattens the cornea, which lessens the bending of incoming light, thereby allowing it to focus on the retina.
With myopia, the cornea is too steeply curved and too much focusing power is produced. This makes distant objects blurry, because light is focused in front of the retina. Near objects remain clear.
When LASIK is performed for myopia, the laser gently flattens the cornea, which lessens the bending of incoming light, thereby allowing it to focus on the retina.
Retinal Surgery
Retinal surgery generally deals with reattaching the retina when it is pulled or torn from its normal position. The retina lies in back of the eye, sending visual information via the optic nerve up to the brain. If breaks or holes occur along this connection, it may cause total blindness.
Retinal detachment can occur at any age for any number of reasons. However, the condition is most common around midlife or later. Retinal detachment is sometimes caused by an age-related shrinking of the eye's gelatinous contents (called vitreous) away from the surface, leading to a tear.
Some of other factors that increase the likelihood of a detached retina are:
Severe physical trauma
Ocular infection or inflammation
A previous cataract operation
Glaucoma
Nearsightedness
A preceding retinal detachment in the other eye
Family history of detached retinas
Weak retinal areas (can be detected by an ophthalmologist during eye exams)
Some retinal detachments are caused by diabetes or abnormalities in the development of the eye.
Preventive Measures
If you experience visual disturbances, such as dark spots, light flashes, and wavy or blurry vision, consult your ophthalmologist immediately. Retinal detachment is a serious, but easily treated condition.
However, prompt corrective surgery is crucial to preventing permanent damage to your vision. If left alone too long, retinal detachment can lead to your complete blindness or the shrinking of your eye.
That is why it is essential to have regular checkups with your ophthalmologist. More often than not, the weakness and vulnerability of the retina can be detected through eye exams.
When retinal detachment is confirmed, you will undergo several exams (e.g., opthalmoscopy, ultrasound) to determine which type of retinal surgery best suits your condition.
Risks in Retinal Surgery
There is no other alternative for repairing a detached retina but surgery. But just like any medical procedure, retinal surgery involves risks, such as:
Bleeding
Cataract
Infection
Pressure inside eye
Retinal surgery is a common procedure and is usually successful. However, a second surgery may be needed.
If the retina cannot be reconnected by retinal surgery, vision will become continually poorer until the eye becomes totally blind.
Benefits of Retinal Surgery
The foremost benefit is, of course, you will not lose your vision. Depending on the extent of the tear, it may take months for vision to improve. In certain cases, vision is never fully restored to the way it was originally.
This is the reason why early detection is crucial. Some patients with chronic retinal detachment still do not regain any vision despite retinal surgery.
Belated surgery may not do you any good because the more badly torn the retina is and the longer the tear has been present, the less likely it is that vision will return.
Visit your ophthalmologist the minute you experience any unusual visual symptoms.
Retinal detachment can occur at any age for any number of reasons. However, the condition is most common around midlife or later. Retinal detachment is sometimes caused by an age-related shrinking of the eye's gelatinous contents (called vitreous) away from the surface, leading to a tear.
Some of other factors that increase the likelihood of a detached retina are:
Severe physical trauma
Ocular infection or inflammation
A previous cataract operation
Glaucoma
Nearsightedness
A preceding retinal detachment in the other eye
Family history of detached retinas
Weak retinal areas (can be detected by an ophthalmologist during eye exams)
Some retinal detachments are caused by diabetes or abnormalities in the development of the eye.
Preventive Measures
If you experience visual disturbances, such as dark spots, light flashes, and wavy or blurry vision, consult your ophthalmologist immediately. Retinal detachment is a serious, but easily treated condition.
However, prompt corrective surgery is crucial to preventing permanent damage to your vision. If left alone too long, retinal detachment can lead to your complete blindness or the shrinking of your eye.
That is why it is essential to have regular checkups with your ophthalmologist. More often than not, the weakness and vulnerability of the retina can be detected through eye exams.
When retinal detachment is confirmed, you will undergo several exams (e.g., opthalmoscopy, ultrasound) to determine which type of retinal surgery best suits your condition.
Risks in Retinal Surgery
There is no other alternative for repairing a detached retina but surgery. But just like any medical procedure, retinal surgery involves risks, such as:
Bleeding
Cataract
Infection
Pressure inside eye
Retinal surgery is a common procedure and is usually successful. However, a second surgery may be needed.
If the retina cannot be reconnected by retinal surgery, vision will become continually poorer until the eye becomes totally blind.
Benefits of Retinal Surgery
The foremost benefit is, of course, you will not lose your vision. Depending on the extent of the tear, it may take months for vision to improve. In certain cases, vision is never fully restored to the way it was originally.
This is the reason why early detection is crucial. Some patients with chronic retinal detachment still do not regain any vision despite retinal surgery.
Belated surgery may not do you any good because the more badly torn the retina is and the longer the tear has been present, the less likely it is that vision will return.
Visit your ophthalmologist the minute you experience any unusual visual symptoms.
Tuesday, March 17, 2009
Horizon Advantage - Laser
Horizon Laser Vision Center uses the most advanced VISX Star S4™ Excimer Laser, the CustomVue, for both LASIK and PRK. This laser utilizes the latest technology currently available, which translates into greater accuracy of treatments, safety and improved visual outcomes. View an animation of the CustomVue procedure.
The VISX Star S4™ Excimer Laser System is a computer-assisted surgeon-controlled device that includes WaveScan® and ActiveTrak® devices combined with Variable Spot Scanning (VSS®) technology in addition to excimer lasers.
Excimer lasers are cool concentrated beams of ultraviolet light that safely, painlessly evaporate microscopic layers of the cornea leaving the underlying tissue virtually untouched.
The WaveScan uses light wave technology to identify and measure imperfections in an individual's eye 25 times more accurately than standard methods used for glasses and contact lenses. These measurements are used to individually customize laser vision correction. The WaveScan produces a WavePrint Map®, which is a visual representation of how a patient's entire optical system processes light. This map is much like a fingerprint - no two are alike. It allows for a more precise and detailed analysis of a patient's vision and is used by the ophthalmologist to ensure optimal treatment results.
ActiveTrak™ 3D Eye Tracker follows the tiny motions of your eye instantaneously and automatically, in all three dimensions, continually repositioning the laser to ensure accuracy. Without a tracking device, laser vision correction requires patients to hold their eyes as still as possible during the procedure. However, even a 'still' eye makes minute, involuntary movements - including moving slightly with each breath. With 3D ActiveTrak, you can relax during your laser vision correction, knowing the procedure will be delivered with precision and accuracy.
Variable Spot Scanning* (VSS™) is an exclusive VISX laser technology that allows for a larger treatment area. This offers the ophthalmologist greater flexibility in developing a more personalized laser vision procedure. It adjusts the laser beam size according to the treatment, minimizing corneal tissue removal. This also allows for quicker treatment times that are typically between 10 to 40 seconds. Variable Spot Scanning technology adds a blend zone that allows the treatment on the cornea to be extended to 8 mm which may help reduce the risk of night vision symptoms in certain patients.
The VISX laser has been used to perform over 5 million procedures globally. Visit the VISX web site to learn more about this advanced technology.
The VISX Star S4™ Excimer Laser System is a computer-assisted surgeon-controlled device that includes WaveScan® and ActiveTrak® devices combined with Variable Spot Scanning (VSS®) technology in addition to excimer lasers.
Excimer lasers are cool concentrated beams of ultraviolet light that safely, painlessly evaporate microscopic layers of the cornea leaving the underlying tissue virtually untouched.
The WaveScan uses light wave technology to identify and measure imperfections in an individual's eye 25 times more accurately than standard methods used for glasses and contact lenses. These measurements are used to individually customize laser vision correction. The WaveScan produces a WavePrint Map®, which is a visual representation of how a patient's entire optical system processes light. This map is much like a fingerprint - no two are alike. It allows for a more precise and detailed analysis of a patient's vision and is used by the ophthalmologist to ensure optimal treatment results.
ActiveTrak™ 3D Eye Tracker follows the tiny motions of your eye instantaneously and automatically, in all three dimensions, continually repositioning the laser to ensure accuracy. Without a tracking device, laser vision correction requires patients to hold their eyes as still as possible during the procedure. However, even a 'still' eye makes minute, involuntary movements - including moving slightly with each breath. With 3D ActiveTrak, you can relax during your laser vision correction, knowing the procedure will be delivered with precision and accuracy.
