Sep
10
The Latest Technology in Laser Eye Surgery
Posted by admin in Eye surgery
In December 1995, Christine Fulmer decided to receive one of Lancaster County’s first-ever laser-corrective eye surgeries. It was a momentous one. After all, the procedure had received federal approval only a handful of weeks previous.”I was a little nervous at the time, but now, 10 years down the road, I would have the procedure done again in a minute,” Fulmer said.
“After I got the surgery, there was a small discomfort, something like having a cinder in my eye,” she said. “But I used medicated drops to calm the inflammation … and as soon as I could see again, there was a marked difference.”
First pioneered in Boston at the Massachusetts Eye and Ear Infirmary in the mid-1990’s, just 10 years later the procedure has now become almost commonplace, with celebrities like Tiger Woods, Nicole Kidman and even former “Wonder Woman” Linda Carter benefiting from the treatment.
When the procedure first came on the scene in the mid-1990’s, said Dr. Frank Manning with Manning & Rommel Associates in Lancaster, doctors removed the skin of the cornea and used a laser to shape the front part of the eye that covers the iris and pupil in a procedure called excimer laser photo-refractive keratectomy, or PRK.
Today, he said, lasers can be used to simply cut a small flap in the cornea and shape it using highly sensitive beams of light.
“In the beginning doctors could only work with an early-generation laser. They could only do one eye at a time, and then patch up the eye after each procedure,” Manning said. “Now, we can use highly-sensitive equipment to ‘map’ the eye and to guide the laser during treatment, and we also use more powerful lasers.”
The results, Manning said, produce fewer side effects with highly improved vision, usually costing patients, on average, between $2000 and $2,500 per eye.
For Dr. Kerry Givens, a laser vision correction specialist at Campus Eye Center in Lancaster, people thinking about getting the surgery should keep in mind that the procedure isn’t for everyone, such as those with excessively thin corneas, or who have been diagnosed with connective tissue diseases.
“Age is also always a consideration. In Europe, I know that some LASIK specialists will treat people at an extraordinarily young age, but personally, 21 is as young as I’ll go. Up until then, the eye is often still growing,” Givens said.
As for people over 65, he said, health issues like glaucoma, cataracts and macular degeneration can rob patients of the benefits of the laser correction.
Givens said there are many reasons why people might decide to get the procedure done: some because they are tired of the hassles associated with contact lenses and others because they love sports that make wearing glasses impossible, such as swimming or kickboxing.
“Of course, some people point out that even though I’m a laser vision correction specialist, I myself wear glasses. One reason is because I have a pretty large amount of astigmatism, which is harder to correct perfectly with current LASIK technology, but still easy to correct with glasses,” Givens said.
To perform his job, he said, he needs “perfect vision acuity” to do eye microsurgery on patients.
“If I had LASIK done on myself, there’s a possibility that I could end up with even a little less sharpness than what my glasses provide right now,” Givens said. “It would hamper my ability to do surgery confidently.”
Patients, he said, often comment on why a laser vision correction specialist is wearing glasses, but Givens said that by discussing his own choice on the issue he’s able to help patients understand that laser vision correction surgery is not for everyone.
“Simply wearing glasses or contacts doesn’t necessarily make you a good candidate (for this procedure),” he said. “Anyone thinking about getting the treatment should discuss the pros and cons of the decision at length with their eye doctor, plus be prepared to go through extensive presurgical screening.”
Patients, Manning said, need to remember the procedure is surgery, so getting it done is not “100 percent safe”.
“There’s about a one in 5,000 risk of infection, but by and large patients who decide to get this surgery are happy with the results,” he said. “People tell me that, once they’ve had the surgery done, they’re so grateful for the little things, such as being able to see when they get up in the middle of the night.”
Ten years after the procedure was approved, Manning said, LASIK eye surgery has become “an acceptable mainline alternative” to glasses. “A decade later, the procedure is stable without a lot of long-term adverse consequences for the eye.”
For Fulmer, the reason she decided to have the surgery in the mid-1990’s was for her work, when she was a supervisor with RR Donnelley in Lancaster.
“I had to be able to read fine print in catalogues and work up pricing, as well as handle special orders,” said Fulmer, who is now a grandmother employed by Wolf Furniture in Lancaster.
