Archive for August, 2006

Lasik eye surgery is an amazing advancement in technology that has helped millions of people who want to obtain better vision. Though the concept behind Lasik surgery is essentially the same from surgeon to surgeon, the actual tools used can be slightly different. In fact, some surgeons prefer using the “all lasers” approach, while others use a microkeratome.
Recent Advances
Recently, developers have created the IntraLase system, which seems to improve the safety of the Lasik procedure. This is because IntraLase uses laser energy rather than the microkeratome in order to cut a thin flap in the eye’s cornea. The microkeratome, on the other hand, is a cutting tool that does not utilize this advanced technology.
Once the flap is but and lifted, energy from the excimer laser is used to reshape the cornea. This reshaping process helps to achieve a sharper focus. After the procedure is complete, the flap is put back in place and acts as a sort of natural “bandage” in the healing process.
Benefits of IntraLase
Complications during Lasik surgery are rare, but of those that do occur, most are the result of the oscillating blade of the microkeratomes. The metal blade of the tool can create uneven edges on the flap. This results in abnormal surfaces on the cornea, which can lead to vision defects like astigmatism.
The metal blades of microkeratomes also have been traced back to the formation or improper or incomplete flaps, which can lead to scars that distort vision. Many surgeons feel that this type of scarring is less likely to happen with the IntraLase system.
The IntraLase system creates flaps using laser energy by inserting an exact pattern of many small overlapping spaces. This pattern is created below the surface of the cornea. The laser of the IntraLase system is capable of operating at the very high speed of pulses every one quadrillionth of a second. This helps target the tissue and divide it a molecular level, rather than with heat or by impacting the surrounding tissue.
The IntraLase laser also makes it possible for individuals with thin corneas to undergo the procedure. Previously, those with thin corneas (of about 500 to 600 microns) were considered to be ineligible for the procedure because the microkeratomes cut about 100 to 200 microns. This caused too much of the cornea to be cut away. The IntraLase laser, on the other hand, can cut a flap as thin as 100 microns because it is more consistent and reliable.
Another advantage of the IntraLase laser is that it follows the cornea’s curvature. This creates a flap with more manageable vertical edges, rather than the thin edges created by microkeratomes. These thicker edges are less likely to tear. In addition, this reduces the likelihood of cells growing beneath the flap and pushing it up, which will create an irregular surface on the cornea. Partially formed flaps, or “buttonholed” flaps, are also less likely to occur with IntraLase.
The sterility of the IntraLase laser also decreases the chances of developing an eye infection.
Possible Complications of IntraLase
Although the IntraLase system is associated with far fewer Lasik complications than using microkeratomes, surgeons are noticing one possible complication of the system. Recently, some surgeons have reported that patients who undergo the “all lasers” Lasik procedure experience the postoperative complication of having an unusual sensitivity to light. According to reports this complication has occurred in 1-20% of IntraLase patients, although one surgeon only reported the 20% figure.
Fortunately, many surgeons also have reported that this postoperative complication is only temporary. In fact, they report that using steroid eye drops for a couple weeks seems to rectify the problem.
For those surgeons who prefer to use the IntraLase system, they argue that the side effects of IntraLase are only temporarily. The side effects of microkeratomes, on the other hand, are more serious and can be permanent.
Cost of IntraLase
Using the IntraLase system instead of microkeratomes may have an increase in overall safety, but it also increases the cost of the procedure. According to one report, using the “all lasers” approach adds an additional $300 per eye to the cost. Often, patients are given the choice between using a microkeratome or the IntraLase system. Some surgeons, on the other hand, exclusively use the IntraLase and automatically include it in their fee.

In September of 2005 the FDA (Food and Drug Administration) approved a new custom lasik procedure. This procedure can treat a number of patients previously ineligible for the surgery. This procedure can treat high myopia, or nearsightedness. Nearsightedness occurs when the eye is too long and light rays focus in front on the retina instead of focusing on the retina. Some of the symptoms of nearsightedness are blurred distant vision, eye strain, and squinting. You may also have a hard time seeing at night. This problem is easily fixed with glasses. Contact lenses can also be an answer if the problem is not too severe. But many people do not want to be inconvenienced by the hassles of glasses or contacts. People want the freedom to get up in the morning and just see. That’s all. No contacts. No glasses. They just want pure vision. That’s all they want. New breakthroughs in technology are happening all the time. These breakthroughs in lasik technology have changed people’s life. It has made their lives better. It has improved the quality of life that was once unattainable.
The FDA approved a lasik procedure to treat patients with astigmatism. Astigmatism is the effect of the eye being shaped like a football instead of round like a baseball. Light rays are focused on two points on the retina instead of just one. This deformity will result in blurred vision, double vision, and shadows on letters when reading. This deformity has been a problem for decades. Up until recently it has prevented some people from getting contact lenses. Only people with slight astigmatism were able to comfortably wear contact lenses. Breakthroughs in contact lenses have not accommodated patients with extreme astigmatism. But even now not all patients can be helped. But with this new breakthrough in lasik, patients can have their eyes repaired to normal, or at least be repaired enough to comfortably wear contact lenses. Either way, their vision is enhanced and many are happy just to get rid of the glasses and finally be able to wear contacts, or possibly nothing at all.
Another approved surgery allows for lasik surgery to be done on patients with hyperopia. Hyperopia is another word for farsightedness. This happens when light rays focus behind the retina instead of on the retina. This results in blurred near vision. Some patients that have sever farsightedness and have to step back from what they are reading. Some patients required magnifying glasses to see something that is right in front of them. Many are embarrassed by this. They can see you 30 feet away, but when you get right up close they can’t see you. It makes some feel insecure and feel as though they are going blind. Though it is easily fixed by wearing glasses to read and see things up close, having to constantly take your glasses on and off can be rather inconvenient, and many choose not to. Many prefer to put their glasses on and keep them on or take them off and keep them off. Taking them off and on is inconvenient and you run the chance of leaving your glasses somewhere and never finding them again. Then you have to buy a chain to put on your glasses. Some patients find this embarrassing because it reminds them of their grandparents. It makes them feel old, and that is not good for morale. Eye surgery is what many people want to fix their eye problems. Until just recently, that option was not available to these patients.
These fantastic breakthroughs are the result of a new laser technology. The new Visx STAR Excimer laser system was recently approved by the Food and Drug administration. This new breakthrough in technology allows doctors to do more than they ever could before. Now they have the ability to reshape the eye to correct nearsightedness, farsightedness and astigmatism. Before this marvelous breakthrough patients with myopia, hyperopia, and astigmatism were not good candidates for lasik eye surgery. Now they have something to celebrate. They can now join the rest of the vision impaired and have the option for lasik!