Variable Spot Scanning* (VSS™) is an exclusive VISX laser technology that allows for a larger treatment area. This offers the ophthalmologist greater flexibility in developing a more personalized laser vision procedure. It adjusts the laser beam size according to the treatment, minimizing corneal tissue removal. This also allows for quicker treatment times that are typically between 10 to 40 seconds. Variable Spot Scanning technology adds a blend zone that allows the treatment on the cornea to be extended to 8 mm which may help reduce the risk of night vision symptoms in certain patients.
The VISX laser has been used to perform over 5 million procedures globally. Visit the VISX web site to learn more about this advanced technology.
Why Does LASIK Cause Dry Eyes?
LASIK may cause some patients to experience Dry Eyes after their surgery. This is especially true if there was tendency toward dry Eyes before the LASIK procedure. During the LASIK procedure, a thin layer of tissue is created, called a flap, under which the actual laser energy is applied to reshape the cornea to correct nearsightedness, farsightedness and astigmatism. Anatomically, when the flap is created, the very fine cornea nerves may be severed as part of the LASIK procedure. This is a normal part of the procedure. However, these nerves are required in order "signal" the Lacrimal Gland to produce tears. So, sometimes, the temporary interruption of the corneal nerve impulses can actually cause a lesser amount of tears to be produced, resulting in Dry Eyes after LASIK. Sometimes if the Dry Eyes after LASIK are moderate or severe, your vision may actually be blurry due to the tear film instability. Your LASIK surgeon may elect to treat you for Dry Eyes before your LASIK procedure in order to fortify your tear film so that you will have a comfortable and asymptomatic post operative period. ALL LASIK patients will need to use artificial tears or lubricating drops as a matter of course as it helps the tear film reestablish itself after the LASIK procedure. During your consultation it is important to disclose any symptoms you may have of Dry Eyes and to disclose any medications you are taking that might predispose you to dry eyes after your LASIK procedure. In this way, your LASIK surgeon can take the necessary steps to prescribe whatever is necessary to obtain the best possible results for you. Fortunately, virtually all Dry Eyes symptoms after LASIK are temporary and gradually decrease over time until they end within a few months of having your LASIK procedure.
Dry Eye Diagnosed
There are several diagnostic tests that your eye care provider may use to help diagnose Dry Eyes. The first test is called a Schirmer Tear Test and involves placing a small strip of filter paper under the lower eyelid. This test measure the actual rate tear film production. A second test is called a Break Up Time and involves placing a small amount of fluorescent dye in your tears and observing the patterns of dryness of the tear film on the eye's surface. The third test is called a Lactoferrin Assay which can measure the amount of Lactoferrin in your tears indicating whether a Dry Eye is present.
Tear Film
A normal tear film consists of three layers. The outermost layer of the tear film is called the Oily Layer and is produced by the Meibomian Glands. This layer produces a smooth tear film and prevents it from evaporating too quickly. The middle layer is called the Aqueous layer is the watery layer that washes away debris from the eye's surface. It is produced by the Lacrimal Gland and is what we normally think of as tears. The innermost layer is called the Mucous Layer and is composed of mucous produced by the conjunctiva or the clear covering of the eye tissues. The Mucous Layer allows the normal tear film to stick to the surface of the eye. Your eyelids act to smooth the tear film and smooth it over the eye's surface each time you blink. This produces a smooth optical surface and clear vision. People who have Dry Eyes and do not have a smooth and regular tear film often have blurry vision from the lack of a smooth tear film.
Dry Eye Syndrome?
The eye requires that it be continuously covered by natural tears produced by the eye. Dry Eyes is a condition where some people so not produce enough tears to keep the eye comfortable and healthy. This condition where not enough tears are produced is called Dry Eyes. Tears may be produced by two different methods in the eye. In the first method, tears are produced at a slow and steady rate and provides the eye with its natural lubrication. In the second method, your eyes produce large quantities of tears in response to irritation or strong emotions. If your eyes are healthy they constantly produce enough lubricating tears. If your eyes are irritated by getting something in them such as a foreign body, crying...or if they are too dry, they will produce an excessive amount of tears.
PROVEN Technology
With an absolute commitment to optimal patient outcomes, Dr Wolfe believes in the need for continued investment in the latest technology to be a leader in the industry.
The IntraLase method is the first technology to offer a truly all-laser, blade-free LASIK procedure – using a computer-guided, ultra-fast femtosecond laser. It is the safest and most advanced laser eye technology in the world, and it’s clinically proven to increase your potential to achieve 20/20 vision.
Our LadarVision laser is a quantum leap forward in laser eye surgery offering highly accurate, individually tailored LASIK and ASLA treatments.
The LadarWave is a diagnostic tool that provides us with very detailed information about your eyes. This sophisticated technology allows us to customise your laser eye surgery, diagnosing a wide range of visual irregularities. Unlike most other clinics, Vistaeyes includes customised treatment as a standard part of its procedures.
Our LadarVision laser incorporates the most advanced laser radar eye-tracking system, called the LadarTracker. Unlike older, video-based technology, the LadarTracker confirms the position of your eye 4000 times per second and monitors the movement of your eye during the procedure, helping to direct the laser beam onto the cornea with maximum precision. This allows you to relax during the procedure, without having to worry about freezing your gaze.
At Vistaeyes, we are dedicated to helping you achieve the best possible visual outcome.
For more information on our technology, click on the links below. To see how our Customised technology can enhance the result of your laser eye surgery, try our Vision Simulator.
The IntraLase method is the first technology to offer a truly all-laser, blade-free LASIK procedure – using a computer-guided, ultra-fast femtosecond laser. It is the safest and most advanced laser eye technology in the world, and it’s clinically proven to increase your potential to achieve 20/20 vision.
Our LadarVision laser is a quantum leap forward in laser eye surgery offering highly accurate, individually tailored LASIK and ASLA treatments.
The LadarWave is a diagnostic tool that provides us with very detailed information about your eyes. This sophisticated technology allows us to customise your laser eye surgery, diagnosing a wide range of visual irregularities. Unlike most other clinics, Vistaeyes includes customised treatment as a standard part of its procedures.
Our LadarVision laser incorporates the most advanced laser radar eye-tracking system, called the LadarTracker. Unlike older, video-based technology, the LadarTracker confirms the position of your eye 4000 times per second and monitors the movement of your eye during the procedure, helping to direct the laser beam onto the cornea with maximum precision. This allows you to relax during the procedure, without having to worry about freezing your gaze.
At Vistaeyes, we are dedicated to helping you achieve the best possible visual outcome.
For more information on our technology, click on the links below. To see how our Customised technology can enhance the result of your laser eye surgery, try our Vision Simulator.
How Custom Wavefront LASIK Works
LaserVue surgeons will begin by using the Wavefront device to transmit a safe ray of light into your eye. The light is then reflected back off the retina, out through the pupil, and into the device, where the reflected wave of light is received and arranged into a unique pattern that captures your lower and higher order aberrations.
All of these visual irregularities are then displayed as a wavefront map. The map provides information on more than just the front surface of the eye. It shows the variability of how light is focused in different areas of the eye. This information is then transferred to the excimer laser, enabling the surgeon to customize the LASIK procedure to your unique visual requirements. The final result is a treatment as unique as your DNA or a fingerprint. Like conventional LASIK, custom LASIK won't cure all vision-related problems, so it's important to discuss its applications with LaserVue doctors to determine if you are a good candidate.
All of these visual irregularities are then displayed as a wavefront map. The map provides information on more than just the front surface of the eye. It shows the variability of how light is focused in different areas of the eye. This information is then transferred to the excimer laser, enabling the surgeon to customize the LASIK procedure to your unique visual requirements. The final result is a treatment as unique as your DNA or a fingerprint. Like conventional LASIK, custom LASIK won't cure all vision-related problems, so it's important to discuss its applications with LaserVue doctors to determine if you are a good candidate.
Potential Benefits of Wavefront LASIK
Wavefront technology is groundbreaking because it has the potential to improve not only how much you can see, visual acuity measured by the standard 20/20 eye chart, but also how well you can see, in terms of contrast sensitivity and fine detail. This translates into a reduced risk of glare, halos and difficulty with night vision post-LASIK.
How much you see depends on what lower order aberrations you have; lower order aberrations are also called refractive errors and include myopia, hyperopia, and astigmatism. Traditional LASIK treats these lower order aberrations.
