LASER EYE SURGERY - A to Z EYE CARE WEBSITE

Comparison of Benefits and Risks of LASIK to PRK

2009-11-06T12:22:00.001-08:00

(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.

Laser Manufacturers

2009-11-06T12:21:00.004-08:00

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.

PRK Laser Types

2009-11-06T12:21:00.003-08:00

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.

PRK Laser Energy

2009-11-06T12:21:00.001-08:00

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.

The Magic of PRK

2009-11-06T12:20:00.000-08:00

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

2009-11-06T12:19:00.000-08:00

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.

Laser eye surgery risks highlighted

2009-11-06T12:10:00.000-08:00

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

LASIK Eye Surgery

2009-06-26T03:21:00.001-07:00

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.

Vancouver Laser Eye Surgery Centers

2009-03-25T06:55:00.002-07:00

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.

The Benefits of PRK Eye Surgery

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(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.

Prevent Bad Lasik Eye Surgery

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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.

What to Expect from Plastic Eye Surgery

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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.

Risks of Having Lasik Eye Surgery Problems

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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.

Creating the Corneal Flap

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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.

LASIK - Price

2009-03-25T06:51:00.000-07:00

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.

Astigmatism

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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

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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.

Myopia

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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.

Retinal Surgery

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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.

Horizon Advantage - Laser

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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.

Why Does LASIK Cause Dry Eyes?

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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

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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

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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?

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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

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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.

How Custom Wavefront LASIK Works

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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.

Potential Benefits of Wavefront LASIK

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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.

The Next Generation in Laser Eye Surgery

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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.

Steps of the Lasik Procedure

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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.

American Society of Cataract and Refractive Surgery

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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.

CONTRAINDICATIONS

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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

RECOVERY

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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 Principles

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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.

PerfectPulse Technology

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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.

VISX Excimer Laser System features

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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.

WaveFront technology

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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.

WaveFront technology

2009-03-17T05:33:00.001-07:00

iLASIK technology: NASA approved

2009-03-17T05:32:00.002-07:00

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.

Blade-Free Wavefront Laser Vision Correction

2009-03-17T05:32:00.001-07:00

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?

London Eye Centre

2009-03-17T05:31:00.000-07:00

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.

In India - AKAL Eye Hospital

2009-03-17T05:30:00.001-07:00

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.

Expectations

2009-03-17T05:29:00.001-07:00

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.

Refractive eye surgery

2009-03-17T05:27:00.000-07:00

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.

Refractive errors

2009-02-23T04:43:00.001-08:00

Refractive errors requiring the use of eyeglasses exist in nearly one-fifth of children before the late teenage years. The most common clinically significant refractive error is myopia (nearsightedness), usually seen in school-aged children and correctable with eyeglasses. Hyperopia (farsightedness) can cause problems in performing close work but usually does not necessitate correction in children unless it is sufficient to cause crossed eyes or reduced vision. Astigmatism (unequal curvature of the refractive surfaces of the eye) necessitates corrective eyeglasses if it causes significantly decreased vision or is of such severity to contribute to the development of amblyopia (lazy eye). In addition, unequal amounts of refractive error between the two eyes (anisometropia) also may lead to amblyopia and may require a prescription for corrective eyeglasses. The detection of amblyopia at an early age is an important aspect of the routine eye examination in the pediatric population. Left undetected and untreated, amblyopia may lead to irreversible visual deficit.

We hope this information has been useful to you, and we look forward to keeping in touch with you in the future.

Preventing Eye Infections

2009-02-23T04:42:00.004-08:00

You can also protect your eyes by preventing infections that could harm them. Conjunctivitis, which is also sometimes called pinkeye, is an eye infection that can be caused by a virus, bacteria, an allergic reaction, a chemical, or an irritant (something that gets in the eye). Conjunctivitis that is caused by germs like viruses and bacteria can easily pass from person to person. After you shake hands with someone who has a bad cold and pinkeye, for instance, you could spread the infection to your own eye by touching it with your hand.

To avoid spreading the germs that can cause eye infections:
Don't share eye makeup or drops with anyone else.
Don't touch the tip of a bottle of eye drops with your hands or your eyes because that can contaminate it with germs.
Never put contact lenses in your mouth to wet them. Many bacteria and viruses — maybe even the virus that causes cold sores — are present in your mouth and could easily spread to your eyes.
Wash your hands regularly!

Caring for Your Eyes

2009-02-23T04:42:00.003-08:00

Just as you wear a seat belt to protect yourself when you're in a car, it's wise to protect your eyes before something happens to them.

Wearing sunglasses is high on the list of ways you can care for your vision. Buy a pair of sunglasses with ultraviolet (UV) protection to use whenever you're in the sun. UV light causes long-term damage to the inner structures of the eye, but wearing sunglasses whenever you're in the sun can help prevent conditions such as cataracts and macular degeneration. A cataract is an eye condition in which the lens of the eye becomes clouded, impairing vision. Macular (pronounced: mah-kyuh-lur) degeneration is an eye disease in which the macula, a structure within the eye that allows you to see, gradually deteriorates, leading to decreased vision or blindness. (Need one more reason not to smoke? Smoking puts you at greater risk for developing macular degeneration.)

You can also care for your eyes by putting on protective eyewear whenever you play sports like racquetball or when you're doing projects in shop class or the science lab. It only takes a second for something to hit an unprotected eye and cause serious damage. And avoid being near fireworks that could explode and harm your eyes. Why take chances with your vision?

Although steering clear of fireworks probably seems like an obvious way to protect your eyes, you may not think about protecting them around the house. Yet something you might do every day — staring at a computer screen for a long time — can strain your eyes. That's because most people blink about 10 times per minute. But when you stare, your blink rate can go down to two or three times per minute. The best thing you can do is to blink more! It also helps to change your focus frequently. Look at something across the room for a few moments and then go back to looking at the computer screen.

If your eyes feel dry and irritated when you use the computer, use artificial tears. Don't use products that remove the red from your eyes, though, because they may contain a chemical that eliminates redness temporarily but actually makes your eyes look worse later.

You should take special care of your eyes if you have a medical condition such as diabetes or juvenile rheumatoid arthritis because these conditions put you at an increased risk of developing serious eye disease. Be sure to see your doctor at least once a year if you have any medical condition that can affect your eyes. Depending on your situation, your doctor may need to check your eyes as often as every 3 months.

Dealing With Common Eye Problems and Injuries

2009-02-23T04:42:00.001-08:00

The best rule of thumb for when to see an eye specialist if you injure your eyes is "when in doubt, check it out!"
If you have a red eye, pain in an eye that doesn't go away within a short period of time, or at any time have had changes in your vision, then it's time to have your eyes checked.
If you get any small foreign objects in your eye, such as sand or sawdust or metal shavings, don't rub it. Flush your eye for several minutes with lukewarm water (it may be easiest to do this in the shower). If it still feels as though there is something in your eye, then be sure to see an eye specialist.
If you've been hit in the eye and it looks strange or appears to be bleeding, or if you have changes in or lose your vision, go to a hospital emergency department right away to be checked out.

One of the most common eye injuries for teens is a scratched cornea, which is often related to wearing contact lenses or playing sports. With a scratched cornea, it may feel like something is in your eye when there's really nothing there. Your eye may get red and irritated, produce lots of tears, and be overly sensitive to light.

If you think you have any kind of eye injury and you wear contact lenses, stop wearing your contacts until you see an eye specialist. Wearing contact lenses if you have an eye injury could damage your eyes more or cause an infection to develop. Don't worry — if your cornea is scratched, it usually will heal after a week or two of medicated eye drops and not wearing your contacts. You may hate wearing your old glasses, but it's just for a little while — and it beats permanently damaging your eyes!

Common Vision Problems

2009-02-23T04:40:00.000-08:00

Have you ever wondered whether there's any truth in some of the stuff you may have been told about how to treat your eyes? For example, you may have been warned that sitting too close to the TV or computer can ruin your eyes. But actually that's wrong. You may also have heard that using a night-light (instead of bright light) to read will cause nearsightedness, but there's no clear scientific evidence to support this idea. You can strain your eyes if you don't have enough light when you read, but it won't ruin your vision.

So what's the cause of many common vision problems? Often, eye shape is the culprit. Someone with perfect 20/20 vision has eyes that are basically round like a baseball. Someone who needs corrective lenses to see usually has eyes that are shaped differently.

Myopia (pronounced: my-o-pee-uh), or nearsightedness, is one of the most common problems teens have with their eyes. When a teen has myopia, he or she is unable to focus properly on things that are far away. People with myopia have eyes that are a little longer than normal, measuring from the front of the eyeball to the back. This extra length means that light focuses in front of the retina (the part of the eye that receives images and sends them to the brain) instead of on it, and that affects vision. Glasses or contacts can easily correct this problem.

Hyperopia (pronounced: hi-puh-ro-pee-uh), or farsightedness, is another problem. People with hyperopia have trouble focusing on things close up because their eyes are too "short" from front to back. In people with hyperopia, light focuses behind the retina instead of on it, causing blurry vision. Someone with significant farsightedness will need glasses to correct his or her vision. But here's an interesting fact: Many babies are born farsighted! Their eyeballs get longer as they grow, and most of them outgrow the condition.

Another condition where the eye is differently shaped is astigmatism. Here, the cornea isn't perfectly round. To be able to see well — either close up or far away — the person needs contact lenses or glasses.

Once people reach 18 and their eyes are fully grown and less likely to change, some people choose to have refractive surgery to correct myopia so they don't have to wear contacts or glasses anymore. Refractive surgery is a procedure — usually done with a laser — that reshapes the eye to change the way light enters it and forms an image, allowing a person to see better. Refractive surgery can sometimes also be done on people with farsightedness or astigmatism once their eyes have matured and stopped growing.

NEW LASER CORRECTION

2009-01-22T07:30:00.003-08:00

NEW LASER CORRECTION (REIKP)

The acquired experience of excimer laser surgery has proved that the combined method of photorefractive keratoectomy with fine microsurgery technique has advantages over other operations. Special requirement to ametropia correction precision привели resulted in developing at our clinic an absolutely new operation which was named refractive modifying excimer laser intrastromal keratoectomy with protection (REIKP). The prototype of the REIKP operation is LASIK.

A lot of experience in refractive surgery acquired by leading ophthalmology clinics of the world within these years and permanent analysis of the data received enabled to detect certain unwanted moments of the procedure performed in accordance with the universally recognised method of LASIK affecting the final result.
Introduction of changes at all the stages of the operation including preliminary sparing local anaesthesia (pain relief) enables to imrove the quality of the procedure performed and speeds up the rehabilitation process greatly. Complete revision of the whole operation course enabled to single out the REIKP as an absolutely independent and new operation in its quality which eliminates refraction anomalies.

During this procedure unlike during the PRK prior to the laser influence the surgeon forms a thin rag of the cornea surface layers with a microkertom and lays it in a special way. Computer modelling of the cornea optic surface with laser doesn't touch its surface layers. This method enables to operate on the both eyes simultaneously. THe patients' eyesight recovers within several hours after the operation. The REIKP procedure is absolutely painless and endured well even by children.

The procedure period is less than 1-2 minutes. Within 1.5-2 hours after the operation slight lachrymation, photophobia and winking discomfort can be observed. All this time the patient is under observation of our specialists. The REIKP enables to reach high visual acuity with all the patients and improve their satisfaction with the operation result. During this operation we use only NIDEK-EC 5000 excimer laser and the best keratom by MORIA (France).

Contact lenses

2009-01-22T07:30:00.001-08:00

Contact lenses which became widespread in the middle of the fifties of the 20th century have a number of advantages over spectacles and can for today offer normal life even to a very active person going in for sports. Nonetheless, wearing them is also connected to certain inconvenience. A lot of people just can't get used to a foreign body in the eye. But even if you have adapted to lenses well sometimes they cause irritation and can contribute to bringing an infection, which, in its turn, can cause serious, up to blindness, consequences. They are contraindicated for wearing during any, even the lightest, colds. The process of taking the lenses off and putting them on is rather unpleasant and, worse than that, can fall out at the most unsuitable moment.

In an attempt to get rid of the inconvenience connected to wearing spectacles or contact lenses more and more people resort to the surgeon's help.

Spectacles

2009-01-22T07:29:00.002-08:00

The most widespread method of shortsightedness correction is spectacles. With all their advantages spectacles bring a lot of inconvenience to their owner: they get dirty all the time, steam up, sli off from the bridge of the nose, prevent from going in for sports or just engage in physical activity. In order to avoid the overstrain of the eyes spectacles are chosing by the 8th line of the table and, as a result, do not provide 100 % of teh eyesight. They limit the side vision greatly, affect the stereoscopic effect and space perception, which is especially important for drivers and in case of an accident the broken lenses can cause a serious trauma. Besides, the incorrectly chosen spectacles can be the reason for the constant overstrain of the eyes and gradual development of eye diseases connected to it.

Farsightedness

2009-01-22T07:29:00.001-08:00

Farsightedness (hypermetropia) - the inability to see close objects - is connected to the shortened form of the eyball or insufficient power of cornea. With farsightedness light rays passing through the cornea focus behind the retina, as a result of which the image perceived as blurred. People suffering from the hypermetropia of high degree can hardly see close as well as distant objects. With young people slight hypermetropia can be compensated at the expense of the active work of the lens. At that the person sees distant as well as close objects equally clearly but the overstrain causes headache, the feeling of "sand" in the eyes and quick tiredness.

With elderly people the inability to see close objects clearly can be caused not by the shortened form of the eye but the reduction of the lens elasticity and its muscles weakening. This disease is called presbyopia or gerontal farsightedness.

Todat there exist three methods of correcting farsightedness:

spectacles
contact lenses
laser correction.

Historians divide the authorship to the invention of spectacles between the emperor Neron who gazed at the gladiators' fights through a large emerald and ancient Chinese who used to tie especially finished pieces of quartz glass to the eyes. Ancient Roman doctors tried to treat shortsightedness by prescribing the patients to lay bags with sand onto the eyes, which caused temporary change in the cornea form and the whole eyeball and, in a way, anticipated modern surgical correction methods.

Diabetic Retinopathy

2009-01-19T04:47:00.001-08:00

Diabetes mellitus is a condition which affects millions of Indians. It impairs the body's ability to use and store sugar. Elevated blood sugar levels and excessive thirst and urination are the indicators of diabetes. It can affect vision by causing damage to the blood vessels of the retina, or a higher incidence of cataract and glaucoma. Changes are also seen in blood vessels all over the body.

WHAT IS DIABETIC RETINOPATHY?

It is an advanced stage of the diabetic disease process in which the blood vessels in the retina are damaged and leak fluid or blood. The longer a person has diabetes, the more the risk of developing diabetic retinopathy. People with type I diabetes [diabetes since childhood] are more likely to develop diabetic retinopathy at a younger age.

WHAT ARE THE SYMPTOMS OF DIABETIC RETINOPATHY?

Early diabetic retinopathy usually has no symptoms. Gradual blurring of vision may occur if fluid leaks in the central part of the retina [the macula]. In late diabetic retinopathy [proliferative stage], new abnormal blood vessels begin growing on the surface of the retina or the optic nerve. These vessels have weak walls and leak blood out into the retina and vitreous [jelly that fills most of the eye]. Presence of blood in the path of light entering the eye blocks vision.

HOW IS DIABETIC RETINOPATHY DIAGNOSED?

A complete eye examination is required for the detection of diabetic retinopathy. We perform a painless examination of the retina of the eye using an instrument called the indirect ophthalmoscope after dilating the pupils. If diabetic retinopathy is found, a special test called fluorescein angiography may be performed where a dye is injected in the vein and photographs of the retina are taken.

HOW IS DIABETIC RETINOPATHY TREATED?

In early cases only regular follow-up may be necessary. More advanced cases require treatment to control the damage of diabetic retinopathy and improve sight. Laser photocoagulation involves the focusing of a powerful beam of laser light on the damaged retina to seal leaking retinal blood vessels and stop abnormal blood vessel [neovascularization] growth.

Vitrectomy - In the event of the patient presenting with very advanced diabetic retinopathy, a microsurgical procedure known as vitrectomy is recommended. Blood-filled vitreous gel of the eye is replaced with a clear solution to aid in restoring vision. Sometimes the retina may also be detached. Vitrectomy surgery is then performed to reattach the retina.

HOW TO PREVENT VISUAL LOSS IN DIABETES?

Prevention of diabetic retinopathy and accompanying visual loss is a team effort involving the patient and our team of diabetic eye specialists. Early detection of diabetic retinopathy is the best protection against loss of vision. Diabetics must have their retinas examined atleast once a year. Our diabetic clinic is designed towards providing regular preventive care as well as follow-up for patients with established diabetic retinopathy.

Lasers

2009-01-19T04:46:00.001-08:00

Broad Beam Lasers
A broad beam laser uses a relatively large beam diameter (from 6.0 to 8.0 millimeters) that can be manipulated to ablate the cornea. The broad-beam laser results in the shortest procedure time. This speed creates less likelihood of overcorrection and decentration - a complication caused by movement of the pupil. A disadvantage is an increased possibility of center islands - a complication related to ablation. However, ophthalmologists have learned to decrease the incidence of center islands by using several short laser pulses to ablate the cornea instead of one longer one.

Slit Scanning Lasers
A slit scanning laser uses relatively small beams linked to a rotational device with slit holes that can enlarge. During surgery, the laser beam scans across these holes to gradually increase the ablation zone. A uniform beam and potentially smoother ablations characterize slit scanning lasers. Disadvantages include a slightly higher propensity for decentration and slightly greater risk of overcorrection.

Spot Scanning Lasers
These systems have the potential to produce the smoothest ablations and use radar technology to track the eye's movement. They also have the potential to treat irregular astigmatism and link to topography. These lasers must be linked to eye tracking to ensure proper centration.

Wavefront Technology

2009-01-19T04:45:00.000-08:00

Wavefront Technology is the latest technology available to treat vision correction.

Wavefront treatment is personalised by not only correcting your prescription but also aberrations or imperfections which occur naturally in your eyes. Each treatment is unique to your eyes. The result of the Wavefront treatment using the latest technology is a better quality of vision.