“Not having glasses back then was a huge advantage in my personal and private life, and now I have friends who are stuck walking around with glasses hanging down around their necks … and frankly, I think that’s ridiculous.”
“I’m so glad that having the surgery . .. freed me from having to deal with that,” she said.
Source: Lancaster Online
Aug
19
Lasik Eye Surgery Procedures
Posted by admin in Lasik eye surgery
LASIK stands for Laser Assisted In-Situ Keratomileusis. It actually reduces people’s dependence on their glasses or contact lenses and involves a simple short surgical procedure on your eye using a cool laser beam. The whole procedure is virtually painless, takes only minutes per eye and is a one day procedure so you may go home the next day.
The Lasik procedure is as simple as the following three easy steps.
- The cornea is like a few layers of stacked paper. An instrument called a microkeratome gently glides across the top two of these layers creating a flap which has like a hinge.
- The doctor then has access to the third layer or the stroma of your eye. The Excimer Laser then alters the shape of the cornea by the effect it has on the stroma.
- The flap is then repositioned back over the newly contoured stroma without the need for stitches as eye tissue binds togethervery quickly and simply on its own.
After this simple process, you are then sent home to rest. You will feel a little discomfort, rather like having an eye lash stuck in your eye for about 12 hours or so until the healing process is well under way.
On average, one in 5 people are not suitable for Lasik surgery and this can only be determined by a professional. Those not deemed suitable for Lasik may be more suited to other types of surgery so it is important to be aware of your options.
One of the best parts about Lasik eye surgery is that by the next day, your vision will have improved to the point where you can at least drive a car. Many people report their eyesight having improved to 20/20 vision!
The end result hopefully of Lasik surgery is to return the cornea to as close to a normal shape as possible, and in doing so improve your vision. Although Lasik surgery appears to produce what seem to be miraculous cures, it is also possible that complications may be included in the end result.
For those in the forty plus bracket who decide to try Lasik surgery, they may discover that they still require eyeglasses for reading. If you are thinking about Lasik eye surgery, it is advisable to do thorough research, gather all the facts and get a solid understanding of what you should expect before committing to the procedure.
Source: PR-GB
Jul
31
Laser eye surgery left author ‘unable to see’
Posted by admin in Lasik Surgery
A children’s author was left with blurred vision after an eye surgeon tore her left cornea, a hearing was told.
Jan Fearnley, 41, one of the most successful author-illustrators of her generation, had hoped that Dr Haralabos Eleftheriadis could correct her sight so she could swim and cycle without contact lenses.
But shortly after the Lasik surgery began Dr Eleftheriadis, 43, removed the equipment from her eye and apologised. He later told Mrs Fearnley that her eye had “reacted” to the blade during the laser surgery at the Ultralase clinic in Guildford, Surrey, in April 2005.
Mrs Fearnley, who is short-listed for a Blue Peter Award and the Children’s Book Award for her Mr Wolf’s Pancakes, wept as she told the General Medical Council on Monday: “My vision is my livelihood.”
The author and illustrator had to have two operations to correct the damage but still has blurred vision and sees double lines when she reads with her left eye. She told the panel: “I was waiting for the pressure to start. There seemed to be a bit of fumbling and something was put on my eye then taken off. I remember thinking, ‘This isn’t right.’
“There was just silence and a bit more fumbling about, then the equipment was taken off my eye.” The hearing was told the Dr Eleftheriadis then said to her: “I am really sorry, I can’t proceed with the laser.
“Later I was told it was because I had small eyes and I was really shocked to hear that, because I had sat through hours of tests.” The surgery is designed to improve a patient’s sight by permanently changing the shape of the cornea, the thin clear covering over the iris.
A knife is used to cut a flap in the cornea, which is then folded back to reveal the middle of the cornea.
Mrs Fearnley was left with an “incomplete flap” or “buttonholed flap” when the cornea in her left eye was torn.
Giving evidence yesterday, Dr Eleftheriadis said he had to change the suction ring, which is used in the surgery, to a smaller one when he couldn’t get Mrs Fearnley’s eye open. After the change, Dr Eleftheriadis told the panel he tried to obtain suction using a special foot pedal “just once”. Shortly afterwards Dr Eleftheriadis realised the eye had ‘buttonholed’ and he stopped the procedure.