How well you see can depends on what higher order aberrations you have; higher order aberrations are irregularities other than refractive errors, and can cause such problems as decreased contrast sensitivity or night vision, glare, shadows, and halos. Higher order aberrations do not always affect vision. Wavefront LASIK treats both lower and higher order aberrations.
How much you see depends on what lower order aberrations you have; lower order aberrations are also called refractive errors and include myopia, hyperopia, and astigmatism. Traditional LASIK treats these lower order aberrations.
How well you see can depends on what higher order aberrations you have; higher order aberrations are irregularities other than refractive errors, and can cause such problems as decreased contrast sensitivity or night vision, glare, shadows, and halos. Higher order aberrations do not always affect vision. Wavefront LASIK treats both lower and higher order aberrations.
The Next Generation in Laser Eye Surgery
LaserVue strives to bring the newest Wavefront LASIK technology to our patients from our San Francisco, San Jose, Oakland East Bay, and Santa Rosa offices.
No two eyes are the same. Like your DNA or fingerprint, your vision is unique.
Until now, laser vision correction treatment was based on diagnostic technology similar to that used for the prescription eyeglasses or contact lenses. Wavefront LASIK at LaserVue Eye Center takes laser vision correction to an entirely new, personalized level by combining exclusive diagnostic technology with the excimer laser.
The advanced diagnostic portion of the wavefront technology produces a precise, detailed analysis of your vision and provides a custom laser vision correction plan that addresses your individual needs. This Wavefront data is coordinated with the VISX STAR S4 & Alcon Allegretto Wave Excimer Laser System to create a new level of vision, comfort, and safety.
No two eyes are the same. Like your DNA or fingerprint, your vision is unique.
Until now, laser vision correction treatment was based on diagnostic technology similar to that used for the prescription eyeglasses or contact lenses. Wavefront LASIK at LaserVue Eye Center takes laser vision correction to an entirely new, personalized level by combining exclusive diagnostic technology with the excimer laser.
The advanced diagnostic portion of the wavefront technology produces a precise, detailed analysis of your vision and provides a custom laser vision correction plan that addresses your individual needs. This Wavefront data is coordinated with the VISX STAR S4 & Alcon Allegretto Wave Excimer Laser System to create a new level of vision, comfort, and safety.
Steps of the Lasik Procedure
Step One
Wavefront technology allows the LASIK treatment to
be customized for each individual. The WaveFront Map captures unique imperfections in each individual’s eyes, linking diagnostic information with laser treatment. Using this Wavefront data, LaserVue doctors obtain a "fingerprint" image and map of your entire optical system. This information is evaluated by the surgeon and transferered to the excimer laser.
STEP TWO
The IntraLase (femtosecond) Laser is used to create the corneal flap with the safety and precision of a computer-controlled laser beam. This laser replaces the hand-held microkeratome blade historically used in the first step of LASIK. The ultrafast laser virtually eliminates almost all of the most severe, sight-threatening LASIK complications related to microkeratomes. The femtosecond laser also creates an optimal surface below the flap, allowing better visual outcomes. The surgeon then gently folds this laser generated flap back to prepare the eye for the excimer laser treatment.
Step three
A cool laser beam is used to painlessly reshape the cornea and eliminate sources of aberration through a series of computer-driven pulses based on the patient's refractive and wavefront error. The laser beam is able to vaporize microscopic amounts of the cornea, enabling a precision previously unattainable.
Step Four
Finally, the protective flap that was created in step two is gently placed back in its original position. The cornea begins healing immediately and you can return home. This highly advanced combination of LASIK technologies has been proven in extensive clinical trials to provide both excellent safety and outstanding visual outcomes — beyond 20/20 in many cases. Most patients are able to return to work and drive the next day.
Wavefront technology allows the LASIK treatment to
be customized for each individual. The WaveFront Map captures unique imperfections in each individual’s eyes, linking diagnostic information with laser treatment. Using this Wavefront data, LaserVue doctors obtain a "fingerprint" image and map of your entire optical system. This information is evaluated by the surgeon and transferered to the excimer laser.
STEP TWO
The IntraLase (femtosecond) Laser is used to create the corneal flap with the safety and precision of a computer-controlled laser beam. This laser replaces the hand-held microkeratome blade historically used in the first step of LASIK. The ultrafast laser virtually eliminates almost all of the most severe, sight-threatening LASIK complications related to microkeratomes. The femtosecond laser also creates an optimal surface below the flap, allowing better visual outcomes. The surgeon then gently folds this laser generated flap back to prepare the eye for the excimer laser treatment.
Step three
A cool laser beam is used to painlessly reshape the cornea and eliminate sources of aberration through a series of computer-driven pulses based on the patient's refractive and wavefront error. The laser beam is able to vaporize microscopic amounts of the cornea, enabling a precision previously unattainable.
Step Four
Finally, the protective flap that was created in step two is gently placed back in its original position. The cornea begins healing immediately and you can return home. This highly advanced combination of LASIK technologies has been proven in extensive clinical trials to provide both excellent safety and outstanding visual outcomes — beyond 20/20 in many cases. Most patients are able to return to work and drive the next day.
American Society of Cataract and Refractive Surgery
Several Major Studies Presented at American Society of Cataract and Refractive Surgery
Annual Symposium Point to Wavefront Technology as Future of Laser Eye Surgery
April 14, 2003 (San Francisco, CA) - After receiving wavefront-guided LASIK, a promising new technology that allows physicians to customize the LASIK procedure, an overwhelming majority of patients experienced sharper, crisper vision with 96 percent of treated eyes attaining 20/20 vision, according to data presented today at the annual scientific sessions of the American Society of Cataract and Refractive Surgery (ASCRS).
Wavefront-guided LASIK works by beaming light through the eye, taking detailed measurements as the light bounces back. These measurements are recorded on a virtual map, highlighting each patient's individual visual imperfections. During LASIK surgery, this map is used by the surgeon to tailor the laser beam settings, making the procedure customized to the precise vision specifications of each individual patient. As a result, wavefront-guided LASIK leads to sharper, crisper vision, and a reduction in many of the most common complications associated with LASIK, such as nighttime vision difficulties such as glare and halos.
"This new technology has been tremendously beneficial to the patients, because we have provided them with enhanced sharpness and quality of vision with fewer complications, which means higher patient satisfaction," says Douglas Koch, MD, trial investigator and professor of ophthalmology at Baylor College of Medicine in Houston, Texas. "In addition there is an important diagnostic role, since it enables us to approach the surgery with a clearer understanding of each individual's unique correction needs."
The multicenter study evaluated the use of bilateral wavefront-guided LASIK in 320 eyes of 173 patients. While 94 percent of eyes reached 20/20 vision, an important clinical vision standard, a remarkable 74 percent saw 20/16 or better, a significant improvement over this standard for good vision.
The findings are supported by other studies on wavefront technology to be presented at ASCRS' annual meeting, which contain similarly encouraging results. Notably, a study presented by Stephen G. Slade, MD, national medical director, TLC Laser Eye Centers, found that a very high percentage of patients reported that light sensitivity (92.4 percent), glare (84.7 percent) and night driving difficulties (89.7 percent) were improved or unchanged after wavefront-guided surgery. In addition to reduced complications, almost 99 percent of patients reported that they were "very satisfied" with the wavefront-guided surgery.
"ASCRS applauds all technological advancements in the field of laser eye surgery, especially when they have such a significant impact on patient outcomes," says Stephen S. Lane, MD, ASCRS president, clinical professor of ophthalmology, University of Minnesota in St. Paul, Minnesota. "In fact, we have just included information on wavefront in our LASIK Screening Guidelines to ensure that patients are informed about this new tool and how it may affect their vision quality."
LASIK is currently the most common type of laser eye surgery in the U.S., performed an estimated 1.5 million times each year. The LASIK Screening Guidelines, the first initiative of the Eye Surgery Education Council (ESEC), were designed to help patients assess whether they are an 'ideal,' 'less than ideal,' or 'non' LASIK candidate. The LASIK guidelines outline what patients should expect from their doctor and from the procedure itself. The recently-updated guidelines include a description of wavefront and how it works, potential evaluation and treatment uses for the technology, and a discussion of expectations for wavefront-guided procedures.
Multicenter Trial of Wavefront-Guided LASIK, Robert Maloney, MD, Colman Kraff, MD, William Colberston, MD, Terance O'Brien, MD, Douglas Koch, MD. ASCRS/ASOA Annual Symposium & Congress, San Francisco, April 2003.