This type of treatment requires a sophisticated piece of equipment called an Aberrometer, which is capable of generating an accurate map of each eye and its aberrations (imperfections). Advance VisionCare has obtained the latest Wavefront technology: Zyoptix from Bausch and Lomb. The system used generates the Wavefront map, which is used diagnostically for initial consultation and post-operative analysis to ensure the best possible treatment is provided. Sophisticated software will then convert the wavefront map into a unique treatment prescription, which in turn will be electronically transferred to a computer controlling the laser itself.
The benefits of 'Wavefront' Treatment are :
Patients experience a higher quality of vision i.e. contrast (black on white) is more defined, than with standard LASIK.
Patients may experience a better vision in poor lighting, twilight, or for night driving.
The recovery time to good vision may be more rapid than with standard LASIK.
Wavefront technology removes less corneal tissue therefore patients with thinner corneas may be able to be treated than with standard LASIK therefore able to treat higher prescription safer and more accurately.

It is important to note that the aim of this treatment is not to improve detail of vision beyond that achieved with glasses (i.e. lines on the vision chart), but the overall quality of vision when compared to standard treatment.

Improved Quality of Vision

In low lighting conditions our pupils expand (or 'dilate'). Research shows that there are more 'aberrations' or optical imperfections at the outer edges (periphery) of the pupil. This results in a distortion of the light entering the eye. As a result, it is possible to be able to look at a round light source in the distance, but instead of seeing a perfectly round shape, you will see an irregular image. This distortion of light reduces the quality of our vision and explains one of the reasons why many patients experience difficulty with their vision when driving at night.

Zyoptix treatments have been designed to remove these optical imperfections, improving not just what we see, but the quality of how we see objects.
97% of patients reported a marked or extreme improvement in their quality of vision.
98.2% of patients said they would have a Zyoptix treatment againQuality of Vision After Surgery %

Extreme Improvement 84.7%

Marked Improvement 12.1%

Moderate Improvement 1.8%

Slight Improvement 1.2%

No Improvement 0.3%

Satisfaction with Surgery %

Very Satisfied 98.8%

Neutral 1.2%

Moderate Improvement 0%

Slight Improvement 0%

What results can you expect?

Significantly more Wavefront patients in this study experienced improved results with their vision when driving at night than patients that had received a standard Bausch & Lomb LASIK treatment.

Night Driving

More than 8 out of 10 Wavefront patients in this study reported same or better quality of vision in various common light conditions. 90.7% of patients reported the same or fewer difficulties with night driving.
Excellent Visual Acuity

Zyoptix produces a better quality of vision as well excellent visual acuity results. In this recent FDA approved trial, 91.3% of patients achieved 20/20 (6/6) vision without any correction 6 months after the treatment. 99.4% of patients achieved 20/40. 70.3% of patients achieved 20/16 vision without any glasses or spectacles, which is an improvement over the accepted standard of 20/20 vision.

Cataract Surgery

2009-01-19T04:44:00.001-08:00

Blurry vision due to cataracts is common in adults over the age of 50, and new advances in cataract surgery make it easier than ever to treat this problem. At our Columbus, Ohio area centers, we have helped many cataract sufferers restore their vision through advanced cataract surgery procedures.

Although it is a common problem, many people do not know what cataracts are or that they are suffering from them. Below, we have provided information about cataracts and cataract surgery so that you can better understand this common vision problem. To determine if cataracts have affected your vision and if cataract surgery is needed, the experienced eye professionals at Bloomberg Eye Center in Columbus, Ohio, will perform a thorough eye examination.
Cataracts refer to a condition in which the normally clear lens of the eye becomes cloudy, causing glare, and affecting a person’s ability to see clearly. Cataracts rarely affect younger people, while people 60 and older are at the greatest risk of developing cataracts. Other factors, such as certain diseases and injuries, as well as heredity, can also increase your risk of developing cataracts.

If you believe your blurry vision is due to cataracts and would like to find out if cataract surgery can help, contact our Newark and Columbus, Ohio practice to schedule a free evaluation and consultation.

Eye Care Centre in India

2009-01-19T04:43:00.000-08:00

Chaudhary Eye Centre & Laser Vision is a super specialty eye institute.
The Specs Removal / Correction Clinic covers all the aspects of the latest technology for laser eye surgery / eyesight correction & treatment i.e. C-Lasik Laser ( Customized / Customised Lasik Laser / Wave front guided Lasik), Simple Lasik Laser, E-Lasik (Epi-Lasik), Phakic IOLs ( ICL & Verisyse) & RLE (Refractive Lens Exchange).

The Cataract Clinic handles procedures like Phaco (Stitchless cataract surgery) with foldable lens and the latest multifocal lenses like Restor (Alcon) & Tecnis-multifocal (AMO).
The Vitreo Retina Clinic is a comprehensive retina management unit and covers procedures like Digital Flourescein Angiography, Retinal Lasers, TTT & PDT, Ultrasonography B scan, Vitreo Retina surgical procedures etc.

The Squint Clinic handles all complex squint conditions of the eye.
The Oculo-plastic Clinic caters to plastic surgery of eye tissues including DCR, Ptosis and skin grafting etc.

The Cornea Clinic manages eye donation and cornea transplant.

The Glaucoma Clinic takes care of preventive screening, visual field analysis and management of raised intraocular pressure of eye.

All procedures are performed by a group of senior eye specialists / doctors, and the institute is directed by Dr Sanjay Chaudhary, a pioneer in the field of lasers in eye surgery in India. The facilities are available at Chaudhary Eye Centre and Laser Vision, Daryaganj, New Delhi, India. The Centre / Center is located in the heart of Delhi, being 3 kms from the Railway Station and 40-minute drive from the Delhi International airport (IGI). The laser machines used are from the best-known international brands.

Rapid Eye Technology

2009-01-19T04:40:00.000-08:00

Rapid Eye Technology is intended to complement rather than substitute for proper medical or psychological care. RET techniques and processes are tools for personal growth and as such are not intended for the treatment or diagnosis of any medical or psychological condition. If you are suffering from a medical or psychological condition of any kind seek out the advice of a qualified and licensed medical or psychological professional.

We make every effort to ensure that the prices listed on our website are accurate. The Rapid Eye Institute will not be held liable for any typographical errors or prices listed in error. Prices, policies, and offers subject to change without notice.

Macular degeneration

2009-01-06T06:37:00.001-08:00

Macular degeneration, often called AMD or ARMD (age-related macular degeneration), is the leading cause of vision loss and blindness in Americans aged 65 and older. Because older people represent an increasingly larger percentage of the general population, vision loss from macular degeneration is a growing problem.

AMD occurs with degeneration of the macula, which is the part of the retina responsible for the sharp, central vision needed to read or drive. Because the macula primarily is affected in AMD, central vision loss may occur.

A significant study* estimated that 1.75 million U.S. residents had advanced age-related macular degeneration with associated vision loss, with that number expected to grow to almost 3 million by 2020.

Laser Types

2009-01-06T06:31:00.001-08:00

Excimer lasers, designed for laser-assisted in situ keratomileusis (LASIK), are marvels of modern medicine.

Many potential LASIK recipients want to know more about subtle differences among currently approved instruments. But for most people, laser choice makes no significant difference.

Most experts agree that surgeon skill and experience and the quality of care before and after a corrective eye surgery procedure are far more critical factors affecting final LASIK outcomes

Although all approved excimer lasers meet safety and effectiveness criteria established by the FDA, certain people may be better off with one type of laser over another.

A Patient Experience with surgery

2009-01-06T06:25:00.000-08:00

I was tired of wearing glasses, and really did not enjoy putting on contact lenses, so I decided to get my vision corrected.

There was no preparation before the procedure, but you definitely need someone to come with you to guide you back home.

I entered the doctor’s office and I was given some eye drops while in the waiting room. A few minutes later I was taken into a holding room where I put on scrubs.

After a few minutes I was guided to the surgery room, and directed to lie down with my head in a brace to prevent excessive head movement. A mask was placed over my head so that it only exposed one eye at time and my eye lids where taped open.

The doctor was very good about explaining each step as he was doing it, and I kept my head as still as possible, concentrating on a red light. Water was put on my eye and a brush was used to clean the surface (you don’t feel anything, so it’s kind of cool to see the drops and brush movement). Next, there was an apparatus that was placed over my eye and I felt a slight pressure on the eye.

After this I couldn’t see for a split second then the light was visible again. More washing was done, and then the doctor informed me that the laser part was about to begin and to keep my head as steady as possible. The light intensified (I still couldn’t feel anything) and I heard some noise. After this they washed the eye again, and removed the tape that was applied to the eyelids, and then I blinked.

The doctor informed that it went well and then preceded to do the next eye, which went exactly the same way. From start to finish the entire operation was about 10 minutes.

After the procedure, I went to the waiting room and rested with my eyes closed for 10 minutes. The doctor then called me into his office. He looked on the surface of my eyes, and I read the last line of an eye chart. My eyes were watering throughout this part.

I left and had no pain, but discomfort when I opened my eyes that day. I kept my eyes closed (as recommended by the doctor), opening occasionally. My eyes pretty much watered the first day. I wore dark sunglasses while in the house.

The second day was much better; my eyes felt fine with very minimal watering. It felt as if I was wearing contacts for the first time, so I felt a slight discomfort when I blinked. I remained in the house (recommended by the doctor) this day, again keeping dark sunglasses on.

After that, I functioned normally, and the only thing different was I wore dark glasses while outside for 2 weeks after the procedure.

People's Open Talk

2008-09-18T07:48:00.005-07:00

Basik Lasik: Tips on Lasik Eye Surgery
Produced in cooperation with the American Academy of Ophthalmology.
If you're tired of wearing glasses or contact lenses, you may be considering Lasik eye surgery — one of the newest procedures to correct vision problems. Before you sign up for the surgery, get a clear picture of what you can expect.
The Facts
•Lasik is surgery to a very delicate part of the eye.
•Hundreds of thousands of people have had Lasik, most very successfully.
•As with any surgery, there are risks and possible complications.
•Lasik may not give you perfect vision. The American Academy of Ophthalmology (AAO) reports that seven out of 10 patients achieve 20/20 vision, but 20/20 does not always mean perfect vision.
•If you have Lasik to correct your distance vision, you'll still need reading glasses around age 45.
•Lasik surgery is too new to know if there are any long-term ill effects beyond five years after surgery.
•Lasik surgery cannot be reversed.
•Most insurance does not cover the surgery.
•You may need additional surgery — called "enhancements" — to get the best possible vision after Lasik.
Understanding Your Eyes
To see clearly, the cornea and the lens must bend — or refract — light rays so they focus on the retina — a layer of light-sensing cells that line the back of the eye. The retina converts the light rays into impulses that are sent to the brain, where they are recognized as images. If the light rays don't focus on the retina, the image you see is blurry. This is called a refractive error. Glasses, contacts and refractive surgery attempt to reduce these errors by making light rays focus on the retina.
Refractive errors are caused by an imperfectly shaped eyeball, cornea or lens, and are of three basic types:
•myopia — nearsightedness; only nearby objects are clear.
•hyperopia — farsightedness; only objects far away are clear.
•astigmatism — images are blurred at a distance and near.
There's also presbyopia — "aging eye." The condition usually occurs between ages 40 and 50, and can be corrected with bifocals or reading glasses.
Are You a Good Candidate for Lasik?
Lasik is not for everyone.
•You should be at least 18 years old (21 for some lasers), since the vision of people younger than 18 usually continues to change.
•You should not be pregnant or nursing as these conditions might change the measured refraction of the eye.
•You should not be taking certain prescription drugs, such as Accutane or oral prednisone.
•Your eyes must be healthy and your prescription stable. If you're myopic, you should postpone Lasik until your refraction has stabilized, as myopia may continue to increase in some patients until their mid- to late 20s.
•You should be in good general health. Lasik may not be recommended for patients with diabetes, rheumatoid arthritis, lupus, glaucoma, herpes infections of the eye, or cataracts. You should discuss this with your surgeon.
•Weigh the risks and rewards. If you're happy wearing contacts or glasses, you may want to forego the surgery.
•Understand your expectations from the surgery. Are they realistic?
•Ask your doctor if you're a candidate for monovision — correcting one eye for distance vision and the other eye for near vision. Lasik cannot correct presbyopia so that one eye can see at both distance and near. However, Lasik can be used to correct one eye for distance and the other for near. If you can adjust to this correction, it may eliminate or reduce your need for reading glasses. In some instances, surgery on only one eye is required. If your doctor thinks you're a candidate, ask about the pros and cons.
Finding a Surgeon
Only ophthalmologists (Eye MDs) are permitted to perform Lasik. Ask your Eye MD or optometrist for a referral to an Eye MD who performs Lasik. The American Academy of Ophthalmology website (www.eyenet.org) feature "Find an Eye MD" can provide you with a list of their members who perform Lasik. Ninety-five percent of all ophthalmologists (Eye MDs) are Academy members. Also, the International Society of Refractive Surgery website (www.LocateAnEyeDoc.com) will provide you with names of refractive surgeons.
Ask your surgeon the following questions:
1.How long have you been doing Lasik surgery?
2.How much experience do you have with the Lasik procedure?
3.How do you define success? What's your success rate? What is the chance for me (with my correction) to achieve 20/20? How many of your patients have achieved 20/20 or 20/40 vision? How many patients return for enhancements? In general 5-15% return.
4.What laser will you be using for my surgery? Make sure your surgeon is using a laser approved by the U.S. Food and Drug Administration (FDA). As of this publication's printing, the FDA has approved five lasers for Lasik; they are manufactured by VISX, Summit, Bausch and Lomb, Nidek and ATC. Contact the FDA for updates.
5.What's involved in after-surgery care?
6.Who will handle after-surgery care? Who will be responsible?
7.What about risks and possible complications?
Risks and Possible Complications
Before the surgery, your surgeon should explain to you the risks and possible complications, and potential side effects, including the pros and cons of having one or both eyes done on the same day. This is the "informed consent" process. Some risks and possible complications include:
•Over- or under-correction. These problems can often be improved with glasses, contact lenses and enhancements.
•Corneal scarring, irregular astigmatism (permanent warping of the cornea), and an inability to wear contact lenses.
•Corneal infection.
•"Loss of best corrected visual acuity" — that is, you would not be able to see as well after surgery, even with glasses or contacts, as you did with glasses or contacts before surgery.
•A decrease in contrast sensitivity, "crispness," or sharpness. That means that even though you may have 20/20 vision, objects may appear fuzzy or grayish.
•Problems with night driving that may require glasses.
•Flap problems, including: irregular flaps, incomplete flaps, flaps cut off entirely, and ingrowth of cells under the flap.
The following side effects are possible, but usually disappear over time. In rare situations, they may be permanent.
•Discomfort or pain
•Hazy or blurry vision
•Scratchiness
•Dryness
•Glare
•Haloes or starbursts around lights
•Light sensitivity
•Small pink or red patches on the white of the eye
Surgery: What to Expect Before, During and After
Before: You'll need a complete eye examination by your refractive surgeon. A preliminary eye exam may be performed by a referring doctor (Eye MD or optometrist). Take your eye prescription records with you to the exams. Your doctor should:
•Dilate your pupils to fine-tune your prescription.
•Examine your eyes to make sure they're healthy. This includes a glaucoma test and a retina exam.
•Take the following measurements:
oThe curvature of your cornea and your pupils. You may be rejected if your pupils are too large.
oThe topography of your eyes to make sure you don't have an irregular astigmatism or a cone-shaped cornea — a condition called Keratoconus.
oThe pachymetry — or thickness — of your cornea. You need to have enough tissue left after your corneas have been cut and reshaped.
•Ask you to sign an informed consent form after a thorough discussion of the risks, benefits, alternative options and possible complications. Review the form carefully. Don't sign until you understand everything in the form.
•If your doctor doesn't think Lasik is right for you, you might consider getting a second opinion; however, if the opinion is the same, believe it.
If you qualify for surgery, your doctor may tell you to stop wearing your contact lenses for a while before the surgery is scheduled because contacts can temporarily change the shape of the cornea. Your cornea should be in its natural shape the day of surgery. Your doctor also may tell you to stop wearing makeup, lotions or perfume for a few days before surgery. These products can interfere with the laser treatment or increase the risk of infection after surgery.
During: Lasik is an outpatient surgical procedure. The only anesthetic is an eye drop that numbs the surface of the eye. The surgery takes 10 to15 minutes for each eye. Sometimes, both eyes are done during the same procedure; but sometimes, surgeons wait to see the result of the first eye before doing the second eye.
The Surgical Procedure: A special device cuts a hinged flap of thin corneal tissue off the outer layer of the eyeball (cornea) and the flap is lifted out of the way. The laser reshapes the underlying corneal tissue, and the surgeon replaces the flap, which quickly adheres to the eyeball. There are no stitches. A shield — either clear plastic or perforated metal — is placed over the eye to protect the flap.
After: Healing is relatively fast, but you may want to take a few days off after the surgery. Be aware that:
•You may experience a mild burning or sensation for a few hours after surgery. Do not rub your eye(s). Your doctor can prescribe a painkiller, if necessary, to ease the discomfort.
•Your vision probably will be blurry the day of surgery, but it will improve considerably by the next day when you return for a follow-up exam.
•If you experience aggravating or unusual side effects, report them to your doctor immediately.
•Do not drive until your vision has improved enough to safely do so.
•Avoid swimming, hot tubs and whirlpools for two weeks after surgery.
Alternatives to Lasik
You may want to discuss some surgical alternatives to Lasik with your eye doctor:
•Photorefractive keratectomy (PRK) is a laser procedure used to reduce myopia, hyperopia and astigmatism without creating a corneal flap.
•Astigmatic keratotomy (AK) is an incisional procedure to reduce astigmatism.
•Intrastromal corneal rings are clear, thin, polymer inlays placed on the eye to correct low myopia only.

Glaucoma Surgery

2008-09-18T07:48:00.004-07:00

The surgical management of glaucoma is offered to patients if drug therapies have not been satisfactory or are inappropriate (e.g., because of the desire to avoid drugs during pregnancy). There are two types of surgical treatment: those using a laser and those using surgical techniques.

During laser treatment for open-angle glaucoma, laser light is aimed at the eye’s trabecular meshwork (the eye’s drainage system). The laser application results in a biological and mechanical reaction in the trabecular meshwork to open the previously blocked meshwork and increases the flow of aqueous fluid from the eye.

The most common conventional (incision) surgical technique is called filtering microsurgery, which involves making a hole through which the excess fluid drains and lowers pressure in the eye. Surgery is used if medication and laser procedures have not been successful or if there is a medical emergency for which pressure must be relieved immediately.

Laser Surgery
Laser surgeries lower intraocular pressure by enhancing the drainage of aqueous fluid or slowing its production. The kind of laser surgery used depends on the type of glaucoma being treated. The length of time the pressure remains lowered depends on the type of laser surgery, the type of glaucoma, and the patient’s individual characteristics.

