Archive for October, 2006

Lasik eye surgery is a procedure that helps to correct poor vision. It takes place in an office setting and it takes very little time to complete. In addition, it is relatively painless. To date, millions of people have benefited from this procedure.
Despite its simplicity and the number of people who have taken advantage of this innovative technique, there is potential for serious medical complications. Before going through with the procedure, therefore, the doctor asks a series of health related questions and completes a complete examination. Afterward, Lasik eye surgeons often define candidates into three categories: the ideal candidate, the less-than-ideal candidate, and the non-candidate. The following are some health issues that can decrease a patient’s status when determining whether or not he is a good candidate for Lasik eye surgery.
Extremely Low Vision
Lasik eye surgery is limited in the amount of vision it can correct. Therefore, some people are beyond the procedure’s ability to help. For this reason, the FDA does not allow patients with more than +6.00 diopters of hyperopia or -14.00 diopters of myopia to undertake the surgery. In addition, patients with more than 6.00 diopters of astigmatism are ineligible according to FDA standards, as well. The doctor can determine this information easily with a refractive eye exam.
Changing Prescription
While we grow, our eyes continually change size and shape. For this reason, a young person’s prescription for eyeglasses or contacts is constantly changing. Most prescriptions, however, stabilize by the time a person reaches the age of 18. For some people, this stabilization doesn’t occur until sometime in the 20’s. For this reason, surgeons prefer operating on patients over the age of 18 and whose prescription has remained stable for at least two years. This helps ensure that the eyes have stopped developing. Otherwise, operating on eyes that are still growing can create complications and the vision correction will become non-existent as the eyes continue to change.
Patient Health
Certain health factors can prevent a potential Lasik candidate from being considered ideal. For example, certain autoimmune disorders that slow the healing process make Lasik eye surgery a higher risk. In addition, patients with conditions requiring medications such as immunosuppresants and steroids are also considered less-than-ideal because these medications also slow the healing process and increase the risk of complications.
Patients who are pregnant or who are nursing are also not considered ideal candidates for Lasik eye surgery. This is because the shape of the eyes can be temporarily changed by hormonal changes during these times of a woman’s life.
Patient Anterior Eye Health
Most doctors divide the eye into two portions: anterior, or front, and posterior, or back. The anterior portion of the eye includes the iris, the eyelids, the cornea, the conjunctiva, the sclera, and the lens. The Lasik surgeon will check for abnormalities in these areas using a biomicroscope, called a slit-lamp. In order to complete this test, the patient needs to put his chin on a chin rest located over the examining chair. The doctor will then shine a line into the patient’s eyes to examine the anterior area of the eye. Abnormalities in this area can decrease a patient’s likelihood of being considered an ideal Lasik eye surgery patient.
Patient Posterior Eye Health
Specific eye diseases, such as ocular hypertension, glaucoma, and diabetic retinopathy, can be detected through a posterior eye exam. This area includes the optic nerve, the retina, and blood vessels. An exam of the posterior region is called a fundus exam. Shining a light into the patient’s eye and looking through his pupil accomplish the exam.
Irregularly Shaped Cornea
A cornea that is extremely irregularly shaped is impossible to operate on. Patients with the condition keratoconus, for example, are ineligible for the procedure. This is because it gradually makes the shape of the cornea steeper until it finally becomes cone-shaped. A small amount of irregularity in the cornea shape is fine, as with patients who have mild to moderate astigmatism. The surgeon examines the patient’s corneal topography prior to surgery. This will help determine whether or not he is an ideal candidate for Lasik eye surgery.
Thin Corneas
Some patients have corneas that are too thin; this makes it impossible to create the “flap” necessary to perform the procedure. Therefore, Lasik surgery will actually make the patient’s vision worse instead of better. The doctor measures the thickness of the patient’s cornea using a pachometer.
Lasik surgery is an extraordinary procedure that has helped thousands of people see better. Through a thorough examination and proper treatment of your visual difficulties, you, too, can experience the wonders of Lasik.