U.S. Clinical Trial of LASIK for Myopia with the Zyoptix System: Efficacy Assessment an Patient Satisfaction, Stephen G. Slade, MD, ASCRS/ASOA Annual Symposium & Congress, San Francisco, April 2003.
Annual Symposium Point to Wavefront Technology as Future of Laser Eye Surgery
April 14, 2003 (San Francisco, CA) - After receiving wavefront-guided LASIK, a promising new technology that allows physicians to customize the LASIK procedure, an overwhelming majority of patients experienced sharper, crisper vision with 96 percent of treated eyes attaining 20/20 vision, according to data presented today at the annual scientific sessions of the American Society of Cataract and Refractive Surgery (ASCRS).
Wavefront-guided LASIK works by beaming light through the eye, taking detailed measurements as the light bounces back. These measurements are recorded on a virtual map, highlighting each patient's individual visual imperfections. During LASIK surgery, this map is used by the surgeon to tailor the laser beam settings, making the procedure customized to the precise vision specifications of each individual patient. As a result, wavefront-guided LASIK leads to sharper, crisper vision, and a reduction in many of the most common complications associated with LASIK, such as nighttime vision difficulties such as glare and halos.
"This new technology has been tremendously beneficial to the patients, because we have provided them with enhanced sharpness and quality of vision with fewer complications, which means higher patient satisfaction," says Douglas Koch, MD, trial investigator and professor of ophthalmology at Baylor College of Medicine in Houston, Texas. "In addition there is an important diagnostic role, since it enables us to approach the surgery with a clearer understanding of each individual's unique correction needs."
The multicenter study evaluated the use of bilateral wavefront-guided LASIK in 320 eyes of 173 patients. While 94 percent of eyes reached 20/20 vision, an important clinical vision standard, a remarkable 74 percent saw 20/16 or better, a significant improvement over this standard for good vision.
The findings are supported by other studies on wavefront technology to be presented at ASCRS' annual meeting, which contain similarly encouraging results. Notably, a study presented by Stephen G. Slade, MD, national medical director, TLC Laser Eye Centers, found that a very high percentage of patients reported that light sensitivity (92.4 percent), glare (84.7 percent) and night driving difficulties (89.7 percent) were improved or unchanged after wavefront-guided surgery. In addition to reduced complications, almost 99 percent of patients reported that they were "very satisfied" with the wavefront-guided surgery.
"ASCRS applauds all technological advancements in the field of laser eye surgery, especially when they have such a significant impact on patient outcomes," says Stephen S. Lane, MD, ASCRS president, clinical professor of ophthalmology, University of Minnesota in St. Paul, Minnesota. "In fact, we have just included information on wavefront in our LASIK Screening Guidelines to ensure that patients are informed about this new tool and how it may affect their vision quality."
LASIK is currently the most common type of laser eye surgery in the U.S., performed an estimated 1.5 million times each year. The LASIK Screening Guidelines, the first initiative of the Eye Surgery Education Council (ESEC), were designed to help patients assess whether they are an 'ideal,' 'less than ideal,' or 'non' LASIK candidate. The LASIK guidelines outline what patients should expect from their doctor and from the procedure itself. The recently-updated guidelines include a description of wavefront and how it works, potential evaluation and treatment uses for the technology, and a discussion of expectations for wavefront-guided procedures.
Multicenter Trial of Wavefront-Guided LASIK, Robert Maloney, MD, Colman Kraff, MD, William Colberston, MD, Terance O'Brien, MD, Douglas Koch, MD. ASCRS/ASOA Annual Symposium & Congress, San Francisco, April 2003.
U.S. Clinical Trial of LASIK for Myopia with the Zyoptix System: Efficacy Assessment an Patient Satisfaction, Stephen G. Slade, MD, ASCRS/ASOA Annual Symposium & Congress, San Francisco, April 2003.
CONTRAINDICATIONS
The treatment should not be performed and the doctor informed
if you suffer from any of the following
Þ uncontrolled vascular disease or with autoimmune disease
Þ are immune-compromised or on immunity-suppressing drugs or have a previous history of keloid formation
Þ pregnancy, nursing, expecting to become pregnant within six months following the LASIK procedure or on hormone therapy for gynaecological dysfunction
Þ have residual, recurrent, or active eye disease(s) or abnormality except for myopia [or hyperopia] in either eye
Þ have any active or residual systemic disease(s) likely to affect wound healing capability
Þ had herpes infection of the eye in the past
Þ have unstable or uncontrolled diabetes
Þ have progressive myopia or hyperopia [unstable spectacle power]
Þ amblyopia (lazy eye); glaucoma; severe dry eye
if you suffer from any of the following
Þ uncontrolled vascular disease or with autoimmune disease
Þ are immune-compromised or on immunity-suppressing drugs or have a previous history of keloid formation
Þ pregnancy, nursing, expecting to become pregnant within six months following the LASIK procedure or on hormone therapy for gynaecological dysfunction
Þ have residual, recurrent, or active eye disease(s) or abnormality except for myopia [or hyperopia] in either eye
Þ have any active or residual systemic disease(s) likely to affect wound healing capability
Þ had herpes infection of the eye in the past
Þ have unstable or uncontrolled diabetes
Þ have progressive myopia or hyperopia [unstable spectacle power]
Þ amblyopia (lazy eye); glaucoma; severe dry eye
RECOVERY
An improvement in vision is noticed within 4-6 hours with restoration of functional vision by the next morning. However, complete recovery may take upto 48 hours. Some people get back to work the day after treatment. Two or three days are suggested. For a few days after LASIK, patients may experience blurriness of vision. This is part of the healing process and this blurriness usually clears up in a few days.
LASIK is a permanent treatment. However, patients who are 40 years and above, may require reading glasses. During your consultation we will give you can an idea of the procedure and the level of vision you can expect. Millions of patients worldwide and thousands with our doctor have had an Excimer laser refractive procedure done on them successfully.
LASIK is a permanent treatment. However, patients who are 40 years and above, may require reading glasses. During your consultation we will give you can an idea of the procedure and the level of vision you can expect. Millions of patients worldwide and thousands with our doctor have had an Excimer laser refractive procedure done on them successfully.
LASIK Principles
Light falling on the cornea [the front surface of the eye] has a smooth curvature- referred to as a "wavefront". As this smooth wavefront shape courses through the various optics of the eye, ocular aberrations [imperfections] are induced. It results in an irregular wavefront curvature reaching the retinal surface, which degrades the retinal image quality. An aberration-free eye would result in a smooth wavefront image on the retinal surface. Wavefront-guided customized LASIK, also referred to as "customized ablation" or custom LASIK performs corrections based on individual wavefront measurements.
Current refractive procedures such as traditional or standard LASIK correct lower order aberrations such as spherical and cylindrical numbers alone. However, higher order aberrations affect the quality of vision and may not significantly affect the vision as read on the chart. It is these subtle deviations from the ideal optical system, which can be corrected by wavefront procedures, and thereby improve image quality.
Current refractive procedures such as traditional or standard LASIK correct lower order aberrations such as spherical and cylindrical numbers alone. However, higher order aberrations affect the quality of vision and may not significantly affect the vision as read on the chart. It is these subtle deviations from the ideal optical system, which can be corrected by wavefront procedures, and thereby improve image quality.
PerfectPulse Technology
Provides personalized laser vision correction
Safety and Precision
ALLEGRETTO WAVE ® laser systems apply PerfectPulse Technology® to help ensure safe and precise work at a high speed.PerfectPulse Technology® simply means that every laser pulse is completely controlled from its generation to the point when it contacts the cornea.Each ultra-thin laser pulse is used to sculpt the corneal surface with the utmost precision.In order to further enhance the precision of the treatment, PerfectPulse Technology® uses advanced high-speed eye-tracking to follow the eye’s fastest movements and to help ensure an accurate placement of each laser pulse on the cornea.During the treatment, the energy stability of every pulse is controlled to ensure that each laser pulse creates the same accurate result.
In the ALLEGRETTO WAVE® Excimer Laser clinical trials conducted in the U.S., for instance, some patients reported that their night-driving glare had improved after the treatment.*
*Refer to product labeling
The ALLEGRETTO WAVE® Excimer Laser works with a pulse frequency of 200 Hz. This results in a correction time of only 4 seconds per diopter (considering a fully corrected optical zone of 6.5 mm).The rapid repetition rate may result in more comfort for our patients and a minimization of external influences.