“I explained to her that the flap on the left eye was not of good quality and it was not safe to proceed. I did not say anything about small eyes.”
He added: “I feel very, very sorry for her having a buttonhole and the impact that had on her life.” He told the panel that he has carried out 3,500 Lasik procedures since 2002 and Mrs Fearnley’s “buttonholed” left eye was the only one he had ever had.
Dr Eleftheriadis, of Northwood, north-west London, admits having difficulty placing the suction ring on the left eye but he denies attempting to obtain suction more than once.
He denies his conduct was inappropriate, unprofessional and not in Mrs Fearnley’s best interests. The doctor now practices in Southend, Essex.
The hearing continues.
Source: Telegraph
Jul
17
CustomVue Monovision LASIK Approved By FDA
Posted by admin in Lasik Surgery
The U.S. Food and Drug Administration approved the marketing of the most recent development in eye surgery for presbyopia: the CustomVue Monovision LASIK device.
The manufacturer, AMO/VISX, has agreed to conduct a post-approval study to follow-up on 500 patients for six months who have undergone the surgery to determine postoperative quality of vision and quality of life at the request of the FDA.
Monovision LASIK surgery treats eyesight to provide permanent monovision correction so that one eye is corrected to clearly see distant objects while the other eye is corrected to clearly see close-up objects.
The device is able to map the entire optical path of the eye, including the tiny distortions and imperfections that are naturally present. This information provides a unique “fingerprint of your vision,” which is then loaded into a computer for the surgery.
This type of surgical procedure is not for everyone, but it is growing in popularity as the choice of options grows in the field of vision correction.
Surgery to provide monovision is particularly effective for treating presbyopia, which is basically the age-related farsightedness that requires most people 40 years and older to find themselves needing to use reading glasses to see close-up.
Daniel Schultz, M.D., director of FDA’s Center for Devices and Radiological Health states, “Unlike traditional LASIK, Monovision LASIK may reduce the need for reading glasses in some people over 40.”
Many people who wear contact lenses for nearsightedness begin to have problems seeing close up when wearing their lenses. In the past, most of these individuals began to wear reading glasses or magnifiers to read or see close-up objects clearly.
Others began wearing bifocal lenses, which can help, too, but cannot always correct for another eyesight problem that some people experience, that is, astigmatism.
This latest development, monovision LASIK surgery adjusts for each eye independently. This type of procedure usually requires an adjustment period as the brain must get used to the change since normally the eyes focus together, not independently.
The dominant eye is the one that is corrected to see the distance objects, whereas the other is corrected for close-up objects this permanent surgical procedure.
Although this surgery eliminates the need for most people to wear glasses or contacts afterward, some individuals may still require further adjustments with one or the other type of corrective lenses, but this will be drastically reduced.
This procedure should be contemplated with an ophthalmologist, not to be confused with an optometrist, who cannot perform surgical procedures.
Also, as with any type of surgery, there are always potential problems or risks associated with it. The change from the eyes working together to focus (as being normal) to the eyes working independently can cause problems with depth perception. Reduced peripheral vision can also occur.
It is recommended that contact lenses that provide monovision correction be tried out first to get an idea of whether or not the permanent surgery is right for the individual. This trial may better help determine whether or not this option is viable for the individual and whether or not it is worth any other associated risks involved in having the surgery.
The procedure is usually quick and painless, and the majority of people are pleased and experience rapid visual recovery, excellent visual results, and increased safety.
Several million Americans have already undergone some type of LASIK procedure and usually recommend it to others.
Results of the clinical study trial for this new technology found that 94 percent of patients treated with this surgery were able to see 20/20 or better without glasses.
Most participants in the study trial were also very satisfied with their night vision after the procedure compared to their night vision before with glasses or contacts.
Source: AHN
Jun
24
Lasik Eye surgery evolves at rapid rate
Posted by admin in Lasik Surgery
The business of ophthalmic surgery has changed significantly in the past two decades. Remember when radial keratotomy, better known as RK, was the dominant refractive surgery to reduce patients’ dependence on glasses or contacts? Radial keratotomy worked well for those patients with low prescriptions and very little astigmatism. Yet the procedure had limitations and was not an option for those with strong prescriptions or large pupils. In hindsight, it proved a cruder, less predictable version of today’s advanced laser techniques.
