Archive for December, 2006

In the past, many advertisements for Lasik Eye Surgery have either stated or suggested that the Lasik procedure would eliminate the need for glasses or contacts ‘for life.’ These claims, according to the FDA, were too general and were unproven. Due to the FDA’s efforts, and their considerable power, most of these claims have been toned down, but it’s still a good idea not to believe everything you read.
Flowery words in exotic surroundings! Lasik marketing techniques range from flowery words extolling the wonders of being eyeglass free; to images of beautiful people in exotic surroundings, conspicuously not wearing glasses, amidst more flowery words commending more wonders of being eyeglass free. Then there are the testimonials by powerful people, well-known local and national celebrities who try to send you to this Lasik specialist . . . or that one, and enticements abound: raffles, free seminars, coupons, financial incentives for new patient referrals, and promises of lifetime guarantees or 20/20 guarantees that are are misleading. These are just a few of the many techniques that are designed to get prospective patients into the office. The flim-flam may not stop there either, your “Patient Counselor” may be less ‘counselor’ than highly-trained and well-compensated salesperson.
It’s important to note that some of the marketing techniques described above fall in the category of harmless, even acceptable advertising. Many of these techniques, however, are frowned upon by ethical Lasik surgeons as well as by the legitimate, highly-respected organizations that credential Lasik surgeons . . . not to mention the FDA.
The risks of Lasik: As a savvy consumer, you may be able to see through most of the visual and verbal gimmicks that are used to entice you as you try to find the best place to have your Lasik procedure performed; you cannot, however, evaluate information that is not presented in the advertisements. Information describing the risks of Lasik surgery never appears in Lasik advertisements and is, in fact, not required to be there. This is not to suggest that an ethical Lasik practitioner will not explain the risks (or at least the most prevalent risks) of Lasik surgery at the initial consultation, but without having researched the procedure you will not be able to tell if he is being completely candid.
Lasik is a delicate and complex procedure that depends on the precise movements of two pieces of equipment: the microkeratome, a surgical knife, and a computer-controlled excimer laser. At stake are two of the most delicate and complex organs in the human body. Just this brief two-sentence description of Lasik surgery should raise several flags over the possible dangers of Lasik. There is the possibility of hardware or software malfunctions in the equipment and the possibility of operator (surgeon) errors.
A new legal specialty is born. Most of the time, the result of a Lasik procedure satisfies the patient but there is a small percentage of patients who, after the procedure, experience vision problems including anomalies such as halo vision, starbursts and reduced low-light vision that interferes with their ability to drive at night. There are also isolated instances of blindness as a result of errors in Lasik surgery. These types of problems do not always surface immediately after surgery, they will often not appear until the nerves and muscles associated with the eyes prove unable to adjust to the surgery. The percentage of patients who experience post-surgery problems, compared with those whose procedures are successful is not great but it is apparently great enough to have given birth to a new legal specialty, added to the credentials of virtually every injury lawyer is the term: Lasik Injury Law.
Competition is the culprit! Competition between Lasik specialists is fierce and has reached the point where the type of misrepresentation, overstatement, euphemism and sometimes misrepresentation described here have become the rule rather than the exception. The reasons are obvious, if not justified: Lasik equipment is expensive to purchase and maintain, the Lasik surgeon has spent many hours mastering the specialty, the technicians that assist the surgeon are well-paid professionals and there is always rent to be paid for office space. To offset these expenses, Lasik clinics require a steady flow of patients and the pressure of this requirement can easily lead to ambiguous advertising claims.

With the new leaps and bounds that are being made in the field of corrective eye surgery there are fewer and fewer people who do not qualify or meet the requirements to get lasik surgery. Today just about anyone can get corrective lasik eye surgery. However there are a few exceptions to this rather generalized statement. These are the minimum requirements that guide most doctors in their decision to qualify or disqualify a patient for lasik:
1. Your refractive error should be stable
2. You should be at least 18 years of age or older
3. No other ophthalmologic disorders
4. No other general disorders
Your refractive error is the degree to which light reaches the back of the eye. This is the cause of astigmatism, myopia and hyperopia. Myopia is caused by rays of light that get focused in front of the retina as opposed to focusing on the retina itself. This causes nearsightedness. 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, and with today’s new technology lasik is now an option for many patients.
Hyperopia is the exact opposite. 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 severe farsightedness and have to step back from what they are reading. They use things such as magnifying glasses, and reading glasses to read and to see things right in front their face. Glasses and contact lenses can help alleviate some of these problems, and now so can lasik.
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 can result in double vision, blurred vision, and shadows on letters when reading. This abnormality 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.
You should be at least 18 years of age or older before considering lasik. This is because your body is still developing and changing, including your eyes. Your eyes are still growing and changing their shape until you reach full maturity. Most people’s eyes stop changing about the age of 16, yet some need that extra two years to finish. It is best that you wait till you are at least 18 to avoid any negative side effects or to avoid needing a second surgery done later.
Ophthalmologic disorders are disorders in the eye. Examples of these optical disorders are cataracts and glaucoma. These problems need to be take care of in advance if at all possible to avoid complications with surgery and recovery. People who have any optical disorders should not consider lasik as it may be ineffective or progress the damage of the eye ever further. Very few people with optical disorders actually improve their eye sight with lasik.
Other disorders such has arthritis should not be present either as it will slow the healing process. Many physiological disorders have been know to cause undo stress on the eyes, and it is for this reason that lasik is not recommended for people with general disorders.
Please remember that these rules are guidelines and not all doctors follow them to the letter of the law. Like most rules there are exceptions and only a competent doctor can decide if you should risk surgery under your conditions. Find a doctor you trust and let him/her examine your eyes and listen to their council to decide if lasik is best for you. Lasik is a risk even for the perfect candidate. Don’t risk more than you have to. Discuss it with your doctor and if he/she thinks you are a good candidate for surgery, then proceed with it, but only then.