In some cases, laser surgery may have to be repeated to control internal eye pressure more effectively. Typically, medications will still be needed to maintain fluid pressure within the eye, although a lower dose than previously used may be sufficient. If the laser therapy does not lower the pressure in the eye satisfactorily or the effects wear off, the surgeon may recommend conventional surgery.

What to expect: Laser surgeries are preformed in a doctor’s office in a facility called an ambulatory surgical center or in a hospital. Although some patients may experience a slight stinging sensation, the procedures are usually painless. In some instances, local anesthetic agents are used, in which case there is little if any discomfort.

When the procedure is over, patients may experience blurred vision and some irritation. Normal activities, such as driving and work, may be resumed the next day.

Risks: As with all surgery, there are risks. Risks of laser glaucoma procedures may include a short-term increase in intraocular pressure or an excessive drop in pressure. Both complications are rare and controlled with glaucoma medications. There is a small risk for cataract formation after some types of surgery.

Benefits: Failure to control glaucoma can result in destruction of the optic nerve and permanent blindness of the affected eye. Reducing or preventing raised intraocular pressure by laser therapy is effective in reducing the risk of blindness from glaucoma.

Laser Treatments for Primary Open-Angle Glaucoma

* Selective laser trabeculoplasty (SLT) reduces intraocular pressure by enhancing drainage of excess aqueous fluid. The laser increases drainage by selectively treating certain cell tissue of the trabecular meshwork. The meshwork is at the entrance of the drainage canals. SLT treatments can occasionally be repeated if necessary.
* Argon laser trabeculoplasty (ALT) reduces intraocular pressure by opening the drainage canals of the eye. In many cases, drugs will continue to be needed to maintain safe internal eye pressure after this procedure.

Laser Treatments for Narrow-Angle Glaucoma

* Laser peripheral iridotomy (LPI) reduces excessive intraocular pressure by making a small hole in the iris, the colored part of the eye. Narrow-angle glaucoma occurs when the angle between the iris and cornea, the clear front part of the eye, is too small. The hole allows the iris to move back from the cornea, opening the angle and enhancing aqueous flow.
* Laser cyclophotocoagulation is used to reduce eye pressure by treating the ciliary body, which produces aqueous fluid. The procedure is most commonly used for patients with extensive and end stage glaucoma damage that are not responding to other glaucoma surgeries.

Conventional or Incision Surgery
As noted above, conventional surgery or filtering microsurgery is used when management of glaucoma through medication and laser surgery has failed or is less desirable. Trabeculectomy is most commonly used to prevent or curtail damage to the optic nerve by reducing intraocular pressure. In this procedure, a small incision is made in the sclera of the eye (see Diagram 2) and a flap of tissue is left to cover the incision, allowing slow release of fluid from the inside the eye to its outer layers. The procedure results in the formation of a small blister-like bump called a “bleb.” The bleb is covered by the eyelid and is usually not visible. The excess fluid is carried away as it is absorbed into the bloodstream.
A new modification of trabeculectomy, is non-penetrating deep sclerectomy or viscocanalostomy, where a full-thickness hole in the eye is avoided. Instead, a very deep dissection is performed in the sclera and trabecular meshwork. Intraocular pressure is lowered as fluid oozes through a permeable thin layer of tissue that is created by the viscocanalostomy. A bleb may be formed, but it is usually smaller than one that would be formed following trabeculectomy.

In case of complicated glaucoma or patients who have had multiple surgeries, the use of a tube-shunt or seton is required. These devices, which include the Ahmed Valve, Baervedlt device, or Molteno device, have a plastic tube that is placed in the eye, which drains to an external reservoir placed outside the eye.

What to expect: Microsurgical procedures are performed in an ambulatory surgical center or on an outpatient basis at a hospital. Patients are usually given limited intravenous sedation but may be given general anesthesia. Medication may also be administered around the eye to prevent its movement. Typically, patients are relaxed and experience little if any discomfort.

Risks and benefits: The risks of incision surgery are small. Nevertheless, as with any incision, there is the risk of bleeding and infection. The eye may be red or inflamed, with discomfort and pain. In some instances, the procedure may not reduce eye pressure as intended. Loss of too much pressure can result in a loss of vision. As with laser surgeries, there are occasional instances in which the pressure is too high or too low. When this occurs, medications or additional surgeries may be needed to control the condition. In some instances, cataracts may develop. In very rare circumstances, an eye can be removed as a result of surgery. As with all procedures or medications, the risks need to be balanced with the benefits of saving vision in the affected eye. Failure to control glaucoma can result in destruction of the optic nerve and permanent blindness in the affected eye.

Success rates for glaucoma filtering surgery are about 70% to 90% for at least 1 year. In some instances, the surgically created drainage channel may “heal” or close, in which case high intraocular pressure can recur. The healing or closure of the drainage opening is a natural process that is more likely to develop in younger people. To prevent or retard closure, drugs such as mitomycin-C and 5-fluorouracil may be administered. If necessary, the surgery can be repeated in the same eye.

Wavefront Technology

2008-09-18T07:48:00.003-07:00

Wavefront-guided LASIK is a promising new technology that provides an advanced method for measuring optical distortions in the eye. Measuring and treating these distortions goes beyond nearsighted, farsighted, and astigmatism determinations that have been used for centuries. As a result, physicians can now customize the LASIK procedure according to each individual patient’s unique vision correction needs. The treatment is unique to each eye, just as a fingerprint is unique. Wavefront systems work by measuring how light is distorted as it passes into the eye and then is reflected back. This creates an optical map of the eye, highlighting individual imperfections.

Wavefront technology functions as a roadmap for LASIK surgery, providing benefits to the patient during both the evaluation and treatment process.

- During the patient evaluation process, wavefront provides the physician comprehensive individual diagnostic information, not available using earlier technologies. Thus, before surgery even begins, the surgeon is better able to determine the appropriate course of treatment.

- During treatment, wavefront allows the surgeon to tailor the laser beam settings, making the surgical procedure itself more precise. In this way, wavefront technology offers the patients sharper, crisper, better quality vision, as well as a reduction in nighttime vision difficulties, such as halos and glare.

Wavefront technology is an adjunct tool used to enhance an already safe and effective procedure. As the most common form of vision correction surgery, LASIK has already benefited millions of patients. The increased safety and the improved quality of vision benefits of customized procedures are an important technological advancement for patients and physicians alike.

Visual Errors

For purposes of this discussion, there are two categories of visual errors or “aberrations:” second-order and higher-order.
Conventional forms of optical correction have been limited to measuring the best spherical and cylindrical visual errors (second-order aberrations), which result in myopia (shortsightedness) or hyperopia (farsightedness) and regular astigmatism (blurriness), and prescribing shperocylindrical lenses in the form of spectacles, contact lenses, and conventional refractive (LASIK) surgery to correct them. Correcting second-order aberrations has the highest impact on acuity, which is the eye’s ability to distinguish object details and shape. At the same time that conventional refractive surgery corrects major, second-order spherical errors, in many cases, it also induces some degree of minor spherical aberrations.

However, about 17 percent of optical errors are higher-order aberrations. If these are minimized, image contrast and special detail are increased. Minimizing higher-order aberrations with wavefront technology by reducing the naturally occurring ones is achievable and may be particularly beneficial to individuals with unusually large amounts of higher-order aberrations.

How Wavefront Works: The wavefront aberrometer

Light can be thought of as traveling in a series of flat sheets, known as wavefronts. To clarify the confusion about light traveling as waves instead of rays, waves are just perpendicular to light rays. These light waves are wrinkled or distorted as they pass through imperfections in the eye. These errors can be displayed on a color map of the wavefront image, which is the tool that is used to diagnose, and then determine corrections, for abberrations in the eye.

There are several ways of analyzing the optical system of the eye using wavefront technology. The most common, the Hartmann-Shack wavefront sensing method, deals with light waves as they exit the eye. In this system, the surgeon or other professional shines a small, low-intensity laser into the eye, and the patient focuses on the light. As that light scatters off of the retina (the rear-most portion of the eye) it passes through the lens, the rear surface of the cornea (the clear, crystalline front part of the eye) and the front surface of the cornea. Thus, the emerging waves of light are distorted by the imperfections in the total visual system of the eye. After leaving the eye, the light passes through an array of many small lenses in the sensing device (called an aberrometer), and is focused into spots, which are recorded by a special camera. The deviation of the spots from their ideal location provides information about focusing imperfections in the visual system.

Wavefront-Guided Treatment

The goal of wavefront-guided laser treatment is to make corrections in the surface of the cornea that compensate for errors in the total visual system. Thus, the amount of wrinkle or error in the wavefront reflected from the back of the eye, as compared to the reference wavefront that was projected into it, defines the compensating optical correction. If the wavefront is retarded in relation to the reference wavefront, the laser must remove more tissue from the part of cornea related to that pattern. If the wavefront is advanced (in front of the referenced wavefront), the laser must remove less tissue. It should be noted that wavefront treatment does induce some minor second-order spherical errors, but to a significantly lesser extent than conventional refractive surgery.

In this way, a wavefront-guided treatment is customized to the characteristics of each eye and intended to minimize higher-order aberrations so that the greatest quality of vision can be achieved.

Wavefront technology is relatively new to the United States. The U.S. Food and Drug Administration (FDA) issued its first approval of a wavefront system in August 2002, and other major US laser manufacturers are expected to receive their approvals in 2003. As the FDA approves systems and they become widely available, patients will have greater access to wavefront technology and treatment.

Prepare for LASIK eye surgery

2008-09-18T07:48:00.002-07:00

Before surgery, your eye doctor takes a detailed medical history and uses specialized equipment to carefully measure your cornea, noting the shape and any irregularities.

If you wear contact lenses, you'll need to switch to glasses full time a few weeks before this exam. Contact lenses can distort the shape of your cornea, which could lead to inaccurate measurements and a poor surgical outcome.

Skip your eye makeup and eye cream on the day before and the day of your surgery. Your doctor may also instruct you to clean your eyelashes daily or more often in the days leading up to surgery, to remove debris and minimize your risk of infection.

You'll need to have someone drive you to and from your surgery. Immediately after surgery, you might still feel the affects of medicine given to you before surgery and your vision may be blurry.

Refractive surgery is usually considered elective surgery — which means it isn't vital to your health and well-being. For this reason, Medicare and most insurance companies won't cover the cost of the surgery. So be prepared to pay out-of-pocket for your expenses.

Risks

2008-09-18T07:48:00.001-07:00

As with any surgery, refractive surgery carries risks, including:

* Undercorrections. If the laser removes too little tissue from your eye, you won't get the vision results you were hoping for. Undercorrections are more common for people who are nearsighted. You may need another refractive surgery (enhancement surgery) within a year to remove more tissue.
* Overcorrections. It's also possible that the laser will remove too much tissue from your eye. Overcorrections may be more difficult to fix than undercorrections.
* Astigmatism. Astigmatism can be caused by uneven tissue removal. This sometimes occurs if your eye moves too much during surgery. It may require additional surgery.
* Glare, halos and double vision. After surgery you may have difficulty seeing at night. You might notice glare, halos around bright lights or double vision. Sometimes these signs and symptoms can be treated with eyedrops that contain a type of corticosteroid, but sometimes a second surgery is required.
* Dry eyes. For the first six months or so after your surgery, as your eyes heal they might feel unusually dry. Your eye doctor might recommend that you use eyedrops during this time. If you experience severe dry eye, you could opt for another procedure to get special plugs put in your tear ducts to prevent your tears from draining away from the surface of your eyes.
* Flap problems. Folding back or removing the flap from the front of your eye during surgery can cause complications, including infection, tearing and swelling. The flap removed during PRK may grow back abnormally.

If you're considering LASIK eye surgery, talk to your doctor about your questions and concerns. He or she can explain how the surgery might benefit you and help put the risks in perspective.

After surgery

2008-09-18T07:48:00.000-07:00

Immediately after surgery, your eye may burn or itch and be watery. You'll probably have blurred vision. You may be given pain medication or eyedrops to keep you comfortable for several hours after the procedure. Your eye doctor might also ask you to wear a shield over your eye at night until your eye heals.

Typically you're able to see the day of your surgery, but your vision won't necessarily be better right away. Expect your vision to improve over the next two to three months. Most people who have refractive surgery eventually attain 20/25 or better vision. Your chances for improved vision are based, in part, on how good your vision was before surgery.

Other types of refractive surgery
Your eye doctor may recommend another type of refractive surgery if you're not a good candidate for LASIK eye surgery. These include:

*

Photorefractive keratectomy (PRK). PRK is sometimes used if you have a low to moderate degree of nearsightedness or farsightedness, or if you have nearsightedness with astigmatism. PRK removes the thin surface layer of your cornea (epithelium). Your eye surgeon then uses a laser to flatten your cornea or make its curve steeper.

The exposed surface of your cornea repairs itself, assisted by a contact lens you wear as a bandage over your eye for three or four days after surgery. You might have eye pain for a few days until your cornea heals. It generally takes up to a week for your eye to regenerate the surface tissue that was removed. During this time you'll notice variations in your vision. It may take three to six months before your vision improves completely. Most people undergoing PRK have both eyes done on the same day.

PRK has become less common in recent years because more eye surgeons prefer the LASIK procedure. Healing after LASIK is more predictable and usually involves less discomfort and scarring.
*

Laser epithelial keratomileusis (LASEK). LASEK is similar to LASIK eye surgery and might be an option if you aren't eligible for LASIK. During a LASEK procedure, a much thinner layer — the surface layer (epithelium) — of your cornea is folded back to allow the laser to focus on parts of your cornea that need reshaping. The epithelial flap is then replaced.

If you have very thin corneas, you might be a better candidate for LASEK because the procedure allows your doctor to remove less of your cornea. People who play sports or have jobs that carry a high risk of eye injuries might also prefer LASEK because a thinner flap means less damage to your vision should the flap be torn before it can heal. As with LASIK, the LASEK procedure can be done on both eyes on the same day.

A Brief Note on LASIK

2008-09-02T07:58:00.002-07:00

LASIK surgery, a laser eye surgery that is safe, may be used to improve the eyesight of millions who suffer with various sight diagnosis. Laser Assisted Situ Karatomileusis, or LASIK, procedures involve the use of a monochromatic beam that reshapes the cornea of the eye. The machines and laser beams used in these procedures are regulated by the Federal Food and Drug Administration (FDA), insuring patients that the process and lasers used are safe. The FDA oversees the selling of medical equipment in the United States. This means that before doctors may purchase a particular medical instrument or device, this piece must be approved by the FDA, who analyze, thoroughly examine, and test the equipment, to determine the equipment to be safe and to be beneficial to the patient. Once an approval for any device is reached, doctors may have access to the instrument.

The procedure of laser surgery for the eyes has grown in popularity, and doctors use an approved refractive laser system for treating various optical conditions. The most common procedures are used to treat refractive errors such as myopia, hyperopia, and astigmatism, which are conditions related to focus. These diagnosis are commonly referred to as farsightedness, nearsightedness, and various astigmatisms. Other optical diseases are not yet being treated with laser surgery for eyes.

Safe LASIK surgeries can even be performed in a doctor's office. The entire procedure may take less than thirty minutes. There are many precautions used to ensure safety and to prevent complications, such as infection. First, numbing medicines are used to prevent extreme discomfort and irritation to the eyes. Doctors will thoroughly clean the eye and surrounding area, removing any possible articles which could cause further irritations. There are simple devices used to keep the eyelids open . Before the procedure, doctors may also prescribe a mild sedative to patients, helping them to relax and stay calm, increasing the likelihood of success.

The actual process of laser surgery for eyes utilizes an intense beam to open a flap in the cornea. The doctor places a ring around the eye during the surgery, where pressure causes the eye to come forward. At this point, the doctor will begin to use various intense beams to open the cornea and reshape it, allowing refractive light to be more focused, improving vision. After the surgical event, there will be a protective covering which should be used to keep patients from rubbing the area, which may be itching and burning and there may be eye drops prescribed, to keep the area clean. Excessive tearing or watering may occur with some patients and patients should also consult with doctors about all post-op instructions.

Even though laser eye surgery that is safe can help restore vivid eyesight, LASIK surgery for eyes is not for everyone. There are certain conditions which may prohibit this high-tech laser beam procedure. Teenagers under the age of eighteen are not good candidates for LASIK procedures. Young people may still grow, and the eye and cornea may alter with time and growth. There are also those who have a condition called refractive instability. Refractive instability is a condition that causes the eye's ability to focus light to change often, making this diagnosis impractical for this procedure. Also, those who are pregnant, who have fluctuating hormones, diabetes, or other diseases which prevent healing, should not consider this process. Anyone with an autoimmune diagnosis will also be advised against taking risks with surgical procedures.

There are different methods used in LASIK surgeries. Those considering LASIK should obtain a quick education about the surgery and research several different doctors who work with laser equipment. While the actual equipment utilized during a procedure is considered safe by the FDA, doctors and their practices are not actively regulated. Also, costs for laser eye surgery that is safe is also not overseen by the government, so patients will want to make sure and pay competitive prices and that they are receiving the entire treatment paid for. With the popularity of laser surgery for eyes, the industry has grown very competitive. Those investigating or considering LASIK procedures will want to avoid advertising campaigns that sound too good to be true, and find reputable doctors to ensure that the laser eye surgery that is safe, truly is.

The Bible tells us, "Happy is the man that findeth wisdom, and the man that getteth understanding. For the merchandise of it is better than the merchandise of silver, and the gain thereof than fine gold." (Proverbs 3:13-14) No one should be quick to rush into any type of surgery, even a laser eye surgery that is safe. The wise person will seek to get knowledge about any medical procedure before taking risks with the body that God has created and given. It is ultimately the responsibility of the patient to determine what is best for their own bodies and what risks involved will make a medical procedure worth those risks. Spend time in prayer and seek the counsel of others before going forward with laser surgery for eyes.

Choosing Your Surgeon

2008-09-02T07:58:00.001-07:00

When choosing a surgeon to perform your laser eye surgery there are many factors that you will want to take into consideration:

*

Experience
*

Comprehensive Skills
*

A Dedication to Refractive Surgery
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State of the Art Equipment
*

Personality, Style, and an Expert Staff

EXPERIENCE

The surgeon you choose should have been performing refractive surgeries for at least three years and performed no fewer then 250 refractive vision correction procedures in the last 12 months. Be sure to speak with recent and past patients that have had the surgery performed by your surgeon. Your surgeon should easily give you a list of 25 or more patients to contact.

