Archive for August, 2007

Custom LASIK surgery, also called Wavefront LASIK, analyzes the way light travels through your eye. This data is compared to the way light travels through an eye with perfect vision and a 3-D map is created of your vision. The surgeon, then, uses your Wavefront map to customize your LASIK surgery.

The Wavefront analyzer, also called an aberrometer, was introduced to the world of LASIK eye surgery in 2003. Doctors say it can result in you having clearer and sharper vision than ever before. It analyzes the way light travels through your eye, compares that data to the way travels through an eye with perfect vision, and creates a 3D map of your vision, demonstrating aberrations in your vision.

That map is programmed into the laser, and then the laser can treat your eye based on that custom map. You may be a good candidate for Custom LASIK if you have mild to moderately high degrees of nearsightedness, farsightedness and astigmatism, combined with what is called “higher order aberrations” in your eye. These are small imperfections in the eye that are linked to halos, visual glare and other problems such as poor contrast sensitivity, that are not treatable with today’s eyeglasses, contacts, or conventional LASIK. It is even likely that night vision will improve.

Pupil size and the thickness of the cornea may indicate a procedure other than Wavefront. Also, if your higher order aberrations are not pronounced, you may be better off having the less expensive Conventional LASIK surgery.

The actual procedure is identical in Wavefront LASIK and Conventional LASIK. It is in the pre-operative testing and the technique for programming the computer with your individual treatment parameters where the two procedures differ. Surgeons who use the Wavefront analyzer say that it brings a whole new level of accuracy to the surgery. The Wavefront system provides information on more than just the surface of the eye and refractive error. It demonstrates how the whole optical system processes light. It is said that the difference in results with the two surgeries is like the difference between standard television and high definition television.

Wavefront LASIK is still a very new procedure, as it was just approved in 2003. The medical profession understands a lot about the eye’s lower-order aberrations and their stability, but far less is known about higher-order aberrations. So, not even the most skilled surgeon can predict how higher-order aberrations will change over the years.

You have to understand that this is still surgery and complications are still possible. Although it is possible that you will not ever need glasses or contact lenses again, it is by no means guaranteed. It is even possible that your quality of vision will diminish.

Not everyone is eligible for Wavefront or Custom LASIK eye surgery. But for those who are, this new technology improves the possible results, diminishing complications and giving new hope to those with halo, glare and contrast sensitivity issues that cannot be corrected with standard LASIK or corrective lenses.

When you consider the possibility of Lasik eye surgery for yourself, information pours in. Everyone has a story. And you need to make decisions. It is mostly permanent and it does make a difference in your life. Hearing someone else’s tempered outside memory provides a peaceful perspective.

My sister had worn glasses for years. In fact she wore two different pair of glasses: one pair for reading, and one pair for distance. I am not sure why, but she either was not a good candidate for contact lenses or decided that she did not want to mess with contact lenses. She had friends who reported successes with Lasik eye surgery, so she decided to look into it.

She reported to the rest of her siblings that she was tired of hauling around two pair of glasses and switching between pairs. Of course, we all weighed in with our feelings and rumors we had heard about Lasik eye surgery.

I looked up what Lasik stands for: laser in situ Keratomileusis. That knowledge didn’t do anything to ease my nervousness. I had heard that some people have a hard time healing from the surgery. I had also heard that some people’s vision got worse after Lasik eye surgery, and that sometimes the operation wore off. I’d also heard that sometimes if the surgery wore off, it couldn’t be redone. Even though I relayed all that to my sister, she still decided to go ahead with the lasik operation.

My sister found an ophthalmologist to do the procedure and reported she had a date for Lasik eye surgery. I had to know how long it would take, whether or not she would be in the hospital, and how long it would take before she would be able to see.

She reported that she would go to the ophthalmologist’s office for the surgery. Her husband would drive her home, and she would have to keep her eyes covered for a period of time. I can’t remember whether it was one or three days.

My sister reported that the Lasik went well and that she went home as expected. When she took the eye coverings off, she said she had to get used to focusing again. One eye could now focus well on things close up, and one could focus pretty well on things far away.

Her brain put the input from both eyes together so she could see without glasses. She was able to return to work within a few days, but then she began to have some problems with one eye. Apparently, one of her eyes was not producing enough tears to keep her eye from drying out, a possible side effect of the Lasik.

She went back to the ophthalmologist and the doctor worked on the problem. At the end of another couple of weeks, her eyes were fine. She was pretty well used to navigating around with her improved eyesight. She didn’t have any further problems and has been a supporter of Lasik eye surgery ever since.

My sister’s Lasik was about three years ago. She has enjoyed her improved vision ever since. We have all just about forgotten what she looked like with glasses on.

LASIK seems to be a fairly safe surgery. About three percent of patients have lingering problems. Only one half of one percent are left with traumatic problems. As LASIK has been in common use for less than a decade, it is still in the experimental phase, and long-term results are still unknown.

If you look around online, it seems that there are two kinds of LASIK websites. There are promotional, commercial sites trying to sell you the services of an eye surgery center, and there are scary sites showing you all the terrible things that can go wrong in LASIK eye surgery. There are other websites out there, though, that show the whole story in a balanced, rational manner.

What has gone wrong in LASIK? Let me tell you, some patients’ eye charts have been inadvertently switched with the charts of other patients and their eyes have been corrected to the wrong levels. There have been equipment failures, such as jamming of the microkeratome blade, which then completely severed the corneal flap. There has been slippage of the flap, poor healing of the flap, and infections.

Medical ethics are always a concern, because surgery has become such big business. There will always be weak people who will try to provide an unnecessary service in order to make more money. LASIK eye surgery has become such big business that some say that articles in professional journals criticizing LASIK are rare. Some medical professionals even say that they have been threatened for criticizing the surgery. It is possible that this has happened. If you don’t feel you can trust your surgeon, don’t have the surgery.

So many people have had LASIK eye surgery in the past decade that even with a three percent failure rate, there are over 180,000 people whose vision is worse off than when they started. That is a lot of people. Even one person who is blind now because of the surgery is too many people. But, as surgeons gain more experience in these endeavors, the incidence of catastrophic complications is reducing. One surgeon stated on an Internet bulletin board that those numbers are down to 0.5%. He said, “.refractive surgery is surgery and it is not perfect.” He’s right.

You should remember that LASIK eye surgery should still be considered experimental and elective. Because it is elective, LASIK eye surgery can be compared to plastic surgery, in that insurance typically does not cover LASIK. You should read all you can, consider your own lifestyle and needs, ask questions of your surgeon and really think about it before you commit. Make sure that you are a good candidate for the surgery. Your health is your own responsibility and these are the only two eyes you will ever have.

Even though all these terrible things could happen to you, it is also more than likely that you could have great results. LASIK surgeons self-report that about 3% of LASIK subjects have complications resulting in poorer vision than that with which they started. About 0.5% of patients have tragic results.