Wavefront Optimized® Ablation Profiles > Excellent Visual Acuity
WaveLight ALLEGRETTO WAVE® lasers customize every treatment to the patient’s individual prescription and cornea while aiming to improve what nature originally designed. The proprietary Wavefront Optimized® treatment considers the unique curvature of the eye, preserving quality of vision and addressing the spherical distortions that may induce glare and affect night vision.
The Principle Behind Wavefront Optimized® Treatments The natural shape of the human cornea is aspheric. This means that all light rays meet in one sharp focus point. Therefore, the ALLEGRETTO WAVE® laser system performs an ablation with the objective to maintain a natural postoperative corneal shape and thus to preserve the cornea's aspheric shape.LaserVue Eye Center is proud to introduce the most advanced options in laser vision correction today. Our premium, no compromise approach has led us to choose the these laser technologies. Every treatment is customized to the patient's individual refraction and corneal curvature by LaserVue Eye Center doctors.
Safety and Precision
ALLEGRETTO WAVE ® laser systems apply PerfectPulse Technology® to help ensure safe and precise work at a high speed.PerfectPulse Technology® simply means that every laser pulse is completely controlled from its generation to the point when it contacts the cornea.Each ultra-thin laser pulse is used to sculpt the corneal surface with the utmost precision.In order to further enhance the precision of the treatment, PerfectPulse Technology® uses advanced high-speed eye-tracking to follow the eye’s fastest movements and to help ensure an accurate placement of each laser pulse on the cornea.During the treatment, the energy stability of every pulse is controlled to ensure that each laser pulse creates the same accurate result.
In the ALLEGRETTO WAVE® Excimer Laser clinical trials conducted in the U.S., for instance, some patients reported that their night-driving glare had improved after the treatment.*
*Refer to product labeling
The ALLEGRETTO WAVE® Excimer Laser works with a pulse frequency of 200 Hz. This results in a correction time of only 4 seconds per diopter (considering a fully corrected optical zone of 6.5 mm).The rapid repetition rate may result in more comfort for our patients and a minimization of external influences.
Wavefront Optimized® Ablation Profiles > Excellent Visual Acuity
WaveLight ALLEGRETTO WAVE® lasers customize every treatment to the patient’s individual prescription and cornea while aiming to improve what nature originally designed. The proprietary Wavefront Optimized® treatment considers the unique curvature of the eye, preserving quality of vision and addressing the spherical distortions that may induce glare and affect night vision.
The Principle Behind Wavefront Optimized® Treatments The natural shape of the human cornea is aspheric. This means that all light rays meet in one sharp focus point. Therefore, the ALLEGRETTO WAVE® laser system performs an ablation with the objective to maintain a natural postoperative corneal shape and thus to preserve the cornea's aspheric shape.LaserVue Eye Center is proud to introduce the most advanced options in laser vision correction today. Our premium, no compromise approach has led us to choose the these laser technologies. Every treatment is customized to the patient's individual refraction and corneal curvature by LaserVue Eye Center doctors.
VISX Excimer Laser System features
VISX laser systems produce smoother ablations on the surface of the cornea after the procedure; promoting faster healing and result in better vision.
VISX laser systems allow the doctor to track your eye movement in all three dimensions during the treatment, for greater control.
VISX laser systems achieve an optical zone that may result in reduced problems with night vision.
VISX ActiveTrak™ laser systems produce seven variable-sized beams, giving the doctor greater flexibility and allowing for a faster, smoother treatment with precise corneal shaping.
VISX laser systems require a shorter procedure time, which enhances comfort and may reduce the risk of postoperative complications.
These features aren't the only reasons why the surgeons at LaserVue have chosen VISX laser systems. Their exclusive focus on laser vision correction technology, combined with a history of excellence in design and rigorous FDA approvals, result in a clinical experience and knowledge that is unmatched in the industry. And if that isn't enough, ask one of our over-two million patients, including eye care professionals and their staff, who have undergone successful procedures with VISX laser systems.
VISX laser systems allow the doctor to track your eye movement in all three dimensions during the treatment, for greater control.
VISX laser systems achieve an optical zone that may result in reduced problems with night vision.
VISX ActiveTrak™ laser systems produce seven variable-sized beams, giving the doctor greater flexibility and allowing for a faster, smoother treatment with precise corneal shaping.
VISX laser systems require a shorter procedure time, which enhances comfort and may reduce the risk of postoperative complications.
These features aren't the only reasons why the surgeons at LaserVue have chosen VISX laser systems. Their exclusive focus on laser vision correction technology, combined with a history of excellence in design and rigorous FDA approvals, result in a clinical experience and knowledge that is unmatched in the industry. And if that isn't enough, ask one of our over-two million patients, including eye care professionals and their staff, who have undergone successful procedures with VISX laser systems.
WaveFront technology
The Fingerprint Of Your Vision™
Your vision is unique—as personal as your fingerprint or your DNA. Wavefront mapping of your eyes provides LaserVue doctors information on more than just the corneal surface of your eye. It reveals the way your entire optical system processes light. The Wavefront Map provides a new level of diagnostic information previously unavailable to the doctor.
Using this information, the doctors at LaserVue can:
Accurately assess whether you're a good candidate for laser vision correction. Anyone who is considering laser vision correction should obtain a Wavefront Map as the first step.
Along with the other diagnostic tests that LaserVue doctors perform, a personalized treatment plan can then be developed to address your unique vision needs.
The Wavefront Map: from the cosmos to LaserVue Eye Center office's
The Wavefront Map is derived from technology first developed to correct distortions of light waves from space. This allowed researchers to accurately view images of stars and planets. The Wavefront Map uses the same technology to measure light waves as they travel through your eye. This technology provides a precise and more detailed analysis of your vision.
Your vision is unique—as personal as your fingerprint or your DNA. Wavefront mapping of your eyes provides LaserVue doctors information on more than just the corneal surface of your eye. It reveals the way your entire optical system processes light. The Wavefront Map provides a new level of diagnostic information previously unavailable to the doctor.
Using this information, the doctors at LaserVue can:
Accurately assess whether you're a good candidate for laser vision correction. Anyone who is considering laser vision correction should obtain a Wavefront Map as the first step.
Along with the other diagnostic tests that LaserVue doctors perform, a personalized treatment plan can then be developed to address your unique vision needs.
The Wavefront Map: from the cosmos to LaserVue Eye Center office's
The Wavefront Map is derived from technology first developed to correct distortions of light waves from space. This allowed researchers to accurately view images of stars and planets. The Wavefront Map uses the same technology to measure light waves as they travel through your eye. This technology provides a precise and more detailed analysis of your vision.
WaveFront technology
The Fingerprint Of Your Vision™
Your vision is unique—as personal as your fingerprint or your DNA. Wavefront mapping of your eyes provides LaserVue doctors information on more than just the corneal surface of your eye. It reveals the way your entire optical system processes light. The Wavefront Map provides a new level of diagnostic information previously unavailable to the doctor.
Using this information, the doctors at LaserVue can:
Accurately assess whether you're a good candidate for laser vision correction. Anyone who is considering laser vision correction should obtain a Wavefront Map as the first step.
Along with the other diagnostic tests that LaserVue doctors perform, a personalized treatment plan can then be developed to address your unique vision needs.
The Wavefront Map: from the cosmos to LaserVue Eye Center office's
The Wavefront Map is derived from technology first developed to correct distortions of light waves from space. This allowed researchers to accurately view images of stars and planets. The Wavefront Map uses the same technology to measure light waves as they travel through your eye. This technology provides a precise and more detailed analysis of your vision.
Your vision is unique—as personal as your fingerprint or your DNA. Wavefront mapping of your eyes provides LaserVue doctors information on more than just the corneal surface of your eye. It reveals the way your entire optical system processes light. The Wavefront Map provides a new level of diagnostic information previously unavailable to the doctor.
Using this information, the doctors at LaserVue can:
Accurately assess whether you're a good candidate for laser vision correction. Anyone who is considering laser vision correction should obtain a Wavefront Map as the first step.
Along with the other diagnostic tests that LaserVue doctors perform, a personalized treatment plan can then be developed to address your unique vision needs.