SKILLS

Make sure your surgeon is qualified to perform your laser eye surgery. Ask him/her which techniques he/she has been trained in. Your surgeon should have the skills to perform more then one type of refractive surgery. Be wary of surgeons that only offer one or two of the available techniques to correct vision problems. Your surgeon needs to be able to offer you the best surgery available for your condition. Additionally, your surgeon needs to have the skills to perform any enhancements to your eyes that may be required after your initial refractive surgery.

DEDICATION

Is your surgeon dedicated to performing laser eye surgeries? Choosing a surgeon that only performs a couple of procedures a week may not have the experience or skills to perform the surgery required for your vision problems. Additionally, you should ask your surgeon which refractive surgery associations and organizations in which he or she belongs. The manufacturers of the laser surgery equipment also provide documentation to the surgeon for any training provided to him/her.

PERSONALITY

Does your surgeon make you feel comfortable? Are you able to ask your surgeon questions and have them answered in a manner that you understand? The answers to both of these questions should be yes. Your vision is invaluable and you must feel at ease with your surgeon on a personal level. Your surgeon should readily be open to questions and answer them to your satisfaction in an honest and caring manner.

EQUIPMENT

Finally, you want to insure that your surgeon's office is equipped with the latest equipment and manned by an experienced staff. Be sure to verify that your surgeon is using a laser that has been approved by the FDA. Some surgeons have been known to use lasers that have been re-imported, custom-made, or home-made. Furthermore, ask your surgeon if the FDA approved laser he/she is using has been properly serviced and maintained.

STAFF

Take the time to interact with your surgeon's office staff before your procedure. A staff that is dedicated to refractive surgery should be able to take care of your needs and insure that your experience is a rewarding one. There are three different types of eye care professionals usually involved in a person's eye care

Lasik Eye Surgery Complaints

2008-08-30T23:35:00.001-07:00

A decade after Lasik hit the market, unhappy patients will air their grievances before the Food and Drug Administration Friday as the government begins a major new effort to see if warnings about the risks are strong enough.

How big are those risks? The FDA thinks about 5 percent of patients are dissatisfied, but can't provide more specifics — and is pairing with eye surgeons for a major study expected to enroll hundreds of Lasik patients to try to better understand who has bad outcomes and exactly what their complaints are.

"Clearly there is a group who are not satisfied and do not get the kind of results they expect," FDA medical device chief Dr. Daniel Schultz said Thursday. The study should "help us predict who those patients might be before they have the procedure."

About 7.6 million Americans have undergone some form of laser vision correction, including the $2000-per-eye Lasik. Lasik is quick and, if no problems occur, painless: Doctors cut a flap in the cornea — the clear covering of the eye_ aim a laser underneath it and zap to reshape the cornea for sharper sight.
The vast majority, 95 percent, of patients see more clearly after Lasik — some better than 20/20 — and are happy they had it, said Dr. Kerry Solomon of the Medical University of South Carolina, who led a review of Lasik's safety for the American Society of Cataract and Refractive Surgery.

But one in four patients who seeks Lasik is told they're not a good candidate, he said. And there is little information about just how badly the 5 percent who get it but are dissatisfied actually fare.

Solomon estimates that fewer than 1 percent of patients have severe complications that leave poor vision. Other side effects, however, are harder to pin down. Dry eye, for instance, can range from an annoyance to so severe that people suffer intense pain and need surgery to retain what little moisture their eyes form. That's the kind of question the FDA's new study aims to answer.

Dry eye is common even among people who never have eye surgery, and increases as people age. Solomon says 31 percent of Lasik patients have some degree of it before the surgery, and that about 5 percent worsen afterwards.

But dry-eye specialist Dr. Craig Fowler of the University of North Carolina says other research suggests 48 percent of patients experience some degree of dry eye at least temporarily after Lasik. Cutting the corneal flap severs nerves responsible for stimulating tear production, and how well those nerves heal in turn determines how much dry eye lingers long-term, he said.

Even if the risks are low, that's little consolation to suffering patients.

"As long as you know any ophthalmologist that's wearing glasses, don't get it done," says Steve Aptheker, 59, a Long Island lawyer who was lured by an ad for $999 Lasik and suffered severe side effects that required seven additional surgeries over four years to restore his vision.

The flaps cut in his cornea literally became wrinkled when they were laid back down, blocking his vision and causing severe pain. A few surgeries later, with a different doctor, Aptheker could function better but couldn't drive at night and saw a halo around objects that caused serious distortion even during the day. With more operations as new technology hit the market, Aptheker said today his right eye sees as well as it did with glasses before Lasik, but his left remains fuzzy and requires halo-reducing drops.

The FDA has long known of those side effects, and thus for years has a Web site with warnings for Lasik patients and required that doctors give every potential patient a brochure outlining risks. Friday, the agency will ask its outside advisers if its warning efforts go far enough.

But Lasik has been refined in recent years to offer crisper vision with fewer risks, said Dr. Steven Schallhorn, an ophthalmologist who oversaw the Navy's refractive surgery program until last year when, based in part on his research, the Navy began allowing its aviators to get Lasik.

Schallhorn advises patients to seek what's called "all-laser Lasik" — where a thin flap is created using a more precise laser instead of a blade — combined with "wavefront-guided" software that maps subtle irregularities in the cornea before it's zapped.

Q&A Eye Surgery

2008-08-30T23:34:00.001-07:00

"Kcpin" asks: I have presbyopia otherwise no problems with sight. I'm 52, female and I wear 2+ enlargers. Are they harmful? And would I benefit from lazer surgery?

Dr. Soloway: There is no harm in using the over-the-counter readers or magnifier glasses, and +2.00 is about right for your age. They shouldn't be used as a reason to not visit with an eye doctor from time to time (perhaps every 2 years) to be certain that you don't have any silent eye problems such as glaucoma.

Sherry Davis of Bristow, Va., asks: I am in my early 40's and recently went to the eye doctor. I was told that I wasn't a good candidate for laser eye surgery because my prescription hasn't stopped changing. My eyesight is slowly beginning to revert to far-sightedness instead of near-sightedness which I've been for many years. Is it true that I shouldn't get laser eye surgery? The Dr. instead is recommending a treatment using contacts to mold my eyes while I sleep at night, slowly correcting my vision. I would prefer to go the laser surgery route. What would you advise?

Dr. Soloway: One of the first prerequisites of laser eye surgery is that your prescription for distance (not the reading glass prescription) is reasonably stable. Slight changes of a quarter diopter (the measurement for glasses strength) are not typically reasons to not have surgery. The method that your doctor is referring to is called "orthokeratology" and is usually practiced by optometrists (who do not do laser surgery) and not by ophthalmologists (some of whom do perform laser surgery). Orthokeratology can work well depending on the practitioner and the original prescription (weaker prescriptions being easier to treat). Both groups of eye doctors might offer different options based on what is available to them. You might consider getting another local opinion, but be certain to bring as many pairs of old glasses in order to have an assessment of just how much your eyes have been changing.

Brad Dick of Lenexa, Kansas, asks: Are any of the new non-medical eye-focusing programs effective? One program claims a person can, through eye exercise, regain the ability to focus at both distant and close distances. Any truth to these claims?

Dr. Soloway: While there is a good deal of controversy over these non-surgical methods of vision correction, in my practice I have found them to be effective over only a very small range of mild prescriptions.

Frank Kitchen of Folsom, Calif., asks: I have been told that I am not a good candidate for Lasic surgery because I have keloid skin associated with scarring. That was 5 years ago. Have any developments been made that I could now have the surgery? I've told that there are some new procedures that may allow me to have the surgery. I would appreciate your comments on this matter. Thank you for your time and consideration.

Dr. Soloway: Keloid formation is primarily a risk of surface excimer surgery and currently it is not a contraindication for LASIK surgery.

Curt Benefield of San Antonio asks: I have had Lasik surgery about 8 years ago to correct my near-sightedness problem. I am now 56 and have lived with presbyopia for about the past 6 years with a correction of about -1.75. Am I a candidate for corrective surgery?

Dr. Soloway: In the U.S., only a re-treatment to make you nearsighted in one eye with the excimer laser of CK for monovision might help. The other surgical procedures for restoration of reading vision such as SSP (scleral spacing procedure) would not be able to be done as they are investigational and most protocols require no prior eye surgery. One presbyopia investigator's practice is in San Diego and you might contact him for an evaluation: Larry Lothringer, MD.

Carolyn of Brookland, Ark., asks: If you have Amphilophia (lazy eye) in the left eye only and wear bifocals would you be a candidate for laser surgery or would you consider it to dangerous to try? Thank you for your reply in advance.

Dr. Soloway: Monovision may not work well with amblyopia (lazy eye) as the second eye may not see well enough on its own. Depending on the level of weakness, laser surgery, while not more risky, might not be a good option on your only good eye.

Brian Williams of Lenoir City, Tenn., asks: I had RK surgery in 1992 to correct near-sightness. I could read fine without glasses then. Three years ago I had to start wearing glasses again for near-sightness and also for reading. Can surgery correct my near-sightness and allow me to be able to read without glasses?

Implantable Contact Lenses (ICL's)

2008-08-30T23:08:00.001-07:00

If your prescription falls outside the treatment range for Laser Vision Correction, then Implantable Contact Lenses (ICL's) are an option available for you.

Implanted lenses are used for the correction of more severe levels of short sight, long sight and astigmatism. They are similar to a small 'contact lens' which is placed inside the eye instead of sitting on the surface. Benefits include; painfree treatment with rapid visual recovery and very good visual acuity results. Success rate is approximately 95%.

Suitability

Using implanted lenses, patients prescriptions from -23d to +12d with (+/-)7d of astigmatism can be treated. The treatment is also available for patients who are unsuitable for laser treatment due to corneal thickness or after cataract removal. The treatment is not suitable for people over 60 years of age or anyone developing cataracts. People with high glaucoma, recurrent eye infections and other eye diseases may not be suitable.

Consultation

An initial consultation will confirm your suitability and determine the strength of lens required. If you decide to go ahead with treatment, the lenses will be made to your exact specifications and will be ready in 4 - 6 weeks. Consultations for Implantable Contact Lenses (ICL's) are currently available in clinics in London and Croydon.

Treatment

The lens is inserted through a small incision in the side of the cornea and sits in front of the eye's natural lens, just behind the cornea. Antibiotic drops are then administered to avoid infection.
The whole procedure takes around 20 - 30 minutes to complete. You will be able to go home on the same day but it is essential that you have someone to accompany you. For utmost safety in case of infection or rejection, lenses are implanted one at a time, allowing a minimum recovery time of one week between treatments.

After treatment

You will need to rest at the clinic for about an hour after treatment with a bandage over the eye. Visual recovery is rapid, with noticeable improvement within a day or two. You should be able to drive and be back to work within two weeks of the procedure.

Aftercare

You will need to be seen by the treating doctor on the day after surgery, so an overnight stay in a local hotel may be desirable. You are then seen after one week when the second eye may be operated on. Aftercare visits are then required after one month and three months and then as directed by the surgeon.

Millions ignore poor eyesight

2008-08-30T23:07:00.001-07:00

Millions of people in the UK are turning a blind eye to their own sight problems, a survey has found. By doing so they are putting themselves and others at risk.

The study of just under 1,000 adults who had not had eyesight correction, found many put off wearing contact lens or glasses even when they suspected they might need them.

The figures suggest that as many as 2.5m Britons who should be seeking help for eyesight problems have failed to do so.

Each person was given a basic eye test, and asked for their opinions on contact lens, glasses and laser eye surgery.

More than one in three (35%) failed the eye test - but of these 33% said they were not surprised and worryingly, 65% were car drivers.

Researcher Dr June McNicholas, a psychologist at Warwick University, said the results suggested that many people had taken a conscious decision not to have their vision corrected.

Lasik - News

2008-08-30T23:05:00.001-07:00

Amidst a declining economy, people are doing just about anything to save a few bucks on their coveted elective surgical procedures. Just because we're about to enter a recession doesn't mean people don't still want their breast augmentations, face lifts, teeth whitening and LASIK surgery.

For the non-squemish and non-bashful, there is a new trend that is saving people as much as 50% on some of their elective procedures. If you agree to have your procedure broadcast LIVE on YouTube (or a number of other popular video posting sites), you may be offered money off of your surgery.

Not all surgeons are participating, but the ones who are are coming from a purely advertising mindset. People who log on to the video sharing websites can watch the procedure, and the video acts as a real-life, real time marketing tool for the surgeons. They're able to show off their talents, and walk viewers through the procedure step by step.

You may not be interested in watching other people's surgeries, ,but if you don't mind being filmed to save some dough, inquire to your local LASIK center. As the procedure only takes five minutes or so, many LASIK surgeons are interested in doing these types of alterna-marketing ideas to entice new patients.

Is Laser Eye Surgery Safer Than Wearing Contact Lenses?

2008-08-30T23:01:00.001-07:00

After comparing data from several recent studies, an Oregon ophthalmology professor has concluded that laser eye surgery may be safer than wearing contact lenses long-term.

The chance of vision loss appears more likely with long-term contact lens wear than with laser eye surgery, said William Mathers, MD, of Oregon Health & Science University Casey Eye Institute in Portland, Ore.

"Several times a year, I have patients who lose eyes from complications because they've been wearing contacts and they've gotten an infection. By this, I mean their eyes have to be physically removed from their bodies," Mathers said in a news release.

"It's not that contacts aren't good. They're better than they've ever been. But one cannot assume contacts are safer."

In contrast, Mathers said the safety record of 18,000 laser eye surgery procedures conducted at Portland's Casey Vision Correction Center demonstrates that no patient has ever lost vision equivalent to two lines on an eye chart. Mathers also cited results from more than 32,000 U.S. military personnel undergoing laser eye surgery in which one in 1,250 lost one line of vision. There were no reports of loss of two lines or more of vision.

Mathers said that between 20 million and 25 million U.S. citizens wear contact lenses. About one million people in the United States undergo laser eye surgery annually.

Aspiring Astronauts May Now Undergo LASIK

2008-08-30T22:59:00.001-07:00

Aspiring astronauts who have undergone "all laser" LASIK can now be considered for NASA's space program because of a recent policy change.

Previously, LASIK was considered unsafe for astronauts in extreme conditions such as liftoff because of a hinged flap created on the eye's surface. After the cornea is reshaped by an excimer laser, the flap is replaced as a type of natural bandage.

Healing times are much faster because of the flap used with LASIK. But NASA officials feared that even a healed flap could become dislodged under extreme conditions.

Now, NASA officials say that modern wavefront-guided LASIK using flaps created by a special laser (femtosecond) known as IntraLase has a safety profile good enough to clear the vision correction procedure for astronauts.

Does Quality of Life Improve After LASIK?

2008-08-30T22:58:00.001-07:00

Visual function as measured by what's seen on an eye chart is one way of determining success following a LASIK surgery procedure.

But the U.S. Food and Drug Administration (FDA) wants to clarify whether LASIK actually improves quality of life.

To do this, the agency will undertake a major study in 2009 in cooperation with the National Eye Institute, American Society of Cataract and Refractive Surgery and the American Academy of Ophthalmology.

The study will assess quality of life following LASIK based on factors such as general satisfaction beyond how eyesight is traditionally assessed.

Between 1998 and 2006, the FDA reported receiving 140 comments from people unhappy with the outcomes of LASIK procedures.

Study Finds High Satisfaction Rate With LASIK

2008-08-30T22:57:00.000-07:00

About 95 percent of the more than 16.3 million people worldwide who have undergone LASIK eye surgery are satisfied with their results, according to the American Society of Cataract and Refractive Surgery (ASCRS).

"We find that there is solid evidence in the world's scientific literature to affirm that there is an exceptionally high level of satisfaction in patients who have had LASIK surgery," said ASCRS president Richard L. Lindstrom, MD.

ASCRS based its conclusions on a review of nearly 3,000 peer-reviewed articles appearing in scientific and medical journals worldwide.

Lindstrom acknowledged that risks are still involved and some outcomes are unfavorable, which is why eye surgeons continually seek to improve technology and techniques.

Researchers who reviewed scientific literature said successful outcomes also involve selecting appropriate candidates for LASIK based on factors such as eye health.

Refractive Surgery

2008-08-30T22:56:00.001-07:00

One of the most advanced techniques of eye surgery today is the so-called refractive surgery. This type of surgical procedure may decrease or even eliminate a person’s dependency on glasses or contact lenses. This procedure is called refractive surgery since it affects the refractive state of the eye, which may cause common vision disorders such as myopia, hyperopia and astigmatism. Currently, the most common type of refractive surgery utilizes laser to reshape the patient’s cornea and eliminate the subtle alterations that cause eye disorders. Surveys point that refractive surgery it’s becoming so widespread and results so successful that nearly 1 million of surgeries are expected to be performed in 2006, in the USA alone.

Favourite Film on your Glasses

2008-08-17T04:45:00.000-07:00

The 29-year-old optician first began experimenting with vinyl and plastic glass frames about eight years ago and now sells a range of Cinematique eyewear with clips from the silver screen worked into the frame.

"I began testing all sorts of plastic until I found my father's record collection, and then I started recycling those without his knowledge," Tipton told Reuters.

That's when Tipton, who grew up in the United States with a Hungarian mother, decided to set up his funky eyewear business.

Now he, along with his brother, are based in Budapest and their collection is sold across Europe and North America.

Their Cinematique frames are made by recycling 35mm and 16mm movies. The film is collected from cinemas and dates from after 1989.

"They (customers) tell us they'd like a film from Woody Allen or they want Mission Impossible 3 in their frame or they want a picture of some famous actor, then we will make it here and ship it to them," Tipton said.

Tipton moved to Hungary at the start of this decade and is now targeting increasingly affluent eastern European customers with a list of about 300 films to choose from.

The frames are designed on a computer and a company in Italy manufactures them. The front of the frames is made by a sister company in neighboring Slovakia.

Not all films make good material though, as the images must have bold colors and lots of contrast.

Tipton said a favorite is the 2003 action movie Once Upon a Time in Mexico, which stars Antonio Banderas as hitman El Mariachi alongside Johnny Depp as a psychotic CIA agent.

"There are explosions everywhere, contrast, people flying, jumping, which brings out an added dimension."

Orbscan

2008-08-15T08:10:00.001-07:00

We’re not going to talk a lot about Orbscans because, well, first, we don’t know a whole lot about them, and, second, as far as we know they aren’t much good at what standard topographers do, but what they are good at is corneal thickness.

