IntraLASIK - how it works ? STEP1: INTRALASIK uses the INTRALASE Femtosecond Laser to perform the FIRST step of FLAP CREATION. Local anaesthetic drops are used to numb the eye - it is a PAIN FREE procedure. In order to create an accurate ultra-thin flap the cornea needs to be slightly flattened. The eye is gently held open and the only feeling patients report is this slight pressure which is from making the cornea flat. Unlike the microkeratome which uses a blade, the Intralase laser creates a flap by producing thousands of miniature bubbles in the cornea with micro-accuracy. These bubbles join together to separate a layer of the cornea which becomes the flap. If the surgeon is happy a second set of bubbles creates the side of the flap, leaving a gap at the top for the hinge. In this way a highly PRECISE ultra-thin layer or flap of the cornea is fashioned. The surgeon has the ability to restart the process of flap creation if he is not satisfied avoiding any delay in vision correction (as would happen with regular LASIK the bladed procedure using a microkeratome). How Vision Correction Works ? STEP2: The patient is moved to a SECOND laser - the Excimer (Bausch and Lomb Z100) .

Here the Intralase flap is lifted and the treatment for the patient is applied. (A variety of options are available using the Intralase laser: Standard IntraLASIK, Zyoptix Tissue Savings and Zyoptix Wavefront - the surgeon will inform you as to what is most suitable for you). The flap is then replaced and allowed to dry. The Intralasik procedure requires no stitches and the flap sticks by a variety of natural forces. The patient then leaves the room and sits in a waiting area for about 20 mins, after which the vision is checked and eye examined. A huge difference in vision is immediate, though it continues to improve over the next three months. Treatments Offered What Will You Feel ? The Intralasik procedure takes about 6 minutes per eye. You will have had a tablet to relax you and you will be amazed how quickly the time goes. As mentioned you might feel some pressure with the Intralase laser interface (suction device) and your vision may go either dark or white. With the second portion of the treatment you will not feel anything and will just have to look at a flashing blurry red light. You can be reassured that the using the Intralase laser to create flap is much safer than a blade microkeratome. After the Intralasik procedure (like the microkeratome procedure) your eyes may stream and you might have the sensation of soap in your eyes for about 3 hours. Typically patients just want to go to sleep and once they wake up they are fine.

Posted by RustedMan at 2:12 AM | Permalink | Comments

New Approach Reduces Need for Repeat LASIK Visits

LONDON, September 2006 — A new and complex computer formula devised for the latest generation of excimer lasers used in LASIK vision correction reduces by nearly two-thirds the likelihood that repeat visits for enhancements will be needed, according to researchers at the University of Rochester Medical Center in New York.

With the new formula, researchers say LASIK eye surgeons are much more likely to receive the exact right vision correction in the first procedure.

Positive LASIK outcomes using the new formula were presented in September 2006 at the European Society of Cataract and Refractive Surgery meeting in London. Rochester researchers noted at the meeting that, while many LASIK patients do achieve 20/20 or better vision, they still might be slightly farsighted or nearsighted.

Researchers say the new computer formula for LASIK corrections accounts for the presence of many obscure vision errors known as higher-order aberrations that can affect vision outcomes. With the new computer formula, more people undergoing LASIK may now be able to achieve better than 20/20 vision.

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WaveLight Laser Is Now Also Wavefront-Guided

STERLING, Va., August 2006 — WaveLight's excimer lasers used in LASIK and similar vision correction procedures now will be sold as wavefront-guided or wavefront-optimized depending on eye surgeon preference, based on a new U.S. Food and Drug Administration approval granted in late August 2006.

WaveLight's Allegretto Wave wavefront-optimized excimer laser has for several years used wavefront technology to help provide measurements for individual, customized treatment of the eye. With the newest FDA indication, the excimer laser now can also be wavefront-guided, which means that wavefront measurements automatically are built into the procedure as it takes place in real time.

A WaveLight news release says outcomes for either wavefront-guided or wavefront-optimized systems are similar, except when patients have a higher degree of complex vision problems known as higher-order aberrations. In those cases, results with a wavefront-guided system are slightly better. Company officials say neither type of WaveLight laser system induced symptomatic higher-order aberrations during clinical trials involving 374 eyes.

In clinical trials involving both WaveLight laser systems, all patients were able to see well enough to drive without vision correction such as spectacles at three months following LASIK.

The Allegretto Wave wavefront-guided system has FDA approval for treating up to -7 diopters of myopia with astigmatism of up to 3 diopters.

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Pupil Size May Still Matter in LASIK Outcomes

ST. LOUIS, August 2006 — Despite newer excimer lasers that can treat larger zones in the eye for vision correction, LASIK surgeons still are being advised to notify patients that larger pupil size may be associated with adverse LASIK outcomes.

Large pupil size was a major factor in a St. Louis jury's April 2006 decision to award $3 million in damages to a patient who sued a LASIK surgeon because of vision problems following a procedure. Some recent studies indicate that newer excimer lasers can create favorable outcomes in patients with larger pupils. But LASIK surgeons still should warn patients that large pupils can increase risks, according to discussion in the July 2006 issue of Review of Ophthalmology.

The article notes several reasons why large pupil size can adversely affect outcomes, including the increased possibility that aberrations may result when a larger zone is treated on the eye's surface to accommodate a larger pupil.

Posted by RustedMan at 5:57 AM | Permalink | Comments

LADARVision® 4000 Excimer Laser

LADARVision® is unquestionably one of the most sophisticated and precise laser vision correction systems available today.