The Wavefront Map: from the cosmos to LaserVue Eye Center office's
The Wavefront Map is derived from technology first developed to correct distortions of light waves from space. This allowed researchers to accurately view images of stars and planets. The Wavefront Map uses the same technology to measure light waves as they travel through your eye. This technology provides a precise and more detailed analysis of your vision.
iLASIK technology: NASA approved
Advanced CustomVue Laser Vision Correction: The Most Advanced Custom Wavefront-Guided Treatment Available
The Advanced CustomVue procedure represents the next generation of laser vision correction. Combining the technologies of the WaveScan WaveFront System and the VISX STAR S4 IR Excimer Laser, the Advanced CustomVue procedure is now a potentially superior vision correction alternative to glasses and contact lenses. Clinical studies have shown that 91 percent of all patients treated were as satisfied or more satisfied with their vision after the Advanced CustomVue procedure than they were before the procedure with glasses or contact lenses. Clinical studies also showed high participant satisfaction with night vision after the Advanced CustomVue procedure.
Wavefront-guided Advanced CustomVue™ treatment tailors a distinct correction for each individual eye and its unique imperfections. As demonstrated in clinical trials, the Advanced CustomVue procedure can potentially produce better vision than is possible with glasses or contact lenses. Notable Outcomes:During clinical trials for FDA approval, participants undergoing Advanced CustomVue treatment for all indications achieved the following outcomes:
More than 95 percent of all clinical study participants could pass a driving test without glasses or contact lenses one year after treatment.
Almost three quarters of all clinical study participants could see 20/20 or better without glasses or contact lenses one year after treatment.
Clinical study results showed high participant satisfaction with night vision after the VISX™ Advanced CustomVue procedure compared to night vision before with glasses or contact lenses.
The Advanced CustomVue procedure represents the next generation of laser vision correction. Combining the technologies of the WaveScan WaveFront System and the VISX STAR S4 IR Excimer Laser, the Advanced CustomVue procedure is now a potentially superior vision correction alternative to glasses and contact lenses. Clinical studies have shown that 91 percent of all patients treated were as satisfied or more satisfied with their vision after the Advanced CustomVue procedure than they were before the procedure with glasses or contact lenses. Clinical studies also showed high participant satisfaction with night vision after the Advanced CustomVue procedure.
Wavefront-guided Advanced CustomVue™ treatment tailors a distinct correction for each individual eye and its unique imperfections. As demonstrated in clinical trials, the Advanced CustomVue procedure can potentially produce better vision than is possible with glasses or contact lenses. Notable Outcomes:During clinical trials for FDA approval, participants undergoing Advanced CustomVue treatment for all indications achieved the following outcomes:
More than 95 percent of all clinical study participants could pass a driving test without glasses or contact lenses one year after treatment.
Almost three quarters of all clinical study participants could see 20/20 or better without glasses or contact lenses one year after treatment.
Clinical study results showed high participant satisfaction with night vision after the VISX™ Advanced CustomVue procedure compared to night vision before with glasses or contact lenses.
Blade-Free Wavefront Laser Vision Correction
Expect the Best at LaserVue Eye Center
Drs. Bansal, Singh, and Boghossian at LaserVue strive to offer the most advanced laser eye surgery technology to our patients in the San Francisco, South Bay, San Jose, Oakland East Bay, and Santa Rosa offices.
Our LASIK eye surgery specialists have performed over 20,000 LASIK procedures. Hundreds of doctors, surgeons, and other health care workers have trusted their eyes to our laser vision correction team based around the San Francisco Bay Area.
Drs. Singh and Boghossian have each had laser vision correction themselves. Both now enjoy 20/20 vision without glasses or contacts. Many of our staff at LaserVue have also had laser vision correction. Come see why so many health care professionals, lawyers, pilots, athletes, business professionals, and others just like you choose LaserVue Eye Center!
Our doctors have helped train many local LASIK surgeons, and co-managing doctors through proctoring, lectures, and articles. These doctors have chosen our laser vision correction team for their own LASIK as well as that of their families and staff.
The Multiple LASER Advantage at LaserVue
Be aware of the new laser technology available to you. Most of the lasers do a fine job and the biggest factor in the surgical outcome is the surgical team's actual surgical skill. But there are significant differences in the lasers that one should not overlook. Some lasers give a smoother corneal surface and have an eye-tracking device that better guarantees that the laser treatment is properly centered and focused, and some lasers do not. The Wavefront LASIK specialists at LaserVue have chosen the Visx Star S4 & Allegretto Wave excimer lasers exclusively with which to perform laser vision correction. The Visx Star S4 & Allegretto Wave lasers feature eye tracking and auto-centering. These are among the few FDA-approved lasers with auto-centering, in which the laser treatment is centered upon the eye’s pupil via computer-guided infrared cameras—versus manually in many other laser systems.
At LaserVue Eye Center, we are proud to have received the first Visx S4 laser in United States, the first Allegretto Wave & Intralase FS 60 in the San Francisco Bay Area. LaserVue Eye Center is among a very few facilities in the Bay area where multiple lasers are available, so our LASIK specialists can truly customize the right laser for your individual vision correction.
When you put something as important as your eyesight in someone else's hands, do you want your doctor to use good equipment or the best equipment?
Drs. Bansal, Singh, and Boghossian at LaserVue strive to offer the most advanced laser eye surgery technology to our patients in the San Francisco, South Bay, San Jose, Oakland East Bay, and Santa Rosa offices.
Our LASIK eye surgery specialists have performed over 20,000 LASIK procedures. Hundreds of doctors, surgeons, and other health care workers have trusted their eyes to our laser vision correction team based around the San Francisco Bay Area.
Drs. Singh and Boghossian have each had laser vision correction themselves. Both now enjoy 20/20 vision without glasses or contacts. Many of our staff at LaserVue have also had laser vision correction. Come see why so many health care professionals, lawyers, pilots, athletes, business professionals, and others just like you choose LaserVue Eye Center!
Our doctors have helped train many local LASIK surgeons, and co-managing doctors through proctoring, lectures, and articles. These doctors have chosen our laser vision correction team for their own LASIK as well as that of their families and staff.
The Multiple LASER Advantage at LaserVue
Be aware of the new laser technology available to you. Most of the lasers do a fine job and the biggest factor in the surgical outcome is the surgical team's actual surgical skill. But there are significant differences in the lasers that one should not overlook. Some lasers give a smoother corneal surface and have an eye-tracking device that better guarantees that the laser treatment is properly centered and focused, and some lasers do not. The Wavefront LASIK specialists at LaserVue have chosen the Visx Star S4 & Allegretto Wave excimer lasers exclusively with which to perform laser vision correction. The Visx Star S4 & Allegretto Wave lasers feature eye tracking and auto-centering. These are among the few FDA-approved lasers with auto-centering, in which the laser treatment is centered upon the eye’s pupil via computer-guided infrared cameras—versus manually in many other laser systems.
At LaserVue Eye Center, we are proud to have received the first Visx S4 laser in United States, the first Allegretto Wave & Intralase FS 60 in the San Francisco Bay Area. LaserVue Eye Center is among a very few facilities in the Bay area where multiple lasers are available, so our LASIK specialists can truly customize the right laser for your individual vision correction.
When you put something as important as your eyesight in someone else's hands, do you want your doctor to use good equipment or the best equipment?
London Eye Centre
Technology Overview
London Eye Centre uses the VISX® Star S4 Excimer Laser System, the most advanced technology available. VISX® invented the technology for laser vision correction 20 years ago and continues to be the most trusted name among eye surgeons. Recently, over 70% of surgeons surveyed said they'd select VISX, if they could choose one laser to use on their patients. We have been a training site and clinical trial facility for VISX since 1990 and many top VISX employees have had their own laser vision correction performed at London Eye Centre.
Excellent Results
The latest VISX® model, the Star S4, has a number of new breakthroughs that have improved the excellent results we've already been achieving.
The WavePrint™ Map provides a new level of diagnostic information previously unavailable; it reveals the way your entire optical system processes light. WaveScan-based digital technology identifies and measures imperfections in your eyes 25 times more precisely than standard methods. The powerful WaveScan software can translate this information into a customized treatment.
Variable Spot Scanning (VSS™) is an exclusive VISX laser technology that allows for a larger treatment area. This has minimized earlier night vision issues where pupil size is a consideration.
Without a tracking device, laser vision correction required patients to hold their eyes as still as possible during the procedure. The 3D ActiveTrak™ follows any tiny motions of your eye instantaneously and automatically, in all three dimensions, repositioning the laser to ensure accuracy. You can relax, knowing that you're obtaining a correction that's precisely centered on your eye.
The VISX® laser also preserves more corneal tissue. Combined with the 'No Touch'™ method, this provides the best option for patients with thin corneas who may not be eligible for LASIK or procedures using lasers that remove more tissue.