Photorefractive Keratotomy, or PRK, surgery came on the market as the first FDA-approved laser procedure in the United States. It is still used today in patients with certain eye disorders.
“The tool that has brought about the greatest technological advancement to date in the world of ophthalmology is the Excimer laser,” Dr. Ronald Brown, a cataract and refractive specialist at The Eye Center of Toledo, said. “When LASIK surgery came on the scene 10 years ago in the United States, it was a breakthrough for our field. RK surgery became obsolete in a very short period of time because the results with LASIK were so much better and more predictable.
“Now, we can treat very high levels of nearsightedness, high levels of astigmatism, and even farsightedness. It really has opened the doors of refractive surgery for many patients.”
Today, for appropriate patients, the latest ophthalmic laser advancement is called “Custom LASIK.” Through this technique, ophthalmologists can prepare an individualized treatment for a person’s eye and his or her unique prescription.
“Not only are we treating things like nearsightedness, farsightedness, or astigmatism, but we’re treating other optical imperfections in patients’ eyes, which, in many cases, allows people to see better than they did before with their glasses or contact lenses,” Brown said.
Custom LASIK has been around for approximately two years, Brown said.
“In the old days, we used to program the laser with the patient’s prescription,” Brown said. Now, we use a very complicated machine that not only measures the patient’s prescription as far as nearsightedness, farsightedness or astigmatism, but also the whole complex measurement of imperfections in the patient’s eyes.
“In the Custom procedure, the laser is programmed to achieve an ideal result, which has allowed us to treat a wider range of prescriptions than we have ever been able to treat before and it has improved the patient’s quality of vision, especially when it comes to night vision.”
Today, lasers have sophisticated tracking systems that follow any eye movements during eye procedures.
“When we first started doing eye surgeries, if the patient had a hard time holding his/her eye still, it made the surgery much more challenging,” Brown said. “Nowadays, with the sophisticated tracking systems, it’s not nearly the concern it was because even if the eye is moving around, the laser follows the eye movement. So it has really become a lot safer and more predictable over the last few years.”
Good candidates for LASIK include people who have healthy eyes and desire less dependence on glasses or contact lenses.
“There is an upper limit to what kind of prescription we can treat, so when people come in for screenings, we measure their prescription, we look at the curvature of their corneas, the thickness of their corneas, to make sure they are a good candidate,” Brown said. “Not everyone is a good candidate for LASIK, particularly those who have eye diseases such as glaucoma or cataracts.”
New ophthalmic technologies on the horizon involve implants that are used after certain eye procedures, such as cataract surgery.
“For those patients who are not good candidates for LASIK because of the kind of prescription they have or because of cataract formation, the nice thing is that we can offer them an option that is better for them,” Brown said.
“It really is an exciting time in ophthalmology. Even in the last three to five years, there has been a host of procedures and technologies that have come about and I believe we will see more and more of those over the next five to 10 years as well,” he said.
Source: Toledo Free Press
May
21
Lasik surgery
Posted by admin in Lasik Surgery
If you wear glasses or contacts then you have probably wondered what it would be like to see clearly on your own. You have probably also heard of Lasik surgery. Angie Henry is checking in for surgery. Surgery that will rid her of the glasses she has been wearing since the fourth grade. Henry takes the prescribed Valium and waits for her nerves to settle.
Angie’s first led back to a prep room. Once her eye area is disinfected, Henry enters the operating room to meet Dr. William Wiley.
Dr. William Wiley asks Angie if she can see the wall clock without her glass and without squinting; her reply is ‘No’.
With Henry in position, Dr. Wiley pops in a couple numbing drops and gets to work on her right eye. After the flap is cut in Angie’s other eye as well, Dr. Wiley begins correcting her sight.
The prescription is mapped out with extreme precision days before surgery with a computer and then transferred directly into the interlace machine. The laser is done in 30 seconds.
The procedure is repeated on Angie’s other eye. After a total of about 15 minutes, Angie is sitting up and checking out that wall clock once again.
Dr. William Wiley asked Angie to read the clock again, her reply this time, ‘Yes, it is 6:35′.