Custom Lasik surgery, using wavefront technology, is a relatively new procedure that offers distinct advantages over traditional Lasik surgery. This advance in Lasik technology uses equipment that is capable of making many more measurements of the eye, with more precision than traditional Lasik. The benefit of more measurements is a Lasik procedure that will be individualized (customized) to your eye, more than was ever possible with the traditional Lasik procedure. The laser used for the measurements is also much faster than the one used for the traditional Lasik procedure, this allows the laser to keep up with the uncontrollable eye movements that your eye normally makes (saccadic eye movements), resulting in more accurate measurement that greatly reduce the possibilities of side-effects.
The advanced capabilities of Custom Lasik, as valuable as they are to the patient, only account for a small part of the patients additional cost when Custom Lasik is chosen over traditional Lasik. The primary reasons that Custom Lasik is more expensive are more practical:
” Custom Lasik requires the doctor and his staff to spend additional time for preoperative testing and analysis as well as in the performance of the more complex procedure.
” The wavefront equipment is much more expensive than the equipment used for the traditional Lasik procedure so expenses relating to the purchase or lease and maintenance of the wavefront equipment are higher; additional supplies are also required.
” A royalty fee must be paid to the equipment manufacturer every time the equipment is used, the royalty for the wavefront equipment may be up to $150.00 more than the clinic has to pay for the traditional Lasik equipment.
Time factors. Wavefront is based on NASA research; it measures the unique ability of each patient’s eye to absorb and reflect light. The wavefront equipment is capable of making 200 unique measurements that create what might be called a three-dimensional topographic map of your cornea; compare this to only three measurements made using traditional Lasik equipment. Time is money and the Lasik surgeon and his staff will need to spend up to one-hour more with each Custom Lasik patient than they would with a traditional Lasik patient. This extra time is spent evaluating your condition to see if you are a good candidate for Custom Lasik, performing the pre-op analysis if it is determined that Custom Lasik is right for you, and operating and monitoring the equipment during the wavefront mapping procedure and during the actual surgical procedure all take longer because of the added complexity.
Equipment costs. The additional investment required by a Laser clinic to enable them to perform the Custom Lasik procedure is over $100,000.00. Added to that, the clinic must provide supplies for each patient that are specifically required for the Custom Lasik procedure; these can add up to several hundred dollars for each patient.
Royalties. A royalty payment to the manufacturer of each piece of Lasik equipment, each time that equipment is used, is standard procedure; this royalty payment for the wavefront equipment is typically between $140.00 and $250 per use (where use is defined as a procedure on only one eye), depending on the clinic’s arrangement with the equipment manufacturer. This royalty fee arrangement allows the manufacturer to recoup the cost of research and development.
These costs are in addition to the Lasik clinic’s other costs of operation which include:
” gowns, masks, gloves and other items for keeping the operation sterile.
” microkeratome blades, surgical solutions and medications used during the surgery.
” overhead costs for the surgery center, which includes office and surgical staff salaries and benefits, rent, office equipment, and office administration.
” patient acquisition costs, which include advertising, seminars, and fees paid to other eye care practitioners for comanagement.
” insurance to cover the facility, equipment and malpractice law suits.
” equipment leasing or purchase costs for other pieces of equipment used for associated procedures or other procedures.
” royalty fees to equipment manufacturers for other Lasik equipment.
After gaining a good understanding of the complexity and cost of the wavefront technology and equipment it is somewhat easier to understand why the Lasik surgeon has increased the cost of Custom Lasik in relation to traditional Lasik.

Lasik vision correction surgery is a very popular method for surgically improving eyesight. For individuals who rely on eyeglasses or contact lenses, the Lasik procedure often significantly reduces or completely eliminates the need for corrective lenses. When a Lasik procedure is performed, the Lasik surgeon will carefully screen all patients and do a thorough eye exam.
After a complete health history and eye exam to determine whether or not a particular patient is a good candidate for Lasik, the Lasik surgeon will discuss options. There are several techniques used for Lasik vision correction surgery. The most common procedure uses a laser called an excimer. The excimer laser has been used to help correct vision during Lasik procedures since 1987. The laser profiles the cornea to give the surgeon and patient the best possible outcome for the surgery.
For the most part, Lasik vision correction surgery is done to help improve vision in patients that experience low to moderate vision problems. Both farsightedness and nearsightedness can be improved with the Lasik surgery. Improved vision is usually immediate and there is very little pain associated with this procedure.
The ability to profile the cornea using the excimer laser drastically improves the outcome of the surgery. While no Lasik doctor can promise perfect vision after the surgery, it is estimated that around 90 percent of Lasik patients do have a good outcome. Lasik does not always completely eliminate the need for corrective lenses. It does for some patients, but this should not be expected. Some Lasik patients still need to wear some form of corrective lenses after the procedure.
During surgery, an instrument called a microkreatome can be used instead of the excimer. This instrument is used to create a very thin, circular flap in the cornea. The excimer does they same thing as the microkreatome, but the excimer often gives a more precise cut and has a higher success rate. After the flap has been cut, the cornea is profiles. This means that the Lasik surgeon will fold the flap out of the way and remove corneal tissue using the excimer. This laser uses cool ultraviolet light rays to remove very small pieces of tissue. The doctor will remove more or less depending of the severity of the vision problem. Sometimes, a patient only needs a very small amount of tissue removed.
After the corneal tissue is removed, the Lasik surgeon will then reshape the cornea. This reshaping procedure causes the cornea to focus better and results in improved vision. The flap is then placed back over the area and is left to heal. The entire procedure only takes a minute or two. For patients that need both eyes corrected, the doctor will perform Lasik on one eye, wait for a little while and then do the second eye. Some patients choose to have the second eye a few weeks after the first eye is healed.
There are many advantages to profiling the cornea using the excimer laser. Besides being extremely accurate, the excimer laser often results in a better surgical outcome. Also, when using the excimer, the Lasik surgeon is always in control. The laser has a control unit that controls the movement and intensity of the laser beam. The laser will always fall on the right area of the eye even when there is slight movement of the eye. This is a huge benefit for the patient and the doctor because there are often uncontrollable eye movements during surgery that will influence the outcome of the procedure. The surgeon can also stop the procedure at any time using the excimer laser.
There are many benefits of have a Lasik vision correction surgery. For patients that must depend on glasses or contacts everyday, Lasik can often give people the freedom of doing without. Although some patients still must wear corrective lenses after surgery, most can experience clear vision without glasses or contacts. There are only a few risks of the Lasik procedure, too. Only a fraction of Lasik patients experience difficulties with low light vision, such as halos after surgery. Even fewer experience pain or reduced vision. Many times, these complications clear up on its own without further intervention. Some patients may require a second surgery.