London Eye Centre uses the VISX® Star S4 Excimer Laser System, the most advanced technology available. VISX® invented the technology for laser vision correction 20 years ago and continues to be the most trusted name among eye surgeons. Recently, over 70% of surgeons surveyed said they'd select VISX, if they could choose one laser to use on their patients. We have been a training site and clinical trial facility for VISX since 1990 and many top VISX employees have had their own laser vision correction performed at London Eye Centre.
Excellent Results
The latest VISX® model, the Star S4, has a number of new breakthroughs that have improved the excellent results we've already been achieving.
The WavePrint™ Map provides a new level of diagnostic information previously unavailable; it reveals the way your entire optical system processes light. WaveScan-based digital technology identifies and measures imperfections in your eyes 25 times more precisely than standard methods. The powerful WaveScan software can translate this information into a customized treatment.
Variable Spot Scanning (VSS™) is an exclusive VISX laser technology that allows for a larger treatment area. This has minimized earlier night vision issues where pupil size is a consideration.
Without a tracking device, laser vision correction required patients to hold their eyes as still as possible during the procedure. The 3D ActiveTrak™ follows any tiny motions of your eye instantaneously and automatically, in all three dimensions, repositioning the laser to ensure accuracy. You can relax, knowing that you're obtaining a correction that's precisely centered on your eye.
The VISX® laser also preserves more corneal tissue. Combined with the 'No Touch'™ method, this provides the best option for patients with thin corneas who may not be eligible for LASIK or procedures using lasers that remove more tissue.
In India - AKAL Eye Hospital
blessings of 'Singh Sahib Giani Sadhu Singh Ji Bhaura' the honoured Jathedar of Sri AKAL TAKHAT Sahib. it was his dream to see a hospital where people of all walks of life are cared for and treated. Singh Sahib himself worked all his life for the cause of humanity and finally achieved the highest politico-temporal seat in the SIKH WORLD. He maintained The high esteem of Akal Takhat Sahib for 16 long years-the longest in the history of Akal Takhat Sahib so far.
So the tittle child with the big, mission i.e. to lead this world 'FROM DARKNESS TO LIGHT' was born in the year 1990. This little baby has grown to an able teenager and is continuing to be a guiding light, a light house for the youngsters. Patient satisfaction and care is given foremost importance. This is the hospital-the pioneer to start PHACOEMULSIFICATION i.e. the technique of cataract removal with latest technique with:
No injection
No stitches
No bandage
No admission
This was started way back when others did not believed that such a technique was possible. The hospital is equipped with latest and the best equipment and instruments which are continuously being updated & .upgraded. We believe in quality.
We have fully air conditioned OPD halls, operation theater, waiting hall and seperate Lasik Laser waiting halls. The Hospital is equipped with the automatic eye examination units, slit lamps, ophthalmoscopes both direct & indirect, lensometer,streak retinoscope, trial set, keratometers both manual and automatic, Autorefracter, synaptophor. Fully equipped operationtheater with the latest and the first operating microscope to be imported into the country i.e. latest model of Moller Weidle fitted with CCD camera, and assistant scope. The hospital also has 3 phacoemulsification units i.e. Nidek, Orteli from Switzerland and Diplomax from Allergan. These are fully computerised machines which use ultra sound energy to remove cataract
( ) through small incisions less than 3 mm. The operation theater is very clean equipped with Laminar air flow, with positive pressure ventillation, HEPA Filters which keep the enviornment inside dust free and bacteria free. It is also equipped with split AC and dehumidifier to maintain constant temperature and humidity inside the operation theater.
So the tittle child with the big, mission i.e. to lead this world 'FROM DARKNESS TO LIGHT' was born in the year 1990. This little baby has grown to an able teenager and is continuing to be a guiding light, a light house for the youngsters. Patient satisfaction and care is given foremost importance. This is the hospital-the pioneer to start PHACOEMULSIFICATION i.e. the technique of cataract removal with latest technique with:
No injection
No stitches
No bandage
No admission
This was started way back when others did not believed that such a technique was possible. The hospital is equipped with latest and the best equipment and instruments which are continuously being updated & .upgraded. We believe in quality.
We have fully air conditioned OPD halls, operation theater, waiting hall and seperate Lasik Laser waiting halls. The Hospital is equipped with the automatic eye examination units, slit lamps, ophthalmoscopes both direct & indirect, lensometer,streak retinoscope, trial set, keratometers both manual and automatic, Autorefracter, synaptophor. Fully equipped operationtheater with the latest and the first operating microscope to be imported into the country i.e. latest model of Moller Weidle fitted with CCD camera, and assistant scope. The hospital also has 3 phacoemulsification units i.e. Nidek, Orteli from Switzerland and Diplomax from Allergan. These are fully computerised machines which use ultra sound energy to remove cataract
( ) through small incisions less than 3 mm. The operation theater is very clean equipped with Laminar air flow, with positive pressure ventillation, HEPA Filters which keep the enviornment inside dust free and bacteria free. It is also equipped with split AC and dehumidifier to maintain constant temperature and humidity inside the operation theater.
Expectations
LASIK laser vision correction is an exciting, liberating procedure which frees people of their glasses and contact lenses, resulting in a dramatic life change for the person. 20/20 vision is possible, but expectations of perfection are never guaranteed.
About 90% of the patients achieve legal driving vision without glasses. As with any surgical procedure, there are risks, but the complication rate is very low. The LASIK procedure is tightly controlled and uses leading-edge computers and laser technology.
Glasses may be necessary for fine-tuning vision under certain conditions like night driving, computer work, and heavy reading. People over forty usually require reading glasses unless one eye is purposefully made nearsighted, bluring that eye for distance. This results in a 'one eye far, one eye near situation,' or 'monovision'. Most people prefer both eyes as sharp as possible for distance and the use of reading glasses when necessary.
About 90% of the patients achieve legal driving vision without glasses. As with any surgical procedure, there are risks, but the complication rate is very low. The LASIK procedure is tightly controlled and uses leading-edge computers and laser technology.
Glasses may be necessary for fine-tuning vision under certain conditions like night driving, computer work, and heavy reading. People over forty usually require reading glasses unless one eye is purposefully made nearsighted, bluring that eye for distance. This results in a 'one eye far, one eye near situation,' or 'monovision'. Most people prefer both eyes as sharp as possible for distance and the use of reading glasses when necessary.
Refractive eye surgery
Refractive eye surgery is a general term for surgical procedures that can improve or correct the eye's focus by permanently changing the shape of the cornea.
The surgery is relatively painless, the full recovery period is as short as a few days, and the whole experience lasts less than 20 minutes in most cases. By the standards of many surgeries, this is a very simple procedure. A large percentage of patients walk out of the surgery and within hours are seeing better than they've seen in years. Within time, generally within a few weeks time at the most, they're seeing at 20/20 or 20/40.
Laser vision correction surgery changes the shape of your eye to increase your visual acuity. The first laser surgery devices were developed in 1975 and tested for a decade before finally being tried on humans in Germany. ( Two years later, patients in the U.S. had the experimental surgery done, but the Federal Drug Administration (FDA) did not approve its use until 1995. The surgery takes only a few minutes. Recovery for all procedures takes from less than 24 hours to five days.
The Excimer laser's potential was discovered by Dr. Srinivasan, who was working in a research laboratory on a laser system to cut plastics and other organic materials. By the early 1980's, he realized the potential for the excimer laser to interact with biological tissue. Ophthalmologist Steven Trokel, working with Srinivasan, introduced the idea of using the excimer laser to reshape the cornea.
The first patient to undergo laser vision correction was treated in Germany in 1988. The highly sophisticated excimer laser uses light energy to correct focusing problems by vaporizing away a small amount of tissue from the central area of the cornea. Most surgical laser beams affect tissue by producing heat that burns it, or by producing a shock wave that separates tissue with micro-explosions.
The excimer laser works differently. It uses a charged mixture of fluorine gases to produce a cool beam of ultra violet light. The beam is unique because it breaks the molecular bonds and vaporizes tissue, one microscopic layer at a time. The excimer precisely sculpts tissue with almost no effect on the surrounding tissue. This ability makes it ideal for changing the shape of the cornea.
At present, refractive surgery is most effective for myopia, astigmatism and hyperopia. LASIK is the most recent advance in laser vision correction. LASIK is an acronym for Laser Assisted In-situ Keratomileusis. Compared to the original laser PRK, the surface of the cornea remains largely intact so that LASIK patients are more comfortable and see better more quickly.