Lasik eye surgery is an amazing procedure that has been used around the world to improve the vision of a multitude of people. The key to successful Lasik surgery is to link the information regarding the patient’s visual system to the Lasik laser. In this way, the cuts performed on the cornea of the eye are customized to fit the patient’s individual needs. Currently, wavefront technology is the most promising method for collecting this necessary information.
What is Wavefront Technology?
Wavefront technology is a system that is capable of providing a measurement of refraction at multiple points on the eye as light is reflected upon it. This creates a “map” of sorts, which is like a fingerprint of the patient’s eye, because it is completely unique to the individual.
Certain conditions within the cornea affect refraction. Some of these are considered higher-order aberrations, which have been traditionally associated with irregular astigmatism. The ability to correct these aberrations can result in a better outcome after Lasik surgery. This includes a greater possibility of achieving 20/20 vision, or better. In addition, wavelength technology helps reduce the likelihood of losing the best-corrected vision, of losing visual quality and of having difficulty with night vision. In fact, clinical trials showed that nearly 80% of Lasik eye surgery patients undergoing custom surgery achieved 20/20 vision. This is a higher number of people reporting quality vision after surgery than those who underwent traditional Lasik surgery.
In addition, wavefront can help determine what patients are not ideal candidates for Lasik surgery. For some people, Lasik surgery can actually exacerbate existing visual problems and make them even worse.
How is Wavefront Technology Used?
Traditional eye exams can only detect two corneal abnormalities, these being cylindrical and spherical. A cylindrical abnormality results in astigmatism, while a spherical abnormality results in myopia and hyperopia (near sightedness and farsightedness).
Wavefront technology, on the other hand, can detect an infinite number of aberrations. It accomplishes this by using a fixation target along with an input laser beam. The laser beam generates a light source, which is a wavefront sensor that is used to measure the slope of the wavefront as it exits. The software then determines the excimer ablation’s characteristics.
The visual fixation target is used to help the patient maintain the proper view while the measurement is taking place. As the patient fixates, the laser beam is shined into her eye. This light is then reflected from the retina and back through the pupil. The wavefront of the light leaves the pupil and is relayed to the wavefront sensor. The refractive properties of the human eye then distort the wavefront.
As the laser beam enters the eye, it produces a flat wavefront. In the theoretically perfect eye, a wavefront that is still completely flat will reflect back. In reality this beam of light will travel through a crystalline lens that is imperfect. The light then goes through an irregular cornea and other parts of the eye. All of this in combination causes the wavefront beam to become irregular, which results in valuable data to help determine the present shape of the cornea.
After wavefront is used to evaluate and diagnose existing aberrations in the eye, it is used to create the prescription for reshaping the cornea.
History of Wavefront
Wavefront technology has actually been around for quite some time, but it has only recently been used to aid in the correction of human vision. In fact, wavefront has been used for several years by astronomers for adjusting the optics in their telescopes for a similar purpose. When the reflecting mirror inside a telescope becomes deformed (as the cornea of an eye) it can be adjusted using wavefront data. This data is used to remove aberrations, like the Earth’s atmosphere (just like removing the aberrations found with astigmatism in the eye).
What are the Wavefront options?
There are currently three wavefront manufacturers in the United States. These manufacturers go by the trade names of CustomVue (Visx S4 laser), CustomCornea (Alcon LADARVision laser), and Zyoptix (Bausch & Lomb Technolas 217z laser). Each of these has the ability to create a customized prescription for individual patients.
Wavefront technology is an advanced method for creating precise and individualized prescriptions for Lasik eye surgery patients. With wavefront, patients have an increased likelihood of having a successful Lasik experience.