Corneal thickness is a very important piece of information for diagnosing certain complications from refractive surgery. And this is so important that they measured it before surgery, probably with an Orbscan (which you should ask for a copy of, incidentally), in order to make sure your corneas were thick enough to do surgery safely in the first place. Now, after surgery, the Orbscan can still indicate whether the cornea was made any thinner than intended, particularly important if you are considering further surgical treatment.

It should be noted that Orbscans do not do this flawlessly (they are simply calculating averages over certain areas) and even if they did, for LASIK patients it would be of limited use, because all it really tells is the total thickness including the LASIK flap. Remember that now there are two distinct parts of the cornea: the flap, and everything underneath.

The part you might have a reason to worry about is the thickness of the stroma under the flap. (Although come to think of it, equally, if your flap was really sloppy, and is thicker in some parts than others, you’re going to have reasons to worry about it too.) That is because if it gets too thin, the pressure in your eye may cause bulging, which does not do nice things to your vision and may be a progressive condition called corneal ectasia. So how can you measure the stroma under the flap? Most don’t. They simply take the total thickness at the thinnest point (as indicated on the Orbscan), say, 420 microns, and subtract the thickness the flap was supposed to be, say, 160 microns. That leaves 260 microns. But suppose the flap is thicker? There could be less stroma. Or if thinner, more stroma. The flap can be analysed in better detail using VHF digital ultrasound (Artemis). That is not widely available, but you can get it in London.

Topography

2008-08-15T08:09:00.001-07:00

Topography means a sort of relief map of your cornea. They are the scans where you see a big colourful circley-sort of thing with several different colours ranging from red to blue. The colours equate to different thicknesses of the cornea.

We have a real grudge about the fact that it can be so difficult to get straight answers about what your topographies MEAN. It simply can’t be all that hard. I mean, they have done these surgeries on how many millions of people? But, sadly, they don’t seem to have bothered to do any analysis at all of what makes for a GOOD topography, so now they don’t seem to agree with each other on rules about what constitutes a BAD topography (other than that no patient of theirs is likely to have one). Fortunately we patients have not been left altogether out to dry as there are many doctors who have experience with these problems and because they have been kind enough to spend time helping us, we tend to bombard them with topographies asking for advice.

You will learn very quickly, if you already haven’t, that you’d better get copies of your topographies if you want any help diagnosing your situation. There are people who are willing to help, but you’ve got to do your job by asking for copies.

Axial topography

We’re going to talk mostly about standard topography because it’s probably what will be most relevant to you. There are a number of topographers that fall into this category, with Humphrey Systems perhaps one of the most popular.

First, let’s talk about which of those colourful circles we’re interested in. On a Humphrey, it’s called an Axial Map. And we really hope you have Humphrey topos, but if you don’t, look for something called an Axial Map (or close to it) anyway.

Next, make sure you know which eye is which as they are labelled OD (right eye) and OS (left eye).

Next, let’s talk about resolution. There’s a key to one side of the scan showing what resolution was used. What you really want is one colour change for at least every _ dioptre, meaning, for example, that 42.0 is green and 43.0 is yellow and there’s a few discernible shades in between. Obviously, the greater the resolution, the less information the scan will give you. If resolution is set too high, everything is going to look beautiful. If it is set lower, you actually have a chance of seeing useful information. (Remember when you had to decide between a 2.0 megapixel and a 3.0 megapixel digital camera.... well, this is a lot more important.)

Now, down to business.

I’m taking a big risk in talking about topographies. Why? On the one hand, I’m not an expert. On the other hand, I’ve been told a lot of nonsense by people who should be experts. On the other hand, one or two experts whose opinions I value think it’s complicated stuff and are sometimes hesitant to pronounce judgement on certain kinds of things. On the other hand, one or two other experts whose scientific honesty I value think it is almost as simple as it ought to be and that there are actually some reasonable rules you can apply. On the other hand, when one has seen piles of topographies of people with horrible optical results from LASIK, presumably one ought to be able to identify certain common aspects contributing to the horribleness of their results. On the other hand, one never seems to see post-operative topographies from people with anywhere from acceptable to good to excellent results, because they’re simply so happy their doctor never bothered, and one wonders whether, if nobody’s analysing good topos, how does one know what good topos ought to look like? On the other hand...

For heaven’s sakes, how many hands can a person be expected to count on? Topos, tapas. I’m tired of debating with myself and will simply take the leap.

So, I’m going to take a stab at one or two basic points, and hopefully wherever I am wrong or incomplete, the medical community will rise up in wrath and pummel me with excellent, user-friendly scientific studies showing me the error of my ways in which case I will hasten to revise this text. Incidentally, at the time of this writing a trusted MD friend is engaged in research on this very topic and I am impatiently awaiting the results so that I can get a clearer view on what makes for good topos.

1. You should be looking at something that looks vaguely like a blue circle in a sea of red, with the bluish part extending for a certain way (across at least a couple of the boxes in the grid) then giving way to a progression of colours working their way up the rainbow: green, yellow, and orange, then red.
2. You should be able to identify your functional optical zone in there somewhere. The functional optical zone is the part that has been given full refractive error correction by the laser. The functional optical zone should be close to, but then again may not be anywhere near, the planned ablation zone as indicated on the operative report. That was the plan. This is the reality. We know people with FOZs as small as 2.5mm where their laser was programmed for 5.5. A little bit of this can be due to what’s known as ablation shrinkage, but the rest must be attributed to either what the laser did, or how badly the cornea was bothered by what the laser did.
3. Really small FOZs are Bad Things.
4. FOZs that are not all that small but are still smaller than your pupil size in dim light or dark are also Bad Things.
5. If you can’t identify your FOZ at all because there are so many colours swimming around right in the centre of the ablation, that is a Bad Thing.
6. Now, look at that blue circle (if there is one) or at any rate the central 6mm of your cornea. If it’s reasonably round, that means it had a centre. Try to identify the centre.
7. If the centre of the blue circle is not somewhere very near to the centre of your pupil, that is a very Bad Thing.
8. If the centre of the blue circle is perfectly aligned with the centre of your pupil, but there is a little X indicating your line of sight and that’s kind of offset from your pupil, and you had a high prescription, that might be a Bad Thing. (There is an industry argument over whether the ablation should be centred on the pupil or centred on the line of sight. Kind of important, like, boys, we need to decide whether we’re aiming to wing him or get him right in the heart.
9. Now, look at the central 6mm of your topography, and forget about whether it’s all the same colour (it probably isn’t or you wouldn’t be here). Do you see anything that looks like a bow tie, or a bug splat, or islands swimming around? That might not be a good thing. Now use the key that shows what fraction of a dioptre is represented by a colour. Are any of those fancy things more than 0.5 dioptre different in colour than the stuff around them? That indicates a Bad Thing.
10. Looking at that same central 6mm, use the key and find the minimum and maximum number of dioptres within that circle, and add up the different colours. If you are seeing 3 or more colours, and the minimum and maximum are 1.00 dioptre or more apart from each other, those are Bad Things. You should not have to be looking out at the world through all different kinds of refractive powered cornea. You might still be able to read an eye chart especially if the 1mm at the centre of your cornea is just the right power, but that doesn’t help too much with real life.
11. If your pupil size in dim light is greater than 6mm (which is probably the case: it is statistically true for half the population, and since you’ve got a bad result from surgery, it’s rather more likely to be true of you) look at the area between 6mm and however large your pupil is in dim light, and apply rules 9 and 10, and see if you find any more Bad Things.

By now, you are getting the idea. You ought to have a reasonably nice looking lasered area on your cornea that goes out somewhere at least close to where your pupil’s going to extend to. If you don’t, nobody should be surprised that you have some significant vision disturbances. If you do, you may still have plenty of reasons for vision disturbances when we get down to the dirty details. You’ll have to stay tuned for when The Lone Dog starts talking about that.

Excimer Lasik

2008-08-15T08:08:00.001-07:00

The excimer laser has been used in the past few years to correct myopia. There are several thousand people in the United States who have had excimer laser surgery through research studies that are authorized and reviewed by the Food and Drug Administration. The excimer laser is limited in the U.S. to investigation use only.

In a process called photorefracive keratectomy (PRK), the excimer laser precisely sculpts the surface of the cornea using invisible, high-energy light. While not yet proven, it is hoped that this procedure will produce more stable vision than RK.

No surgical blades are used. The surgery takes about 15 minutes using eye drops to anesthetize the cornea. Complications during the procedure itself are very rare.

For mild to moderate myopia, PRK and RK have similar results. The cornea should be able to withstand injury better after PRK than after RK.

A common but temporary problem after PRK is hazy vision. It usually improves after several months and, based on current clinical trials, rarely results in a permanent scarring of the cornea.

Over 70% of people report some haloes or glare after PRK, especially at night; these symptoms usually decrease over 3 to 6 months. As with RK, however, most people are pleased with the improvement in eye sight unaided by glasses or contact lenses following PRK.

The long-term results and safety of PRK are unknown until research trials are completed.

Laser Eye Surgery: Is It Worth Looking Into?

2008-08-13T06:03:00.000-07:00

"After wearing contact lenses for 35 years, you can't imagine the freedom I felt," says Goldstein.

Goldstein underwent refractive eye surgery, an elective procedure intended to correct common eye disorders, known as refractive errors, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (distorted vision). Although there are several types of surgical techniques being performed today to correct refractive errors, laser refractive correction is fast becoming the most technologically advanced method available, according to the American Academy of Ophthalmology in San Francisco. Doctors say it allows for an unparalleled degree of precision and predictability.

"Laser surgery is the most exciting advancement in ophthalmology," says James J. Salz, M.D., clinical professor of ophthalmology at the University of Southern California in Los Angeles and the doctor who performed Goldstein's surgery. But surprisingly, he says, despite its sudden popularity, "only 20 percent of ophthalmologists in the United States today are trained in its operation."

The Food and Drug Administration first approved the excimer laser in October 1995 for correcting mild to moderate nearsightedness. With that approval, the agency also restricted use of the laser to practitioners trained both in laser refractive surgery and in the calibration and operation of the laser. Currently, the excimer laser has been approved for use in a procedure called photorefractive keratectomy (PRK), and, as of November 1998, for a procedure called laser in situ Keratomileusis (LASIK).

Precision Surgery

PRK is an outpatient procedure generally performed with local anesthetic eye drops. This type of refractive surgery gently reshapes the cornea by removing microscopic amounts of tissue from the outer surface with a cool, computer-controlled ultraviolet beam of light. The beam is so precise it can cut notches in a strand of human hair without breaking it, and each pulse can remove 39 millionths of an inch of tissue in 12 billionths of a second. The procedure itself takes only a few minutes, and patients are typically back to daily routines in one to three days.

Before the procedure begins, the patient's eye is measured to determine the degree of visual problem, and a map of the eye's surface is constructed. The required corneal change is calculated based on this information, and then entered into the laser's computer.

Since 1995, a limited number of laser systems has been approved by FDA to treat various refractive errors, both with PRK and LASIK.

According to FDA's Center for Devices and Radiological Health, clinical studies showed that about 5 percent of patients continued to always need glasses following PRK for distance, and up to 15 percent needed glasses occasionally, such as when driving. In addition, many patients experienced mild corneal haze following surgery, which is part of the normal healing process. The haze appeared to have little or no effect on final vision, and could only be seen by a doctor with a microscope. Some patients experienced glare and halos around lights. These conditions, however, diminished or disappeared in most patients in six months. For about 5 percent of patients, however, best-corrected vision without corrective lenses was slightly worse after surgery than before. In view of these findings, FDA and the Federal Trade Commission (which oversees advertising) issued a letter to the eye-care community in May 1996 warning that unrealistic advertising claims, such as "throw away your eyeglasses," and unsubstantiated claims about success rates could be misleading to consumers.

LASIK

LASIK is a more complex procedure than PRK. It is performed for all degrees of nearsightedness. The surgeon uses a knife called a microkeratome to cut a flap of corneal tissue, removes the targeted tissue beneath it with the laser, and then replaces the flap.

"With LASIK, the skill of the surgeon is important because he'll be making an incision," says Stephen Crawford, O.D., an optometrist practicing in Virginia, "compared to the PRK method where the machine does more of the work." Crawford urges people to find qualified, experienced doctors to perform this surgery. "You'll want someone who's done a number of LASIK procedures since this is a surgeon-dependent operation," he said.

According to Ken Taylor, O.D., vice president of Arthur D. Little, Inc., a technology and management consultant firm in Cambridge, Mass., "Last year, across the country, 40 to 45 percent of refractive surgeries performed by physicians were LASIK, which equates to approximately 80,000 procedures." Doctors not participating in clinical trials may choose to use the approved laser to perform LASIK procedures at their discretion, says Morris Waxler, Ph.D., chief of FDA's diagnostic and surgical devices section. But most uses are considered "off label" and are not regulated by FDA.

Ralph A. Rosenthal, M.D., director of FDA's division of ophthalmic devices, says, "The agency has ruled that individual physicians can perform LASIK under the general 'practice of medicine,' if it's in the patient's best interest."

Advantages of LASIK

Some doctors believe that LASIK is a suitable procedure for correcting the most severe refractive errors. They also say that there is generally a faster recovery time after LASIK than after PRK. In addition, LASIK patients can see well enough to drive immediately and have good vision within a week.

After studying the options, Goldstein first decided on the LASIK procedure, but was surprised to learn that her doctor advised against it.

"Initially, I wanted the quick recovery that LASIK offers," Goldstein says, "but the bottom line was, which surgery will give me the best results, and after considering everything, eventually we agreed on PRK."

James Salz is currently involved in an FDA-sanctioned clinical trial at Cedars-Sinai Medical Center in Los Angeles, which is now studying the laser system specifically for farsightedness (hyperopia) with astigmatism. Although routinely performing laser eye surgery, he still encourages a small percentage of his low to moderately nearsighted patients to undergo radial keratotomy, or RK, an earlier refractive correction procedure that does not require the excimer laser.

With RK, incisions are made in a "radial" pattern along the outer portion of the cornea using a hand-held blade. These incisions are designed to help flatten the curvature of the cornea, thereby allowing light rays entering the eye to properly focus on the retina. The number and length of the incisions determines the degree of correction attained.

"Typically, this is still a practiced procedure for select people with very small corrections of myopia," Salz says.

Conversely, Crawford says that although he will mention RK as an option to his patients considering eye surgery, he is not in favor of this method. He says studies indicate that incisions made during this procedure, which penetrate approximately 90 percent of the cornea, appear to weaken the structure of the eye. Also, once you've had RK done you can't repeat it or have PRK done.

"I think that patients should understand and consider all available options for correcting refractive errors," Crawford says, "but I would never recommend RK to anyone."

Is Laser Surgery for You?

For some, like Goldstein, laser surgery has been the ultimate freedom from the everyday hassles of contact lenses, and a second chance at having normal eyesight. But can everyone expect such dramatic results?

"The answer is no," says Rosenthal. "It's not a foolproof procedure and people need to know that some can end up with worse eyesight than before they went in."

Mary Ann Duke, M.D., a general ophthalmologist practicing in Potomac, Md., adds that there are other reasons why the expectations for laser surgery vary from person to person.

"People who are slow healers or who have ongoing medical conditions [such as glaucoma or diabetes] are not good candidates for laser surgery," she says. "That's why it's so important for patients to undergo a thorough examination with their doctor."

Poor candidates for this surgery also include those with uncontrolled vascular disease, autoimmune disease, or people with certain eye diseases involving the cornea or retina. Pregnant women should not have refractive surgery of any kind because the refraction of the eye may change during pregnancy.

Looking Ahead

At present, a number of other lasers for eye surgery are currently being tested in FDA-sanctioned studies to determine their safety and effectiveness. Investigational Device Exemptions (IDEs) filed with FDA allow for clinical studies involving the excimer laser and the correction of farsightedness. The IDE process is designed to investigate the safety and effectiveness of a device, or a new procedure with an already approved device, either to obtain information for publication or to generate the data needed to obtain marketing approval from FDA.

"If the refractive surgery center says the laser is approved by FDA, it probably is," Waxler concludes. "Still, it is wise for consumers to check that the device being used for their surgery is FDA-approved," he says, or that they make sure they are being treated with a laser that is under study in an FDA-sanctioned clinical trial.

During the first few weeks immediately following laser surgery, Goldstein says, "Every week I kept thinking, 'this is as good as it gets'?" Then, she discovered by the sixth week, as predicted by her surgeon, that her eyesight was noticeably better and eventually stabilized.

"I would tell others to be patient about their expected outcome," she advises. "Even though with LASIK you can expect quicker results, I'm happy with the choice of PRK." by Carol Lewis

Eye Surgery in India

2008-08-13T06:01:00.001-07:00

With the rising economy and increase of per capita income, the Indian Medical sector is at a rise. Medical tourism is India is a rising concept which is slowly and gradually getting very popular in the West. Patients are travelling from all over the world, specially developed countries, to India to get medical treatment. Why ? The advantages include five-star facilities, high quality doctors, very low costs (almost 1/3rd as compared to the developed countries and in most cases, even lower) and finally, a great tourist destination.

A recent study by McKinsey estimated that India's medical tourism industry could yield as much as $2.2 billion in annual revenue by 2012. Airport pick-up & drop, visa assistance, interpreter services, sight seeing, arranging forex services - hospitals are here to service the patients from the west in full energy.

Eye surgery in India is one of the highly growing sectors in medical tourism. Several hospitals and clinics are now fully equipped to handle the inflow of patients from the West with latest technology, highly trained doctors and of course, customized treatment for every patient.

Laser surgery fast becoming an alternative to eyewear

2008-08-13T05:55:00.000-07:00

Eyewear is big business in the United States. Fifty-five percent of Americans regularly wear some form of corrective glasses or contact lenses, shelling out a total of $16 billion a year.

That trend may soon change as a small but growing number of people choose to correct their vision with laser surgery.

This year, an estimated 300,000 people will undergo undergo one on the main two types of laser surgery -- PRK and LASIK -- at an average cost of $2,100-$2,500 per eye.

Although laser eye surgery is considered cosmetic and is rarely covered by insurers, the procedure is fast becoming a popular alternative to eyewear, especially among those fed up with the daily ritual of wearing contact lenses.

"I didn't think about is as an economic decision, for me it was more lifestyle," said laser surgery patient Steven Kornblau, who was considered legally blind without his contact lenses.

Kornblau had LASIK (laser in-situ keratomileusis) surgery, the more complex of the two procedures performed on all degrees of nearsightedness. Under the LASIK procedure, a surgeon uses a knife called a microkeratome to cut into the corneal tissue and then removes the targeted tissue using lasers.