FDA studies have shown that over 98 % of all patients receiving these new procedures were seeing 20/40 or better six months after surgery. Over 84 % were seeing much better than 20/20 after six months.
Many people do not want to be inconvenienced by the hassles of glasses or contacts. People want the freedom to get up in the morning and just see. That’s all. No contacts. No glasses. They just want pure vision. That’s all they want. New breakthroughs in technology are happening all the time. These breakthroughs in lasik technology have changed people’s life. It has made their lives better. It has improved the quality of life that was once unattainable.

Understanding the costs involved in Lasik surgery starts with understanding the procedure, the process and the cost to the clinic.

Screening consultation. At the beginning of your involvement in the Lasik process you will attend a screening consultation that will determine your suitability for the Lasik procedure. The Lasik counselor will need to collect all the information available about your general health, specific health problems, any prescription medication you are taking and your current corrective lens prescription. The counselor will discuss your vision and vision problems with you, based on what can be known at this point, and tell you if and how Lasik surgery can improve your vision. If you are a candidate the option of Custom Lasik will also be presented for your consideration.

If you are not rejected as a bad risk for Lasik surgery for some medical reason, the standard fees for the different procedures will be presented to you and payment options will be discussed. The fee that is quoted may cover all aspects of the procedure, up to and including follow-up care and enhancements, or it may be based on a series of “if this, then” conditions. The fee will probably not cover any optional, “but highly recommended” procedures such as the optional punctal plug occlusion (plugs inserted to treat ‘dry eye’ that block the outflow of tears through the nasal passage). It may be reasonable to assume that your health insurance will not help you pay the cost of Lasik surgery, since most insurance policies look at Lasik as an elective procedure; it would be wise, however to find out for sure. If your insurance does offer coverage for Lasik procedures, you can pursue reimbursement; most Lasik clinics will give you an itemized cost breakdown for the procedure. The Lasik clinic will take the position that, even without insurance coverage, Lasik is a great investment in your personal well being. Depending on the extent that you “need” Lasik rather than just want it, that may or may not be true for you. If money is a major consideration, consider all your options before committing.

Pre-surgical evaluation. A one-to-two hour pre-surgical evaluation is your next step in the Lasik experience. During this evaluation you will undergo a complete dilated eye exam with refraction. This exam will allow the surgeon to confirm that your eyes, aside from known conditions, are healthy and it will determine the exact degree of your nearsightedness, farsightedness, astigmatism, or presbyopia. There will also be tests performed to determine the condition of the cornea.

The Lasik Procedure. The actual Lasik procedure takes a very short amount of time (up to thirty-minutes) and consists of the application of eye drops to numb the eye, cutting a hinged flap in the cornea with a surgical knife, using an excimer laser to reshape the inner portion of the cornea (based on the measurements taken during the pre-surgical evaluation) and then closing the flap, which now conforms to the reshaped inner cornea. This is all done on an outpatient basis.

The follow-up exams. The first follow-up exam should be scheduled for approximately 24-hours after your procedure. This initial follow-up is usually followed by at least four more during the next weeks and months.

Costs. To appreciate the value you receive as compared to the money you spend for a Lasik procedure, cost should not be thought of as money out of your pocket as much as it should be considered reimbursement to the clinic for their expenses. That’s not, perhaps, a conventional way to look at it but it helps you understand the basis for your cost.

” As you can see, the Lasik surgeon and his staff spend a few hours with you and that accounts for some percentage of your cost for the procedure — the clinic, like every business, has a payroll.

” During every step of the procedure supplies were used (masks, gloves, gauze, etc.) adding some additional cost.

” During the pre-surgical evaluation and the Lasik procedure very sophisticated equipment is used. The clinic is either making payments on that equipment or making lease payments. It is also customary (as well as a contractual condition) for the clinic to pay royalties to the equipment manufacturers for every use of each machine.

” Other factors to consider are the clinic’s overhead costs — their cost of doing business: salaries, benefits, rent, office equipment, office administration, advertising, seminars and the healthy cost of insurance.