The last few decades have seen unparalleled growth in refractive surgery options to help people see without wearing glasses. It began with the surge of RK surgery in the 1980’s. Then the unequaled precision of the excimer laser ushered in the modern LASIK (laser in situ keratomileusis) surgery era. Eyecare technology is nowhere more evident than in laser refractive surgery. This cool beam ultraviolet laser was developed by IBM originally in the 1970’s to precisely etch microchips. The original excimer laser procedure was called photorefractive keratectomy (PRK) and was first performed in the U.S. in 1987 and that person continues to see 20/20 today, living proof of the safety and stability of the procedure.
The excimer laser removes 39 millionths of an inch of tissue in 12 billionths of a second. Each pulse gently creates the proper curves on the cornea (clear front dome of the eye) to bring it back into focus painlessly. The cornea is about the thickness of eleven hairs and the laser typically removes a layer as slender as a single hair.
Custom LASIK is the latest form of LASIK. This procedure provides an additional level of precise data about your vision requirements using wave front technology. A device called a wavefront analyzer measures the way light travels through your eye and compares it with the way light travels through an eye with perfect vision. This device creates a 3-D wavefront map that is as unique to you as your fingerprint pattern. This map is then transmitted to the laser, enabling the surgeon to customize the procedure to your individual vision requirements as he gently changes the curve of the cornea (the clear front dome of the eye). The accuracy of Custom LASIK is enhanced by creating the flap using an Intralase laser to make the entire procedure blade-free.
Prescription Ranges – Custom LASIK can correct most common prescriptions. This includes nearsightedness, mild farsightedness and astigmatism. For prescriptions outside the range of LASIK there are other surgical options like “Clear Lens Exchange (CLE)” that our doctors can discuss with you.
Patient selection is very important with this elective and permanent procedure. Like any other surgery we don’t recommend it unless your potential benefits far outweigh the minimal risks. General health issues like rheumatoid arthritis, lupus, uncontrolled diabetes and other conditions are strong points to consider when identifying good candidates. Ideal age is generally held at 20 to about 60 years old. Under 20, many people’s eyes are still changing and your eyeglass strength must be stable within 2 steps for the last 12 months. Over 60, the likelihood of needing cataract surgery which also corrects near and farsighted prescriptions increases and LVC would be redundant.
Expectations – The point we spend the most time on with patients is their expectations of what LASIK or PRK can and can’t do. It can greatly decrease your eyeglass strength and dependence with the goal of daytime driving uncorrected (20/40) attainable by over 90% of patients. But it can’t guarantee you the 20/20 vision that the majority of laser patients enjoy. The single biggest reason is that we are working with human tissue and healing rates which differ for us all and these do affect the final outcome. Another thing to clarify is that the need for reading glasses/bifocals will still occur in our 40s, although there are options to decrease even this need for existing bifocal wearers that are candidates.
Overall laser vision correction is a wonderful option for qualifying patients with realistic expectations. We’ve helped lawyers, doctors, executives and homemakers who rave about their new found vision and freedom after this modern miracle! Please call our office for more information or for a consultation.
Specialty Eye Institute: We are affiliated with Specialty Eye Institute – The Laser Center, Detroit. Click here to link to their website for more information.