PRK (photorefractive keratectomy) is less invasive and used to correct minor problems. The patient is given local anesthetic eye drops before the surgeon gently reshapes the cornea with a cool, ultraviolet beam of light.

Although PRK surgery is less complicated, doctors warn that both procedures include risks -- ranging from infections to night-vision glare -- and don't guarantee perfect vision.

"Some patients have pretty good vision without correction afterward, but still might need glasses for night driving or something like that. Generally, these procedures do not eliminate the need for reading glasses when you are in your late '40s or early '50s," said Dr. Karla Zadnik of the Ohio State College of Optometry.

Some Risk Factors Dealing with Eye?

2008-08-12T07:15:00.001-07:00

Most patients are very pleased with the results of their refractive surgery. However, like any other medical procedure, there are risks involved. That's why it is important for you to understand the limitations and possible complications of refractive surgery.

Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so.

* Some patients lose vision. Some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment.
* Some patients develop debilitating visual symptoms. Some patients develop glare, halos, and/or double vision that can seriously affect nighttime vision. Even with good vision on the vision chart, some patients do not see as well in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment.
* You may be under treated or over treated. Only a certain percent of patients achieve 20/20 vision without glasses or contacts. You may require additional treatment, but additional treatment may not be possible. You may still need glasses or contact lenses after surgery. This may be true even if you only required a very weak prescription before surgery. If you used reading glasses before surgery, you may still need reading glasses after surgery.
* Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.
* Results are generally not as good in patients with very large refractive errors of any type. You should discuss your expectations with your doctor and realize that you may still require glasses or contacts after the surgery.
* For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops).
* Long-term data are not available. LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in 1998. Therefore, the long-term safety and effectiveness of LASIK surgery is not known.

Additional Risks if you are Considering the Following:

* Monovision

Monovision is one clinical technique used to deal with the correction of presbyopia, the gradual loss of the ability of the eye to change focus for close-up tasks that progresses with age. The intent of monovision is for the presbyopic patient to use one eye for distance viewing and one eye for near viewing. This practice was first applied to fit contact lens wearers and more recently to LASIK and other refractive surgeries. With contact lenses, a presbyopic patient has one eye fit with a contact lens to correct distance vision, and the other eye fit with a contact lens to correct near vision. In the same way, with LASIK, a presbyopic patient has one eye operated on to correct the distance vision, and the other operated on to correct the near vision. In other words, the goal of the surgery is for one eye to have vision worse than 20/20, the commonly referred to goal for LASIK surgical correction of distance vision. Since one eye is corrected for distance viewing and the other eye is corrected for near viewing, the two eyes no longer work together. This results in poorer quality vision and a decrease in depth perception. These effects of monovision are most noticeable in low lighting conditions and when performing tasks requiring very sharp vision. Therefore, you may need to wear glasses or contact lenses to fully correct both eyes for distance or near when performing visually demanding tasks, such as driving at night, operating dangerous equipment, or performing occupational tasks requiring very sharp close vision (e.g., reading small print for long periods of time).

Many patients cannot get used to having one eye blurred at all times. Therefore, if you are considering monovision with LASIK, make sure you go through a trial period with contact lenses to see if you can tolerate monovision, before having the surgery performed on your eyes. Find out if you pass your state's driver's license requirements with monovision.

In addition, you should consider how much your presbyopia is expected to increase in the future. Ask your doctor when you should expect the results of your monovision surgery to no longer be enough for you to see near-by objects clearly without the aid of glasses or contacts, or when a second surgery might be required to further correct your near vision.

* Bilateral Simultaneous Treatment

You may choose to have LASIK surgery on both eyes at the same time or to have surgery on one eye at a time. Although the convenience of having surgery on both eyes on the same day is attractive, this practice is riskier than having two separate surgeries.

If you decide to have one eye done at a time, you and your doctor will decide how long to wait before having surgery on the other eye. If both eyes are treated at the same time or before one eye has a chance to fully heal, you and your doctor do not have the advantage of being able to see how the first eye responds to surgery before the second eye is treated.

Another disadvantage to having surgery on both eyes at the same time is that the vision in both eyes may be blurred after surgery until the initial healing process is over, rather than being able to rely on clear vision in at least one eye at all times.

Finding the Right Doctor
If you are considering refractive surgery, make sure you:

* Compare. The levels of risk and benefit vary slightly not only from procedure to procedure, but from device to device depending on the manufacturer, and from surgeon to surgeon depending on their level of experience with a particular procedure.

* Don't base your decision simply on cost and don't settle for the first eye center, doctor, or procedure you investigate. Remember that the decisions you make about your eyes and refractive surgery will affect you for the rest of your life.

* Be wary of eye centers that advertise, "20/20 vision or your money back" or "package deals." There are never any guarantees in medicine.

* Read. It is important for you to read the patient handbook provided to your doctor by the manufacturer of the device used to perform the refractive procedure. Your doctor should provide you with this handbook and be willing to discuss his/her outcomes (successes as well as complications) compared to the results of studies outlined in the handbook.

Even the best screened patients under the care of most skilled surgeons can experience serious complications.

* During surgery. Malfunction of a device or other error, such as cutting a flap of cornea through and through instead of making a hinge during LASIK surgery, may lead to discontinuation of the procedure or irreversible damage to the eye.

* After surgery. Some complications, such as migration of the flap, inflammation or infection, may require another procedure and/or intensive treatment with drops. Even with aggressive therapy, such complications may lead to temporary loss of vision or even irreversible blindness.

Under the care of an experienced doctor, carefully screened candidates with reasonable expectations and a clear understanding of the risks and alternatives are likely to be happy with the results of their refractive procedure.

Laser Thermal Keratoplasty

2008-08-12T07:13:00.001-07:00

Laser Thermal Keratoplasty (LTK) uses the holmium YAG laser to heat the tissue of the cornea, causing it to shrink and steepen the front of the eye to change the focus of incoming light onto the retina, the light-sensitive layer of tissue at the back of the eye. The goal of LTK is to improve the patient’s ability to see objects at a distance. It is unsure how long LTK results will last. When the US Food and Drug Administration approved LTK in the summer of 2000, it was originally labeled a “temporary” treatment. But some studies indicate could work longer than initially believed and the FDA has removed the word temporary. The laser device was approved to be used to treat patients who have farsightedness (between +0.75 to +2.5 diopters ), who are at least 40 years of age, and whose visual acuity has changed very little over time (that is, the patient’s glasses prescription has changed no more than 0.50 diopter in the previous six months.)

According to the FDA, this treatment may improve distance vision in far-sighted people who have difficulty seeing clearly at a distance. Although some patients may retain some or all of the correction achieved during the surgery, for most people the amount of farsightedness correction achieved will decrease over time. The amount of correction remaining at 24 months is typically about half of the correction observed at 6 months. Some patients will regress completely. How long any significant portion of the correction lasts depends on the amount of correction attempted and age.

Surgery May Prevent "Lazy Eye" Blindness

2008-08-12T07:12:00.001-07:00

Dr. Paul Dougherty delicately slipped a tiny lens inside the right eye of 7-year-old Megan Garvin - a last-ditch shot at saving her sight in that eye.

The California girl last week became one of a small number of United States children to have an experimental surgery to prevent virtual blindness from "lazy eye" diagnosed too late, or too severe, for standard treatment.

The new approach: Implantable lenses, the same kind that nearsighted adults can have inserted for crisper vision - but that aren't officially approved for use in children.

"Without this technology, we couldn't help her," says Dougherty, a prominent Los Angeles eye surgeon who invited The Associated Press to document Megan's surgery. "This would be written off as a blind eye."

Up to five percent of children have amblyopia, commonly called lazy eye, where one eye is so much stronger than the other that the brain learns to ignore the weaker eye. Untreated, the proper neural connections for vision don't form, eventually rendering that eye useless.

Catch it early - preferably by preschool - and it can be fairly easy to fix by patching over the strong eye, or using special drops in it, for several hours a day so that the brain is forced to use the weak eye. But the older the child is, the less effective the treatment - and by age nine, brain-eye connections are pretty well set.

The leading cause is eyes that aren't in perfect alignment. But a big difference in focusing power also triggers amblyopia. That's what happened with the Garvin girl, who had near-perfect vision in one eye but the other was too nearsighted to even see the big E on the eye chart.

It's sneaky: Kids don't realize they're seeing clearly out of only one eye, and often won't squint or otherwise signal there's a problem. So Megan was fast passing the window to correct amblyopia when a kindergarten eye exam flagged a problem.

"She reads perfectly, she's a very normal active child," says her mother, Rosie Garvin. "If she would not have had that vision test, I would never have known."

"We went in," Rosie told CBS News, "and they had her cover the one eye, and she did just fine. And then, when they covered the other eye, it was shocking. ... I think anytime that you find something is wrong, or not normal, it's devastating."

Ophthalmologists called it one of the worst cases they'd ever seen.

Glasses weren't do-able: One side would have required a clear lens and the other a Coke-bottle thickness, a prescription of minus-12 diopters.

Her parents tried inserting a contact lens in the bad eye -- getting her to roughly 20-60 vision in that eye, far from perfect, but able to see blurrily while the good eye was patched.

Contacts and young kids are a tough match. Megan cried when her mother inserted it. Teachers would call to say it had popped out.

Frustrated, the Garvins ultimately opted for the implant - and days later, are feeling hopeful. It's blurry, Megan tells her mother, but she can see out of her right eye, and is chafing at the required week of rest to let the tiny incisions in her eye heal.

That's just the first step. Months of patching lie ahead to try to reverse the lazy eye, or the brain would just stick with the connections it has already formed to her strong eye. Dougherty gave no guarantees.

"I know we've got our work ahead of us," says Rosie Garvin, from Simi Valley, Calif. "I'm so relieved ... and going to make sure I do everything they tell me to make sure this works for her for life."

"She's gotta live with the decision that her mom and dad made for her when she was seven years old," Rosie observed to CBS News, "and we're just hoping that we've made the right decision -- that this is something that will be a long-term benefit for her."

Dougherty told CBS News Megan is the first girl to have the procedure in the U.S.

He explained that the lens is rolled up "like a taco" when it's inserted, then it's allowed to unfurl, and winds up flat, covering the iris (colored part of the eye).

Implantable lenses for adults, called phakic intraocular lenses or IOLs, hit the U.S. market in 2004. Unlike cataract surgery, which requires removal of the eye's natural lens because it is clouded, these lenses are put on top of a natural lens that can't focus properly, thus helping sharpen vision.

They have some risks: Surgical infection, inflammation, a potential for cataracts to form. At about $4,000 an eye, it's more expensive than the controversial laser eye surgery LASIK, but the lenses can be removed if there are problems.

But, "How this lens is going to work in a child's eye, we don't know. We've never done studies," cautions Dr. Punin Shah, a cornea specialist at Ochsner Medical Center in New Orleans.

It is legal to implant the lenses experimentally in a child, however.

A handful of medical journal reports show surgeons are starting to try the approach for hard-to-treat amblyopia. In a French study of a dozen children, all had improved vision after the surgery and half recovered normal binocular vision.

Other surgeons are experimenting with LASIK in children like Megan, although she wasn't a LASIK candidate - her corneas were too thin for it to be done safely, and Dougherty says it doesn't work well for such severe nearsightedness.

Dr. Michael Repka, a pediatric ophthalmologist at Baltimore's Johns Hopkins University, says both approaches are in their infancy, but interesting.

"It's an exciting thing in a patient who has had conventional therapy and failed," says Repka, a spokesman for the American Academy of Ophthalmology.

And while catching lazy eye very young is best, stay tuned: Repka's own research shows it can be possible to treat after age nine, long the cut-off, and he is to publish details soon.

Permanent Vision Correction Now Available at Angelo Laser Eye Center

2008-08-12T07:11:00.001-07:00

A new opportunity for permanent vision correction now available at Angelo Laser Eye Center is allowing patients who before had no other options the freedom to see without glasses or contact lenses. The procedure allows for the permanent implantation of contact lenses within the eye, and it is seeing some remarkable results.

“I have been performing vision correction procedures for more than 12 years, but I am excited to now be able to offer implantable contact lenses to our area,” said Daniel Wilson, M.D., ophthalmologist at Shannon Clinic and Angelo Laser Eye Center. “It gives new hope to patients who previously had no other solution. They can now enjoy life and go to the beach or swim without having to worry about glasses or contacts.”

Dr. Wilson is the first and only ophthalmologist to offer the new implantable lenses in this part of the Concho Valley. Although it has been performed successfully worldwide for more than 15 years, the FDA approved it in the U.S. just about a year ago.

“There are some individuals who cannot have LASIK or other vision correction procedures because they are either too nearsighted, their corneas are thinner than normal, or their corneas have an abnormal shape.”

Dr. Wilson adds that most patients pursuing the procedure have vision that is worse than 20/1000 before surgery.

The thin, pliable lenses are made from Collamer, which is an organic protein material containing collagen, so they are easily accepted by the body. They are invisible and undetectable

“The lenses actually give better sight than traditional contact lenses or LASIK surgery,” said Dr. Wilson. “They are maintenance free since they are not on the surface of the eye and also reduce the risk of infection that traditional contacts can introduce to the eye.”

For individuals interested in the procedure, Dr. Wilson first sets up an initial consultation to examine their eyes and ensure they are a good candidate for the procedure.

“We do several things in that first visit including a specular microscopy test where we measure and count the cells on the back or inside layer of the cornea to be sure it is healthy and functional. We also look inside the eye with special technology called gonioscopy to be sure there is adequate space for the implantable lens.”

The outpatient procedure for inserting the lenses takes less than 30 minutes and is similar to cataract surgery except it does not require removing the eye’s natural lens. The patient remains awake, the eye is numbed with a topical or local anesthetic, and a mild sedative may be given if necessary. An opening, just three millimeters wide is made in the cornea, and the implantable lens is inserted placed behind the iris and in front of the natural lens. The opening is self healing and does not require stitches.

“The patient’s vision is checked two hours later, and at that time, most patients can already pass their driver’s test,” said Dr. Wilson.

Patients are able to return to work the following day, and use prescribed eye drops for about three weeks afterward. Patients heal fully within a month.

Although the lenses are intended to be permanent, they are removable and can be changed later if needed. And unlike other corrective vision procedures, there is no alteration to the cornea.

“The procedure is very quick, safe, and effective, and I hope it will be able to help many individuals and enhance their lives,” said Dr. Wilson.

To learn more about implantable contact lenses, call the Angelo Laser Eye Center at (325) 481-2020.

Study compares eye care use among US, Canadian adults with vision problems

2008-08-12T07:10:00.000-07:00

Americans with vision problems who have health insurance appear equally or more likely to access eye care services than Canadians with vision problems, whereas Americans without health insurance visit eye care professionals at lower rates, according to a report in the August issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Although Canada has a national health program, individuals with vision problems in both Canada and the United States sometimes have difficulty accessing eye care, according to background information in the article. "In both Canada and the United States, general health insurance covers medical payment for eye injury and various eye diseases such as cataract, glaucoma and diabetic retinopathy, and optional vision insurance provides additional insurance coverage for eye examinations, contact lenses and eyeglasses and/or frames, and, in some instances, part of the costs for elective laser surgery for vision correction," the authors write. "Many Americans and Canadians have publicly funded or private coverage for optional vision care."

Xinzhi Zhang, M.D., Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues examined differences in use of eye care service among 2,018 Canadians and 2,930 Americans with vision problems who responded to a survey between 2002 and 2003.

Overall, 8.2 percent of Americans with vision problems did not have health insurance. Americans without health insurance had the lowest rate of eye care service use (42 percent), while 67 percent of American with private health insurance, 55 percent with public health insurance and 56 percent of Canadians had visited an eye care professional in the previous year. Individuals with optional vision insurance and with higher incomes were most likely to use eye care services.

Americans with any type of health insurance accessed eye care at approximately the same rate as Canadians. "The difference in use of eye care services between Americans without health insurance and Canadians narrowed when adjusted for income level and was almost eliminated when adjusted for having optional vision insurance," the authors write.

"Among adults with vision problems, a public health gap exists in actual access to eye care services between Canada and the United States, primarily owing to the population without health insurance in the United States," they continue. "However, although health insurance is associated with increased use of preventive services and recommended treatments, simply providing health insurance to all persons may be insufficient to increase the percentage of individuals who use eye care services or to improve vision-related outcomes; economic status and optional vision insurance are also significantly associated with rates of use of eye care services."

"Therefore, public health interventions targeting adults with vision problems without health insurance might be more beneficial if they focused on those at risk for serious vision loss, especially those in the lowest income group," the authors conclude.

Glaucoma

2008-08-09T22:27:00.000-07:00

Glaucoma encompasses a number of conditions that are characterized by a particular pattern of blindness involving optic nerve damage and visual field loss. Most, but not all, of the conditions involve increased intraocular pressure (IOP) within the eye, which is by far, the most common risk factor for vision loss due to glaucoma. This increased pressure damages the optic nerve and can result in a progressive loss of peripheral vision leading to blindness if not properly diagnosed and treated.

It is a serious condition of the eye affecting approximately two percent of the population. It has robbed millions of people of their eyesight. If left untreated, it can cause total, irreversible blindness. Glaucoma can strike anyone, but it need not cause blindness. If glaucoma is found early and treated properly, your eyesight can be preserved. Early diagnosis is the key to prevention of blindness from glaucoma.

Glaucoma is characterized by optic nerve damage and visual field loss. Typically, it involves increased pressure inside the eye that affects the delicate tissues of the optic nerve. Early detection and treatment are the keys to preventing unnecessary vision loss.
Open Angle Glaucoma

Open angle glaucoma is the most common type of glaucoma. This condition is often called Primary Open-angle Glaucoma, or POAG. It is most often completely painless and causes a very gradual loss of peripheral vision, which may go unnoticed for many months or even years. Since it gives no obvious warning to its victim, glaucoma is often called "the sneak thief of sight."

This form of glaucoma is characterized by an excessive production of fluid inside the eye. Although the drainage system of the eye, called the "angles," remain open and function properly, they are unable to remove the excess fluid at a pace sufficient to prevent a rise in pressure inside the eye.

Open angle glaucoma will usually respond well to medications when found in time. In most cases, the medication must be continued for life to keep this condition under control.

Closed Angle Glaucoma

The second type of glaucoma is known as Closed Angle Glaucoma. It is far more rare than open angle glaucoma.

This condition is characterized by blockage of the drainage system of the eye located between the iris and the lens. In many instances, the iris is pushed forward in a condition referred to as pupillary block. This causes the iris to act like a stopper over the drain of a sink, allowing fluid levels inside the eye to build, causing increased intraocular pressure.