“I didn’t feel anything. I could just hear it! It was kind of moving around and it was over! It was not bad at all.”
After a few last minute instructions, Angie and her husband go home.
Dr. Wiley says the average patient pays between 1 and 2 thousand dollars per eye. And almost anyone can have it done as long as you have a stable prescription and a corneas that are thick enough to withstand the laser.
“Once you get Lasik, your sight is set for life.”
Dr. Wiley says there is a five-percent chance that some patients may need touch up surgery if they don’t heal as they’d hoped. With age, Lasik patients may eventually need reading glasses.
Source: 13ABC
May
9
Study Revealed LASIK Still Effective After Age 40
Posted by admin in Lasik Surgery
More and more baby boomers are having LASIK surgery into their 50s, and 60s. For the first time, a large study looked at the safety and effectiveness of LASIK after age 40.
According to the study in the Journal of Ophthalmology, people are most likely never too old for some form of LASIK, as long as they have realistic expectations.
The study looked at people ages 40 to 70 who had some type of LASIK surgery done, and the vast majority did great.
“It all has to do with the changes in vision that take place as we get older,” CBS4’s Dr. Dave Hnida said. “We need reading glasses and our corneas are different. Our eyes don’t focus as well and we lose night vision.”
The study’s advice is for older people to be realistic. LASIK may not get older folks back to 20/20. About 80 percent of people over age 40 do have a good result, which is slightly less than someone younger, but just slightly.
“You may want to try monovision LASIK,” Hnida said. “Correct one eye for distance and one eye for close up. No bifocals or reading glasses.”
Hnida said before people try monovision, they may want to try special contacts that correct each eye differently to make sure they can adjust to it.
Source: CBS 4 Denver
Apr
29
LASIK For Older Adults
Posted by admin in Lasik eye surgery
A new University of Illinois at Chicago study appearing in the online edition of the journal Ophthalmology reports on the safety, efficacy and predictability of laser eye surgery (laser in situ keratomileusis or LASIK) in patients 40-69 years old.
“We are seeing an increasing demand for LASIK surgery for older adults, who present special challenges,” said study co-author Dr. Dimitri Azar, Field chair of ophthalmologic research at UIC.
In LASIK surgery, adjustments in correction are routinely made to compensate for the cornea’s strong healing responses in younger patients, Azar said. Increased age has been previously associated with poorer final clarity of vision, as measured on an eye chart (visual acuity).
“We were able to show that fine adjustments in the correction to the cornea in our older patients that compensate for differences in age-related healing resulted in reliable predictability of correction,” said Azar, who is also professor and head of the UIC department of ophthalmology and visual sciences.
The researchers examined the case histories of 710 consecutive laser eye surgeries on 424 patients between 40-69 years old. The LASIK surgeries were performed to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. All surgeries were performed by Azar between January 1999 and September 2005.
The cases were divided into three groups based on age: group one, 40-49 years old (359 eyes); group two, 50-59 years old (293 eyes); and group three, 60-63 years old (58 eyes).
Outcomes of the laser surgery corrections were analyzed for near-sightedness with or without astigmatism (511 eyes) and far-sightedness with or without astigmatism (199 eyes). Patients’ outcomes included a follow-up of at least six months and, where possible, 12 months. The study found no difference in safety between the groups.
At the final follow-up of the nearsighted-corrected patients, 86 percent of eyes in group one, 85 percent of group two, and 100 percent of group three had 20/30 or better visual acuity without glasses. In all groups, there was 20/40 or better visual acuity for 91 to 100 percent of patients.
For farsighted patients, 80 to 84 percent of all groups had 20/30 or better visual acuity at final follow-up, with 91 to 97 percent of all groups achieving 20/40 or better uncorrected vision. There was no statistical significant difference in final visual acuity between the different age groups.
Another challenge for older patients is difficulty with near vision after LASIK due to the loss of the ability to accommodate (presbyopia), Azar said. “As we age, we lose some elasticity of the lens of the eyes, making it impossible to maintain a clear image as objects are moved closer,” he said.
Many patients in the study opted for monovision, a strategy that compensates for presbyopia by correcting one eye for distance and the other eye for near vision.
“Patients who understand that monovision is a compromise that does not restore accommodation, but rather compensates for its loss, are most likely to adapt well to monovision,” Azar said.