LASIK has been performed internationally for approximately 10 years. It was first performed in U.S. clinical trials in 1991. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.
In 1996, the FDA acted on the data submitted and approved the laser for treatment of low myopia up to -6.00 diopters. In 1997, the FDA approved the laser for treatment of astigmatism up to -4.00 diopters. There are currently three major manufacturers of the excimer laser equipment: Summit Technology, Visx and Nidek.
Oct. 21, 1999 - Summit Technology, Inc. announced that the U.S. Food and Drug Administration (FDA) granted approval for the Company's Apex Plus Excimer Laser Workstation for the LASIK treatment of myopia with or without astigmatism. The approval is for the correction of myopia in the range of 0D to -14.0D with or without astigmatism in the range of -0.5D to -5.0D. This approval gives Summit the widest range of treatments for nearsightedness and astigmatism in the industry.
Nov. 19, 1999 - VISX, INCORPORATED (Nasdaq:VISX) announced today that the U.S. Food and Drug Administration (FDA) has approved the use of its VISX STAR S2 Excimer Laser System(TM) as safe and effective for the treatment of up to 14 diopters of myopia, or nearsightedness, with up to 5 diopters of astigmatism.
September 30, 1999 - Nidek, Inc. announced the FDA had granted PMA supplement approval for the Company's EC-5000 Excimer Laser System for the treatment of Photorefractive Keratectomy for moderate myopia with astigmatism.
The new approval will allow treatment for the reduction or elimination of moderate myopia (nearsightedness) with astigmatism (uneven curvature of the cornea). The approval will allow correction of myopia ranging in severity from -1.00 to -8.00 diopters (D), with refractive astigmatism from -0.50 to -4.00 D cylinder by manifest refraction.
March 2000 - The LADARVision excimer laser, manufactured by Autonomous Technologies, Inc. and recently approved by the FDA, is a self aiming, small spot laser system for the correction of nearsightedness, farsightedness, and astigmatism. We are pleased to offer this next generation laser technology to our patients.
LADARVISION combines both eye tracking and small beam corneal shaping. The built-in eye tracker automatically follows any eye movements during the laser procedure. This allows the system to more accurately aim the laser beam and correct for any movement of the eye during the procedure. The expertise in the area of eye tracking had its origins in many years of research and development for the Strategic Defense Initiative and the National Aeronautic and Space Administration (NASA).
Unlike other laser systems in current use, the LADARVision system also uses a very small laser beam of less than 1 mm to shape the cornea. This beam is moved rapidly across the corneal surface in a computer-controlled pattern of tiny overlapping spots. The amount of corneal tissue removed with each spot is very small, less than the thickness of a single human hair. This changes the shape of the surface of the eye to correct nearsightedness and astigmatism and helps to produce a smooth postoperative corneal surface which may reduce side effects and improve visual recovery.
In addition, by measuring and correcting all eye movements during the laser procedure, the LADARVision system maintains accurate placement of the laser beam. At the same time, your surgeon will carefully monitor your eye on a computer screen which provides additional control.
The actual procedure and its risks and benefits are similar to PRK and LASIK in general. Your surgeon will discuss with you, in depth, if a procedure using the LADARVision system fits your particular needs.
The surgery is relatively painless, the full recovery period is as short as a few days, and the whole experience lasts less than 20 minutes in most cases. By the standards of many surgeries, this is a very simple procedure. A large percentage of patients walk out of the surgery and within hours are seeing better than they've seen in years. Within time, generally within a few weeks time at the most, they're seeing at 20/20 or 20/40.
Laser vision correction surgery changes the shape of your eye to increase your visual acuity. The first laser surgery devices were developed in 1975 and tested for a decade before finally being tried on humans in Germany. ( Two years later, patients in the U.S. had the experimental surgery done, but the Federal Drug Administration (FDA) did not approve its use until 1995. The surgery takes only a few minutes. Recovery for all procedures takes from less than 24 hours to five days.
The Excimer laser's potential was discovered by Dr. Srinivasan, who was working in a research laboratory on a laser system to cut plastics and other organic materials. By the early 1980's, he realized the potential for the excimer laser to interact with biological tissue. Ophthalmologist Steven Trokel, working with Srinivasan, introduced the idea of using the excimer laser to reshape the cornea.
The first patient to undergo laser vision correction was treated in Germany in 1988. The highly sophisticated excimer laser uses light energy to correct focusing problems by vaporizing away a small amount of tissue from the central area of the cornea. Most surgical laser beams affect tissue by producing heat that burns it, or by producing a shock wave that separates tissue with micro-explosions.
The excimer laser works differently. It uses a charged mixture of fluorine gases to produce a cool beam of ultra violet light. The beam is unique because it breaks the molecular bonds and vaporizes tissue, one microscopic layer at a time. The excimer precisely sculpts tissue with almost no effect on the surrounding tissue. This ability makes it ideal for changing the shape of the cornea.
At present, refractive surgery is most effective for myopia, astigmatism and hyperopia. LASIK is the most recent advance in laser vision correction. LASIK is an acronym for Laser Assisted In-situ Keratomileusis. Compared to the original laser PRK, the surface of the cornea remains largely intact so that LASIK patients are more comfortable and see better more quickly.
LASIK has been performed internationally for approximately 10 years. It was first performed in U.S. clinical trials in 1991. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.
In 1996, the FDA acted on the data submitted and approved the laser for treatment of low myopia up to -6.00 diopters. In 1997, the FDA approved the laser for treatment of astigmatism up to -4.00 diopters. There are currently three major manufacturers of the excimer laser equipment: Summit Technology, Visx and Nidek.
Oct. 21, 1999 - Summit Technology, Inc. announced that the U.S. Food and Drug Administration (FDA) granted approval for the Company's Apex Plus Excimer Laser Workstation for the LASIK treatment of myopia with or without astigmatism. The approval is for the correction of myopia in the range of 0D to -14.0D with or without astigmatism in the range of -0.5D to -5.0D. This approval gives Summit the widest range of treatments for nearsightedness and astigmatism in the industry.
Nov. 19, 1999 - VISX, INCORPORATED (Nasdaq:VISX) announced today that the U.S. Food and Drug Administration (FDA) has approved the use of its VISX STAR S2 Excimer Laser System(TM) as safe and effective for the treatment of up to 14 diopters of myopia, or nearsightedness, with up to 5 diopters of astigmatism.
September 30, 1999 - Nidek, Inc. announced the FDA had granted PMA supplement approval for the Company's EC-5000 Excimer Laser System for the treatment of Photorefractive Keratectomy for moderate myopia with astigmatism.
The new approval will allow treatment for the reduction or elimination of moderate myopia (nearsightedness) with astigmatism (uneven curvature of the cornea). The approval will allow correction of myopia ranging in severity from -1.00 to -8.00 diopters (D), with refractive astigmatism from -0.50 to -4.00 D cylinder by manifest refraction.
March 2000 - The LADARVision excimer laser, manufactured by Autonomous Technologies, Inc. and recently approved by the FDA, is a self aiming, small spot laser system for the correction of nearsightedness, farsightedness, and astigmatism. We are pleased to offer this next generation laser technology to our patients.
LADARVISION combines both eye tracking and small beam corneal shaping. The built-in eye tracker automatically follows any eye movements during the laser procedure. This allows the system to more accurately aim the laser beam and correct for any movement of the eye during the procedure. The expertise in the area of eye tracking had its origins in many years of research and development for the Strategic Defense Initiative and the National Aeronautic and Space Administration (NASA).
Unlike other laser systems in current use, the LADARVision system also uses a very small laser beam of less than 1 mm to shape the cornea. This beam is moved rapidly across the corneal surface in a computer-controlled pattern of tiny overlapping spots. The amount of corneal tissue removed with each spot is very small, less than the thickness of a single human hair. This changes the shape of the surface of the eye to correct nearsightedness and astigmatism and helps to produce a smooth postoperative corneal surface which may reduce side effects and improve visual recovery.
In addition, by measuring and correcting all eye movements during the laser procedure, the LADARVision system maintains accurate placement of the laser beam. At the same time, your surgeon will carefully monitor your eye on a computer screen which provides additional control.
The actual procedure and its risks and benefits are similar to PRK and LASIK in general. Your surgeon will discuss with you, in depth, if a procedure using the LADARVision system fits your particular needs.
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