Its onset can be sudden, as is the case with acute angle-closure glaucoma. A sudden onset of severe pain and a red eye are symptoms of acute angle-closure glaucoma. Prompt intervention by the use of medications or through surgery or treatment with a laser is required to obtain relief and protect the delicate tissues in and around the optic nerve.

In other instances, closed angle glaucoma may progress slowly over time, with the formation of scar tissue around the drainage system of the eye. This condition is called chronic angle-closure glaucoma.

Other Types of Glaucoma

Not all types of glaucoma are characterized by high intraocular pressures. In normal-tension or low-tension glaucoma, the optic nerve suffers damage with the resulting visual field loss even though normal intraocular pressures are maintained. It is believed that poor blood flow to the optic nerve causes this condition. Eyes afflicted with this condition are far more susceptible to optic nerve damage with any increase in the intraocular pressure than other eyes are. Only recently have scientists recognized how common normal-tension glaucoma is and begun research into its causes and treatment.

Exfoliation syndrome is a common form of open angle glaucoma that results when there is a buildup of abnormal, whitish material on the lens. This material and pigment from the back of the iris plug the drainage system of the eye, causing increased intraocular pressure. This form of glaucoma responds well to laser treatment.

Pigmentary glaucoma is a hereditary condition typically affecting young, nearsighted, Caucasian males. This condition is characterized by the iris being too large compared to the other structures of the eye. The iris is forced to bow backwards, coming into contact with the structures holding the lens in place. This disrupts the cells of the iris containing pigment, resulting in a release of pigment particles into the drainage system of the eye, which prompts an increase in intraocular pressure as the drainage system becomes clogged.

Other types of glaucoma may be caused by injuries to the eye, tumors, and other eye diseases. A rare type of glaucoma can even be present in children at birth.

Retinal Tears and Detachments

2008-08-09T22:26:00.000-07:00

The retina is the layer of photoreceptor nerve cells lining the back, inside wall of the eye. Just like the film in a camera, the retina reacts to the presence of light. The photoreceptor nerve cells generate a nerve impulse whenever they are exposed to light. These nerve impulses travel via the optic nerve to the brain where an image is perceived. Just like a picture cannot be created by a camera with defective film, vision is not possible in an eye with a defective retina.

Retinal Tears involve a rip or tear in the tissue comprising the retina. They usually arise from degenerative changes in the peripheral retina.

Retinal Detachments are a separation of the retinal tissue from the inside wall of the eye. Similar to wallpaper coming lose from a wall, the retinal tissue may develop folds or come completely away from its proper position along the interior of the eye resulting in loss of vision.

These conditions may be caused by a number of factors, ranging from injury to the head to spontaneous occurrences. Regardless of the cause, a retinal tear or detachment requires immediate medical attention. Treatment with a laser or surgical intervention is necessary to repair a retinal tear or detachment. The chances of successfully restoring vision are dramatically improved when intervention occurs as soon as possible following the onset of symptoms.

Causes

The central portion of the eye is filled with a clear, gel-like material known as vitreous. In young people, the vitreous fills the back cavity of the eye. As a person ages, it is normal for the vitreous material to shrink and pull away from the interior wall of the eye. As it pulls away from the interior wall of the eye, it occasionally pulls a portion of the retina away with it. This results in a retinal tear. They usually occur in the peripheral areas of the retina.

When the retina is torn, vitreous fluid is able to seep through the tear and accumulate behind the retina. This causes the retina to detach from the inside lining of the eye. Once a retinal detachment has started, it usually continues until most of the retina has completely separated from the interior of the eye. The retina is no longer sensitive to light in areas where it is detached, resulting in blindness in the affected region.

The risk of spontaneous retinal tears and detachments increase as we grow older. Nearsighted individuals are at an increased risk for retinal tears and detachments. Persons who have had cataract surgery or experienced a blow to the head or injury to the eye are also at risk for retinal tears or detachments.

Symptoms

Retinal tears and detachments commonly offer the following symptoms:

* New Floaters: The presence of some floaters is common because the vitreous is not completely transparent or uniform in consistency. However, a sudden increase in the number and size of floaters perceived in your vision is a warning sign that a retinal tear is in progress.
* Flashes: The sudden appearance of flashes in vision may indicate that the vitreous material is pulling away from the retina, which is the first stage of a retinal tear or detachment.
* Shadow or curtain over vision: The onset of a growing, dark shadow or the appearance of a curtain being pulled over a portion of the vision in one eye is an indication of a retinal detachment. These symptoms usually occur in the peripheral (side) vision. The growing shadow results from the increasing area of retinal tissue being pulled away from the back wall of the eye and no longer able to react to light.
* Decreased vision: Another common symptom of a retinal tear or detachment is a sudden decrease in vision.

Treatment of Retinal Tears and Detachments

Advances in surgical technology and techniques have resulted in a good success rate for the repair of retinal tears and detachments. The success of these surgical procedures is directly related to the size of the tear or detachment (amount of damage) and the timeliness of the treatment. The sooner surgery occurs after the onset of the retinal tear or detachment, the better the chances of success. With this in mind, it is wise to seek the care of an ophthalmologist at the first symptoms of a retinal tear or detachment.

Surgery to repair retinal tears usually involve the use of lasers or a specialized freezing instrument known as a cryoprobe. These instruments are used to create a scar around the torn area, which usually prevents further tears or future detachments.

The most common surgical method of repairing retinal detachments is through the creation of a scleral buckle. The creation of a scleral buckle involves the placement of a band on the eye's white, outer layer (the sclera). This pushes the wall of the eye inward, placing it in closer proximity to the separated retinal tissue. Often, this allows the retinal tissue to re-attach itself to the interior wall of the eye. Thanks to microsurgical techniques, the scleral buckle is very small and not visible after surgery.

Another surgical option for the repair of retinal detachments is a vitrectomy. During this procedure, the vitreous is carefully removed from the eye and then air or gas is injected into the cavity to push the retina back into its proper position. The gases are gradually replaced by natural fluids produced inside the eye.

The success of these surgical techniques depends upon the size and location of the damaged area of the retina, the length of time that elapses between the onset of the tear or detachment and the surgery to repair the damage, and whether or not other complicating factors are present. Many persons who have undergone retinal reattachment surgery regain all of their previous vision, while some regain only functional vision. Even in these latter instances, the treatment is usually effective in preventing further damage to the retina and more vision loss.

As with most any surgery, follow-up care is necessary after retinal surgery. Each person's reaction to the procedure is unique. Some require upwards of six months to heal. Others require repeated treatments. Following scleral buckle surgery, it is common that there will be a change in your glasses.

Cataract Surgery Latest

2008-08-09T22:16:00.000-07:00

Of all the fields of medicine, cataract surgery has been one of the greatest beneficiaries from advances in techniques and technology. Not so long ago, cataract surgery involved lengthy delays marked by deteriorating vision while the cataract "ripened," an extended and confining recovery period, plus the need for unsightly "cataract" glasses or contact lenses to achieve functional vision after surgery.

Now, the surgery is a simple, out-patient procedure. The stay at an ambulatory surgery center is just a few hours and recovery time after surgery is dramatically reduced. Many people enjoy improved vision with minimal dependence upon corrective eyewear as a result of modern cataract surgery.

The Evolution of Cataract Surgery

A few short years ago, the accepted method of cataract surgery was to open the front portion of the eye and pluck the cataract like a grape. This meant that the cataract had to "mature" or "ripen" to the point that it was firm, making it easier for the surgeon to grasp. For the cataract to reach this stage, vision in the eye became dramatically impaired, often to the point of near blindness.

At first, there were no suitable materials to use as sutures in the eye, so the eye had to be bandaged and heal on its own. This meant the patient was confined to bed with their head literally sandbagged to prevent movement that might jeopardize the healing process. "Cataract" glasses with thick lenses or contact lenses were required to assume the focusing power of the natural lens, which was removed during surgery. Unfortunately, memories of this type of have caused many people to wait needlessly before having cataract surgery.

"No-Stitch" Cataract Surgery Using a Self-Sealing Wound

Although sutures were a major advance, they have been supplanted in most cases by the use of a self-sealing incision. The shape of the incision creates a flap that takes advantage of the natural fluid pressure inside the eye to seal it shut without the need for sutures.

Not every cataract surgery can be performed as a "No-Stitch" procedure. The decision to place a suture is made by the surgeon and always has your best interests in mind.

The advantages of "No-Stitch" cataract surgery using a self-sealing wound include the following:

* Shorter surgery time
* The ability to stop surgery at any point in the procedure
* Dramatically reduced recovery time
* Less surgically-induced astigmatism
* Less discomfort after surgery

To perform "no-stitch" cataract surgery, two other advances were necessary: the development of microsurgical techniques and the creation of foldable artificial lens implants.

Microsurgical Techniques

Cataract surgery is a delicate operation that involves manipulation of the tiny structures of the eye. High-powered microscopes allow the surgeon to view the parts of the eye clearly.

A large incision is no longer required to allow the cataract to be plucked from the eye like a grape. Now, just a tiny incision is necessary so that a probe approximately the width of a match stick can be used to remove the cataract. By use of ultrasound, the probe dissolves the cataract, allowing it to be gently vacuumed from the eye.

Foldable Artificial Lens Implants

Cataract surgery removes the cloudy, natural lens of the eye. Once the natural lens of the eye is gone, another means is needed to bring light rays into proper focus upon the retina. Thick cataract glasses and then contact lenses were used after cataract surgery to perform this function. Unfortunately, both offer a less than satisfactory solution.

Tiny artificial lenses, called intraocular lenses, that could be placed inside the eye proved to be a dramatic solution to clear vision following cataract surgery. They are made of inert materials that do not trigger any rejection responses by the body. Through the use of careful measurements of the eye taken before surgery, your doctor may be able to select a lens power to correct for nearsightedness or farsightedness, helping to reduce dependence upon corrective eye wear after surgery.

A small opening is made in the front of the capsule that holds the natural lens. Cataract Opening

A tiny incision is made to allow for the insertion of a phacoemulsification tip which is used to remove the cataract. By use of ultrasound, the probe dissolves the cataract, allowing it to be gently vacuumed from the eye. Phaco

By using soft material that can be folded, the artificial lens can be inserted inside the eye through the original surgical incision. Insert lens

The lens unfolds to fill the capsule much as the natural lens of the eye had done prior to cataract surgery. Lens unfolds

Illustrations courtesy of Staar Surgical Co., Monrovia, CA

Pain-free Cataract Surgery

Cataract surgery is a pain-free experience thanks to advances in anesthesia. Our patients are awake during the surgery and are able to resume normal activities shortly afterwards. During the relative quick procedure, the surgeon and members of his surgical team attend to your needs. Two types of anesthesia are used to keep our patients comfortable and pain-free during surgery: topical and regional anesthesia.

Topical, or "Eye Drop" Anesthesia - Eye drops are used to anesthetize (numb) the eye allowing patients to have a painless cataract procedure.

Regional Anesthesia - Through the use of an injection gently given near the eye, an anesthetic blocks all feeling in the region of the eye. To eliminate any discomfort during the injection, it is usually given while the patient is momentarily under the effects of a general anesthetic. Regional anesthesia gradually wears off over the course of a day. As it does, the function of the eye is restored.

Each form of anesthetic has its advantages. Your doctor will consider your individual needs to select the form of anesthesia that is best for you. Our goal is to make your cataract surgery a pleasant and pain-free experience.

Eye Surgery Best Tips

2008-08-02T03:04:00.000-07:00

13 Eye Surgery Tips

Each eye surgery procedure and each eye surgery patient is unique. Despite the uniqueness of each procedure, there are a number of universal tips that can help you better prepare for your surgery and speed up your recovery time.

So here are 13 tips to help make your eye surgery procedure a successful one.

1) Take the extra time you need to find a reputable surgeon with extensive experience in your type of surgery.

- Finding the right doctor is the critical first step in the surgery process, and this it not a step you want to take lightly. Your eye surgery will only be successful if it is performed by a qualified medical professional. Selecting a doctor based on cost alone is rarely a good move since surgeons offering cheaper solutions usually do so because they are inexperienced in performing that type of surgery. Keep in mind that should complications arise, that having someone who knows how to quickly and effectively deal with the issue will prevent or minimize any damage done to your eye.

You'll also want to find out what kind of track record your doctor has, and how many procedures they have performed.
2) Thoroughly research the procedure you will be undergoing before signing any consent forms.

- This includes taking the time to ask your surgeon any questions you may have about the procedure. A good doctor will take the time to answer all of your questions as well as inform you of any potential risks and side-effects of the surgery. Take advantage of this and be sure you are fully comfortable with the procedure before you agree to undergo the surgery.

3) Follow all of the pre-operative procedures recommended by your doctor.

- Your doctor may advise you to avoid certain medications, foods, or activities (such as smoking and drinking alcohol) before undergoing eye surgery. These restrictions are put in place to ensure your eyes are in good condition for the procedure, giving you the best possible chance of having a successful surgery and a quick recovery. If you don't follow these restrictions you may put your health and the success of your surgery at risk.

4) Stop wearing contact lenses in advance of the surgery, as directed by your doctor.

- Since contact lens rest directly on your eye, they exert pressure on the cornea and can actually change the shape of your eye. This is an important consideration for individuals undergoing eye surgery, especially patients of refractive eye surgery to correct their vision. In order for the procedure to be successful, it is necessary to pinpoint those regions of the eye that need to be treated. If your eye is not in its normal natural shape or state, any attempts to correct visual impairments will not be successful. For this reason, surgeons will request that many eye surgery patients stop wearing contact lenses anywhere from two to four weeks prior to the procedure.

5) Get a good night’s sleep the night before the surgery.

- A well-rested patient is less likely to be unduly anxious and will recover more quickly than someone who is stressed and suffering from lack of sleep. Remember – adequate sleep is necessary to stay healthy, and this is especially true before surgery.

6) Make arrangements to have someone you trust drive you home from the surgery.

- Your vision will be blurry and you may be under the effects of a sedative after undergoing your eye surgery. Regardless of the type and extent of the procedure, patients are in no condition to drive immediately after eye surgery. Ensure your safety and well-being by arranging for a ride home in advance. If you aren't able to have a family member of friend drive you home, then take a taxi cab.

7) Know what side-effects you may experience before undergoing the procedure.

- Inquire about potential side-effects and make sure you know what to expect during the recovery period before you go in for the procedure. On your surgery day, you will likely be distracted and anxious and will not retain much information. It’s important to know what to look out for after your surgery so you can catch any potential problems before they can cause damage.

8) Call your doctor immediately if you experience any unusual side-effects.

- If you experience anything unusual or are concerned about how you are recovering from your procedure, contact your doctor immediately. Refer to the potential side-effects of the procedure as discussed above, and use these as your guidelines for what is normal and to be expected. If in doubt, err on the side of caution and call your doctor – it’s always better to be safe than sorry.

9) Take all medication as prescribed.

- The medication prescribed by your surgeon is designed to speed the healing process and protect your eye from adverse side effects. Therefore, it is imperative that you take all medication as prescribed.

10) Avoid touching, rubbing, or bumping your eye while it is healing.

- Any direct contact with your eye while it is healing can result in damage to the eye and may result in severe complications. Wearing an eye shield as needed, especially while you are sleeping, can help you avoid contact with your eye.

11) Avoid makeup, lotions, and creams while your eye is healing.

- These items can interfere with the eye’s natural healing ability and prolong your recovery period.

12) Stay away from medications that can interfere with your body’s natural healing process, such as steroids.

- Some medications can prevent your eye from properly healing and delay the recovery process. Be sure to talk to your doctor about any medications you're on prior to surgery.

And last, but not least...

13) Give yourself time to recover from the surgery before jumping back into your busy life.

- Keep in mind that you are recovering from an invasive procedure. It will take some time before you start feeling like your normal self. Taking it easy for a few days will enable your body to rest and heal faster than it will if you subject it to unnecessary stress.

Cataract FAQ?

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What can be done to prevent cataract?
It is not yet clear, why the eye's lens changes as we age and develops into a cataract. Research is on for the preventive measures. There is no drug or drops as yet that has been proven to be of value in preventing cataract. Recent studies show that exposure to UV rays (Ultra violet rays) may be a factor in development of cataract. It is now recommended to wear sunglasses and a wide brimmed hat to lessen the eyes' exposure to UV rays from the sun.

Other studies suggest people with diabetes are at risk for developing a cataract, as are users of steroids, diuretics, and major tranquilizers.

Can cataract occur at earlier age or in childhood also?
Yes. Sometimes the child may be born with cataract or may develop cataract in early childhood. The management of these cataracts is different from that in adult patients. Cataract may also occur at an earlier age because of trauma, inflammation of eye, use of medicines like steroids, general medical conditions like diabetes, radiation etc.

Can the cataract be treated by laser surgery?
Despite some public misconception, laser is not an option for removing cataracts at this time. Even the experimental devices are quite different from what one might imagine for use in a laser cataract surgery. In these devices a laser is used to break up the nucleus of the cataract into pieces small enough that they can be aspirated from the eye, in the same manner that sound waves are used in phacoemulsification. Thus, an incision still needs to be made, and the lens material removed from the eye. A very small incision will always be needed to physically remove the cataractous lens material.

The YAG laser may be used following cataract surgery. The posterior capsule of the lens, which supports the lens implant, sometimes turns cloudy (aftercataract) several months or years after the original cataract operation. If this blurs your vision, a clear opening can be made painlessly in the center of the membrane with a laser. This indeed is a procedure in which the patient sits in the chair and the laser, without making any incision quickly clears the vision.

Will I get good vision after surgery?
Your sight will usually improve within a few days, although complete healing may take 4-6 weeks. This is the time when a checkup for any possible change in glasses is advised.

Even if the surgery itself is successful, the eye may still not see as well as you would like. Other problems with the eye, such as macular degeneration (aging of the retina), glaucoma and diabetic damage may limit vision after surgery. Even with such problems, cataract surgery may still be worthwhile. If the eye is healthy, the chances are excellent that you will have good vision following removal of your cataract.

Will I need to use glasses after surgery?
Unfortunately yes, you would need glasses after cataract surgery. But the power of the glasses is not much if the lens has been implanted in your eye during the surgery. As we know, the eye needs to change its power in able to focus objects at different distances (compare from auto focus camera). The artificial lens that is put in the eye does not have capacity to change its power. Therefore it can work only for a fixed distance, and you will require a bifocal lens to be able to see at distance as well as near.

There is a range of bifocal and multifocal artificial lens implants are now available, but these are not yet very popular. Discuss with your ophthalmologist if you are a suitable candidate for it.