“Although LASIK presents different challenges in the presbyopic age group, our study showed that for this age group, 40-69 years old, LASIK correction for near-sightedness and far-sightedness has reasonable safety, efficacy and predictability,” he concluded.
Source: Medical News TodayÂ
Apr
17
MRSA PERIL OF EYE OPS
Posted by admin in MRSA
THOUSANDS of patients having laser eye surgery are at risk of catching MRSA in the wound, experts said yesterday.
It has been discovered that some who have received the treatment have gone on to suffer a superbug infection in their eye.
Doctors are particularly worried because none of the affected patients was treated in hospitals where the bacteria was rife.
Instead, they may have contracted MRSA from their communities, in what is becoming a growing problem in both America and the UK.
According to experts in the US, 12 patients who underwent laser eye surgery subsequently developed MRSA.
All had been treated in private clinics which are supposed to be so sterile that MRSA cannot survive.
In one case, a male nurse who had a treatment called Lasik in both eyes had almost perfect vision after his operation.
But within two weeks, his left eye had developed an infection that grew worse until his vision was only 20/400 – which meant he was blind in that eye.
It turned out he had been struck down with MRSA, and even after treatment his vision was still left at 20/200, which is severely impaired.
According to a report in the American Journal of Ophthalmology, patients should be warned that there is a risk of suffering an eye infection – known as MRSA keratitis – after the procedure.
Dr Eric D Donnenfeld, who led the study, said: “MRSA eye infection is a potentially serious complication following refractive surgery.
“Surgeons should now be vigilant for community-acquired MRSA keratitis.
“All patients should be informed of the risk factors and warning signs of infectious keratitis, and need to be advised to seek medical attention immediately if they develop signs or symptoms.
“A high degree of suspicion, coupled with prompt and appropriate treatment, may result in improved visual recovery.”
Around 100,000 people in Britain had corrective laser surgery last year – three times the number in 1996.
There are now almost 100 clinics offering the treatment across the country as people shun the expense and hassle of contact lenses and glasses.
Source: Daily Express
Apr
16
Researchers report 13 cases of MRSA keratitis after laser refractive surgery
Posted by admin in MRSA
Researchers identified 13 cases of infection by methicillin-resistant Staphylococcus aureus in eyes treated with laser refractive surgery procedures, possibly representing the first reported series of infectious keratitis caused by the organism, according to the study authors.
“According to a computerized MEDLINE literature search, this is the first case series of MRSA (methicillin-resistant Staphylococcus aureus) infectious keratitis following refractive surgery, the first reports of MRSA keratitis after refractive surgery in patients with no known exposure to a health care facility, the first report of MRSA keratitis after [LASIK] enhancement, and the first reports of MRSA keratitis after prophylaxis with fourth-generation fluoroquinolones,” the study authors said.
Eric D. Donnenfeld, MD, and colleagues reviewed records for 13 cases of MRSA keratitis at 10 centers. The study included eight patients treated with primary LASIK, one patient treated with a LASIK enhancement and two patients treated with PRK. One of the PRK patients developed a bilateral infection, according to the study.
Five patients were health care workers, and four had exposure to health care settings. Three patients denied having any exposure to health care settings, the authors noted.
In all cases, the infection was located at the interface and was associated with interface inflammation. Physicians treated all cases with two topical antibiotics, including fortified vancomycin in all but one case. This one patient received fortified gentamicin and cefazolin, according to the study.
In addition, surgeons performed penetrating keratoplasty in two patients. Another four eyes are awaiting PK and one eye is awaiting phototherapeutic keratectomy (PTK).
“After treatment, in the eyes not scheduled for a PK or PTK, best corrected visual acuity ranged from 20/20 to 20/100,” the authors reported.
“MRSA infectious keratitis is a potentially serious complication following refractive surgery,” the authors wrote.
“Surgeons should now be vigilant for community-acquired MRSA keratitis. All patients should be informed of the risk factors and warning signs of infectious keratitis and need to be advised to seek medical attention immediately if they develop signs or symptoms of infectious keratitis. A high degree of suspicion, coupled with prompt and appropriate treatment, may result in improved visual recovery,” they said.
Source: OSN Super Site