Superlative eye care

2008-08-02T03:02:00.001-07:00

This is the homepage of the Bhatti Eye Clinic, based in Mumbai (formerly Bombay), India. This site promises to develop into a great ophthalmology site for eye patients as well as ophthalmology students, so keep visiting it regularly. As with almost all of Dr S S Bhatti's projects, this site is permanently under construction.

The Bhatti Eye Clinic at Mumbai, in India, is reknowned for its best of breed eye surgery outcomes especially for cataract surgery and laser eye surgery. Besides cataract surgery by phakoemulsification and lasik, exceptional results are also delivered in glaucoma surgery, corneal transplants and oculoplastic surgery, as well as laser procedures for the retina and anterior segment.

Claucoma Surgery

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Glaucoma is a group of eye diseases that are characterized by intraocular pressure levels that damage the optic nerve and nerve fibers that form parts of the retina in the back of the eye. The optic nerve links the light-perceiving tissues of the eye with the parts of the brain that process visual information. Glaucoma is a common cause of preventable vision loss and can be treated by prescription drugs, laser therapies, and surgery. People with glaucoma often have no symptoms until they begin to experience loss of part of their peripheral vision. It is important to note that visual loss from glaucoma is permanent and irreversible in most cases, hence the need for early diagnosis and treatment.

The ophthalmologist making a diagnosis of glaucoma will look for three conditions:
1. Higher intraocular pressures are associated with a higher risk for developing the disease. In addition, it is known that the chances of maintaining vision and side or peripheral vision are related to decreasing pressure within the eye.
2. Loss of tissue or cupping in the center of the optic nerve head or disc at the back of the eye, which suggests optic nerve damage or reduced function.
3. Visual field loss or defect of a glaucomatous type (typically a reduction of peripheral vision, or an increase in the number or size of blind spots) (see photos above).

Some or all these signs may be present if a person has glaucoma. The condition of the optic nerve head and raised intraocular pressure are only detectable during an eye examination by an ophthalmic professional.

During laser treatment for open-angle glaucoma, laser light is aimed at the eye’s trabecular meshwork (in other words the eye’s drainage system). The laser application results in a biological and mechanical reaction in the trabecular meshwork to open the previously blocked meshwork and increases the flow of aqueous fluid from the eye.

The most common conventional (incision) surgical technique is called filtering microsurgery, which involves making a hole through which the excess fluid drains and lowers pressure in the eye. Surgery is used if medication and laser procedures have not been successful or if there is a medical emergency for which pressure must be relieved immediately.

Laser Surgery
Laser surgeries lower intraocular pressure by enhancing the drainage of aqueous fluid or slowing its production. The kind of laser surgery used depends on the type of glaucoma being treated. The length of time the pressure remains lowered depends on the type of laser surgery, the type of glaucoma, and the patient’s individual characteristics.

In some cases, laser surgery may have to be repeated to control internal eye pressure more effectively. Typically, medications will still be needed to maintain fluid pressure within the eye, although a lower dose than previously used may be sufficient. If the laser therapy does not lower the pressure in the eye satisfactorily or the effects wear off, the surgeon may recommend conventional surgery.

What to expect: Laser surgeries are preformed in a doctor’s office in a facility called an ambulatory surgical center or in a hospital. Although some patients may experience a slight stinging sensation, the procedures are usually painless. In some instances, local anesthetic agents are used, in which case there is little if any discomfort.

When the procedure is over, patients may experience blurred vision and some irritation. Normal activities, such as driving and work, may be resumed the next day.

Risks: As with all surgery, there are risks. Risks of laser glaucoma procedures may include a short-term increase in intraocular pressure or an excessive drop in pressure. Both complications are rare and controlled with glaucoma medications. There is a small risk for cataract formation after some types of surgery.

Benefits: Failure to control glaucoma can result in destruction of the optic nerve and permanent blindness of the affected eye. Reducing or preventing raised intraocular pressure by laser therapy is effective in reducing the risk of blindness from glaucoma.

Laser Treatments for Primary Open-Angle Glaucoma

* Selective laser trabeculoplasty (SLT) reduces intraocular pressure by enhancing drainage of excess aqueous fluid. The laser increases drainage by selectively treating certain cell tissue of the trabecular meshwork. The meshwork is at the entrance of the drainage canals. SLT treatments can occasionally be repeated if necessary.
* Argon laser trabeculoplasty (ALT) reduces intraocular pressure by opening the drainage canals of the eye. In many cases, drugs will continue to be needed to maintain safe internal eye pressure after this procedure.

Laser Treatments for Narrow-Angle Glaucoma

* Laser peripheral iridotomy (LPI) reduces excessive intraocular pressure by making a small hole in the iris, the colored part of the eye. Narrow-angle glaucoma occurs when the angle between the iris and cornea, the clear front part of the eye, is too small. The hole allows the iris to move back from the cornea, opening the angle and enhancing aqueous flow.
* Laser cyclophotocoagulation is used to reduce eye pressure by treating the ciliary body, which produces aqueous fluid. The procedure is most commonly used for patients with extensive and end stage glaucoma damage that are not responding to other glaucoma surgeries.

Conventional or Incision Surgery
As noted above, conventional surgery or filtering microsurgery is used when management of glaucoma through medication and laser surgery has failed or is less desirable. Trabeculectomy is most commonly used to prevent or curtail damage to the optic nerve by reducing intraocular pressure. In this procedure, a small incision is made in the sclera of the eye (see Diagram 2) and a flap of tissue is left to cover the incision, allowing slow release of fluid from the inside the eye to its outer layers. The procedure results in the formation of a small blister-like bump called a “bleb.” The bleb is covered by the eyelid and is usually not visible. The excess fluid is carried away as it is absorbed into the bloodstream.

Diagram 2

Illustration courtesy National Eye Institute

A new modification of trabeculectomy, is non-penetrating deep sclerectomy or viscocanalostomy, where a full-thickness hole in the eye is avoided. Instead, a very deep dissection is performed in the sclera and trabecular meshwork. Intraocular pressure is lowered as fluid oozes through a permeable thin layer of tissue that is created by the viscocanalostomy. A bleb may be formed, but it is usually smaller than one that would be formed following trabeculectomy.

In case of complicated glaucoma or patients who have had multiple surgeries, the use of a tube-shunt or seton is required. These devices, which include the Ahmed Valve, Baervedlt device, or Molteno device, have a plastic tube that is placed in the eye, which drains to an external reservoir placed outside the eye.

What to expect: Microsurgical procedures are performed in an ambulatory surgical center or on an outpatient basis at a hospital. Patients are usually given limited intravenous sedation but may be given general anesthesia. Medication may also be administered around the eye to prevent its movement. Typically, patients are relaxed and experience little if any discomfort.

Risks and benefits: The risks of incision surgery are small. Nevertheless, as with any incision, there is the risk of bleeding and infection. The eye may be red or inflamed, with discomfort and pain. In some instances, the procedure may not reduce eye pressure as intended. Loss of too much pressure can result in a loss of vision. As with laser surgeries, there are occasional instances in which the pressure is too high or too low. When this occurs, medications or additional surgeries may be needed to control the condition. In some instances, cataracts may develop. In very rare circumstances, an eye can be removed as a result of surgery. As with all procedures or medications, the risks need to be balanced with the benefits of saving vision in the affected eye. Failure to control glaucoma can result in destruction of the optic nerve and permanent blindness in the affected eye.

Success rates for glaucoma filtering surgery are about 70% to 90% for at least 1 year. In some instances, the surgically created drainage channel may “heal” or close, in which case high intraocular pressure can recur. The healing or closure of the drainage opening is a natural process that is more likely to develop in younger people. To prevent or retard closure, drugs such as mitomycin-C and 5-fluorouracil may be administered. If necessary, the surgery can be repeated in the same eye.

Benefits of RK surgery

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In most cases, RK has proven to be safe and effective for mild degrees of myopia.
What is astigmatic keratotomy (AK) surgery?

Astigmatic keratotomy (AK) is a surgical procedure, similar to radial keratotomy (RK), which is used to correct astigmatism (an irregularly shaped cornea which causes blurring). Instead of using a radial pattern of incisions, the surgeon makes the incisions in a curved pattern when performing AK surgery.
What is automated lamellar keratoplasty (ALK) surgery?

Automated lamellar keratoplasty, or ALK, is a surgical procedure that is mainly used for hyperopia (farsightedness) and severe cases of myopia (nearsightedness). A person with hyperopia has shorter-than-normal eyes, causing objects up close to look blurry.
How is ALK surgery performed?

Although each procedure varies slightly, in general, ALK surgery for myopia involves the surgeon cutting a flap across the front of the cornea with a microkeratome (surgical instrument). The flap is folded to the side and a thin slice of tissue is removed from the surface of the cornea. The removal of tissue flattens the central cornea, or optical zone, reducing refraction. The flap is then put back in place, where it adheres without sutures.

During ALK surgery for hyperopia, the surgeon makes a deeper incision into the cornea with the microkeratome (a surgical instrument) to create a flap. The internal pressure in the eye causes the corneal surface to stretch and bulge. The bulging cornea improves the optical power, correcting the hyperopia. The flap is then put back in place, where it adheres without sutures.
Possible side effects of ALK surgery:

The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:

* astigmatism (blurring caused by an irregularly shaped cornea)
* overcorrection or undercorrection
* inability to wear contact lenses after the procedure
* loss of the corneal flap, requiring a corneal graft
* scarring
* infection
* vision loss
* glare

What is laser thermal keratoplasty (LTK)?

Laser thermal keratoplasty, or LTK, applies heat from a laser to the periphery of the cornea to shrink the collagen fibers, and reshapes the cornea. When the tissue is treated thermally, it contracts the tissue and causes the central cornea to steepen. You must be ages 40 or older to qualify for this procedure.
What is conductive keratoplasty (CK)?

Conductive keratoplasty, or CK, uses heat from low-level, radio frequency waves, rather than laser or scalpel, to shrink the collagen and change the shape of the cornea. A probe that is smaller than a strand of hair is used to apply the radio waves around the outer cornea. This creates a constrictive band that that increases the curve of the cornea and improves vision.
What is an intracorneal ring (Intacs)?

Intracorneal rings, or Intacs, is a micro-thin intracorneal ring that is implanted into the cornea. Intacs produces a reshaping of the curvature of the cornea, thus improving vision. Intacs are only available in the US for low degrees of myopia.
How to prepare for refractive eye surgery:

Most refractive eye surgeries are performed on an outpatient basis, with most procedures lasting less than one hour in duration. In preparation for surgery, you may be asked to:

* arrange for someone to drop you off and pick you up again after surgery.
* not wear your contact lenses for a period of time before surgery, to prevent corneal warpage.
* not wear eye make-up for a couple of days before surgery.

What to expect during surgery:

Although each procedure varies slightly, in general, refractive eye surgery involves minimal discomfort. The eye is usually numbed with eye drops prior to surgery. While in surgery, you may also:

* stay awake during the procedure.
* your eye may be kept open with an eye speculum (a spring-like device between the eyelids).

Specific events that occur during surgery vary depending on the type of surgery performed.
Recovering from surgery:

Recovery times vary depending on the surgery, but can last anywhere from a couple of days to a couple of months. The following are some common symptoms following surgery. However, each individual may experience symptoms differently. Symptoms following surgery may include:

* sensitivity to light
* blurry vision
* minor discomfort
* dry eyes

Eye Surgery for Refractive Errors

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Surgery for correcting or improving refractive errors:

Clear vision depends on how well the cornea and lens permit light rays to fall onto the retina. Light rays must be refracted (bent) to focus on the retina. The retina is the light-sensitive nerve layer that lines the back of the eye, which creates impulses from the light rays that are sent through the optic nerve to the brain.

If the cornea or eye shape is abnormal, vision can become blurry because light does not fall properly on the retina. Called a refractive error, an abnormal cornea shape can often be corrected by refractive eye surgery, which, in turn, corrects the vision problem. Refractive errors can include myopia (nearsightedness), hyperopia (farsightedness), astigmatism (an irregularly shaped cornea which causes blurring), and presbyopia (similar to hyperopia, a condition which causes the lens to harden).

The goal of most refractive eye surgeries is to reduce or eliminate a person's dependency on eyeglasses or contact lenses. Refractive eye surgery is not for everyone. One type of surgery may be more suitable for one person than another. Always consult your physician for a diagnosis and to discuss which type of surgery, if any, may be appropriate for you.

There are several types of corrective surgical procedures for refractive errors, including, but not limited to:

* laser in-situ keratomileusis (LASIK) surgery/wavefront-guided LASIK
* photorefractive keratectomy (PRK)
* radial keratotomy (RK)
* astigmatic keratotomy (AK)
* automated lamellar keratoplasty (ALK)
* laser thermal keratoplasty (LTK)
* conductive keratoplasty (CK)
* intracorneal ring (Intacs)

What is LASIK surgery?

LASIK, or laser in-situ keratomileusis, surgery is used to correct nearsightedness. When a person is nearsighted (myopic), his or her eye is too long or the cornea is too steep, resulting in too much focusing power. The light rays entering the eye come in focus before hitting the retina, resulting in blurry vision when looking in the distance. The procedure, which should be performed by a skilled eye surgeon, involves reshaping the cornea using an excimer laser. LASIK is replacing many of the other refractive eye surgery techniques.

A promising new technology, called wavefront-guided LASIK, provides an advanced method for measuring optical distortions in the eye. The Eye Surgery Education Council states that physicians can now use this technology as a roadmap to evaluate the eye by measuring how light is distorted as it passes into the eye and then is reflected back. This creates an optical map of the eye, highlighting individual imperfections. In addition, the wavefront technology allows the surgeon to tailor the laser beam settings for a more precise procedure. This provides a patient sharper, better quality vision as well as a reduction in nighttime vision difficulties.
How is LASIK surgery performed?

Although each procedure varies slightly, in general, LASIK surgery involves using a computer-controlled excimer laser (a cold, ultraviolet laser) and a microkeratome (a surgical instrument). With these instruments, the surgeon cuts a flap in the center of the cornea to remove a thin layer of tissue. By removing the tissue, the cornea flattens, reducing the myopia. The flap, which is replaced without using sutures, adheres back to the cornea within minutes.
Recovery after LASIK surgery:

In most cases, recovery from LASIK surgery is fast and involves minimal discomfort. Mild pain relievers may be recommended by your surgeon to relieve discomfort during the first day after surgery. Patients typically take eyedrops for a week after the procedure.
Possible side effects of LASIK surgery:

Generally, LASIK has a high success rate. However, side effects do occur. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:

* dry eyes (during the healing process)
* eye discomfort (mostly during the first 24 hours following surgery)
* irregular astigmatism, which can decrease the corrected vision (astigmatism means blurring caused by an irregularly shaped cornea)
* corneal haze or glare
* overcorrected or undercorrected vision
* inability to wear contact lenses in the future
* loss of the corneal flap, requiring a corneal graft
* scarring
* infection
* vision loss

Benefits of LASIK surgery:

For most candidates, LASIK surgery usually involves little pain and recovery is rapid. Other benefits may include:

* LASIK can correct a wide range of myopia, up to 15 diopters (unit of measurement of the refractive power of a lens).
* LASIK can be repeated to correct the vision further.
* The eyes stabilize between three and six months after LASIK surgery.
* The eye is not weakened, because only one flap is cut into the cornea.
* LASIK usually causes little or no scarring of the cornea.
* Post-operative care is usually limited to using eye drops for a week after surgery.

What is photorefractive keratectomy (PRK) surgery?

Photorefractive keratectomy, or PRK, uses the same excimer laser used in LASIK surgery and is performed to reshape the cornea in an attempt to correct mild to moderate myopia (nearsightedness). According to the US Food and Drug Administration (FDA), PRK has a 95 percent success rate. Only about 15 percent of patients need glasses, occasionally, following surgery.
How is PRK surgery performed?

Although each procedure varies slightly, in general, PRK surgery involves an excimer laser beam reshaping the cornea by removing microscopic amounts of tissue from the outer surface. The procedure, which generally only takes a few minutes, uses a computer which maps the eye's surface and calculates the required corneal change.
Possible side effects of PRK surgery:

Generally, PRK surgery has a high success rate. However, side effects do occur. Because the corneal surface is cut, it takes several weeks to heal. In addition, there is some eye discomfort following the surgery that may last for several weeks. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:

* mild corneal haze (following surgery)
* glare or halos around light (this side effect may be present for months following the procedure)

Who is a potential candidate for LASIK or PRK eye surgery?

According to the US Food and Drug Administration (FDA), potential candidates for corrective laser eye surgery must meet the following criteria. However, it is advised that potential candidates consult his/her physician before undergoing any type of corrective eye surgery. The criteria include:

* The candidate must be at least 21 years old if being treated with the Summit laser (one brand of excimer lasers), or 18 years old if being treated with the VISX laser (another brand of excimer lasers). This age requirement is necessary to ensure the eyes have finished growing.
* The candidate must have mild to moderate nearsightedness (myopia).
* The candidate must be free of eye disease, problems with the retina, or scarring of the cornea.
* The candidate must have the financial ability to pay for this costly surgery, since insurance may not cover the procedure.
* The candidate must be aware of all the side effects, risks, and benefits of the surgery. Candidates should also be aware of the alternative treatment options available.

What is radial keratotomy (RK) surgery?

Radial keratotomy surgery, or RK, is a procedure also used to correct myopia (nearsightedness). The procedure involves making microscopic, radial incisions (keratotomies) in the cornea to alter the curvature of the cornea, thus, correcting light refraction. Hundreds of thousands of people who qualified for this type of surgery have undergone the procedure successfully since its introduction to the US in 1978.
How is RK surgery performed?

Although each procedure varies slightly, in general, RK surgery involves an eye surgeon cutting (with a calibrated diamond scalpel) radial or spoke-like incisions into the cornea outside of the center of the cornea (also called the optical zone, which is the area where a person sees through). Due to pressure inside the eye, the incisions cause the center, or optical zone, of the cornea to flatten, reducing refraction.
Possible side effects of RK surgery:

One main side effect of RK surgery is the excessive amount of time it takes for the cornea to heal. In some cases, healing may take weeks. The following are the most common side effects and complications. Each individual may experience side effects differently. Side effects may include:

* a weakened cornea that can rupture
* increased risk of infection
* difficulty in fitting contact lenses, if needed
* discomfort
* glare around lights
* fluctuating vision during the first few months
* cataracts (a change in the structure of the crystalline lens that causes blurred vision)
* loss of vision