LADARVision Excimer Laser

• Using laser and radar technology developed by NASA, LADARVision® was the first approved system with active eye tracking, which compensates for involuntary eye movements. Although other laser systems have now developed eye-tracking systems, LADARVision® has the only system utilizing laser radar tracking technology, a system that measures eye movement 4,000 times each second and is capable of following eye movements regardless of how rapid or erratic they may be. Successful laser application does not rely on your ability to hold your eye perfectly still.

Top left eye without tracking. Right eye with tracking

• LADARVision® is the only Excimer laser system with an FDA-approved claim that states that its LADARTracker™ improves the accuracy of corneal shaping.
  

• Many doctors believe that the LADARVision® system with its LADARTracker™ is ideal for treating farsightedness and astigmatism because correction for these vision problems requires longer laser treatment times. During these longer treatments, the LADARVision® eye tracker accurately follows eye movement.
• LADARVision® has the broadest range of approvals of any FDA-approved Excimer laser and makes it the only one capable of treating all types of refractive errors including nearsightedness, farsightedness and astigmatism.
• LADARVision®'s unique small-spot laser beam (less than one millimeter in diameter) offers micron size reshaping of the cornea resulting in an extremely smooth surface. LADARVision's ability to use a larger optical zone for treatments minimizes potential nighttime side effects of glare, halos, and starbursts. This feature is most important for patients with large pupils.

Posted by RustedMan at 8:29 AM | Permalink | Comments

LASIK

One of the most popular ways to correct vision is with a procedure called LASIK (laser in-situ keratomileusis), which uses a laser to change the curvature of the cornea (outer window of the eye). LASIK has quickly become the procedure of choice for most patients because they recover quickly and have fewer side effects and complications than with other methods of vision correction. In fact, most LASIK patients notice a significant improvement in their vision soon after surgery. LASIK removes tissue within the cornea to treat low to high levels of nearsightedness, farsightedness and astigmatism.

To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.

Treating nearsightedness, the cornea is made flatter

To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.

To treat astigmatism, the cornea is made more spherical -- like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.

LASIK is for those who:

• want to reduce or eliminate thir dependence on glasses or contacts
• are at least 18 years of age
• have had a stable eye prescription for at least one year
• have no health issues affecting their eyes
• have no signs of glaucoma or cataracts

What to expect on surgery day:

You will arrive at the Laser Eye Center about an hour prior to your procedure. Once you have been checked in you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye. Anesthetic eye drops will be used to numb your eyes; no injections or needles will be used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

You will arrive at the Laser Eye Center about an hour prior to your procedure

Next, an instrument called a microkeratome will create a hinged flap of thin corneal tissue, and your doctor will gently fold the flap out of the way. During this process, you may feel a little pressure, but no pain. You will then be asked to look directly at a target light while the laser reshapes your cornea. The Excimer laser will be programmed with the information gathered in your pre-operative exam. The laser treatment will be completed in less than a minute or two, depending on the amount of correction needed. To finish the procedure, the protective layer will be folded back into place where it will bond without the need for stitches.

Following your procedure, your eye(s) will be examined with a slit lamp microscope

You will be asked to come back the next day for another examination of your eye(s). Most people can actually see well enough to drive the next day but it's best not to drive until you have been examined. You should be able to resume your normal activities the day after surgery.

Vision can fluctuate for up to six months, but most people can see well enough to pass a driver's license vision exam following their procedure.

Posted by RustedMan at 7:26 AM | Permalink | Comments

Customized Laser Vision Treatment

LASEK is a relatively new laser vision procedure that combines elements of PRK and LASIK, and may offer some advantages over both. Instead of removing the epithelium (the thin layer of protective skin that covers the cornea) like in PRK, a flap of surface epithelium is loosened with a diluted alcohol solution and moved aside. The surface under the epithelium is then treated with the laser and the epithelial flap is returned to its original position. Using the epithelium flap as a natural protective bandage with LASEK, as opposed to completely removing the epithelium as with PRK, may improve healing and the incidence of postoperative haze. The margin of safety with LASEK may be greater than that with LASIK as the need for a microkeratome is eliminated, so there's no risk of flap complications. LASEK removes tissue within the cornea to treat low to high levels of nearsightedness, farsightedness and astigmatism.	PRK
	LASIK
	LASEK
To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.
To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.
To treat astigmatism, the cornea is made more spherical -- like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.

LASEK is for those who:

• want to reduce or eliminate thir dependence on glasses or contacts.
• are at least 18 years of age.
• have had a stable eye prescription for at least one year.
• have no health issues affecting their eyes.
• have wide pupils.
• have corneas too thin for LASIK.

What to expect on surgery day:

You will arrive at the Laser Eye Center about an hour prior to your procedure. Once you have been checked-in and settled comfortably, you will be prepared for surgery. The area around your eyes will be cleaned and a sterile drape will be applied. You may be given a sedative to help you relax. Eye drops will be used to numb your eyes; no injections or needles are used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking.

You will arrive at the Laser Eye Center about an hour prior to your procedure

Posted by RustedMan at 8:25 AM | Permalink | Comments

Customized Laser Vision Treatment

LADARVision® CUSTOMCORNEA® is the process of reshaping your cornea to reduce or eliminate both lower and higher order aberrations that can affect the quality of your vision and how well you see after your laser vision correction procedure.
On the day of your procedure, the LADARWave™ CUSTOMCORNEA® 3-D map, containing the aberrations of your eye is perfectly registered and aligned with the surface of your cornea.	Map becomes guide for treatment
Then, LADARVision®4000 Excimer laser with its radar eye tracker, tracks your eye movement at 4000 times per second.	LADARTracker™ tracks eye movement.
Then using LADARVision®'s small spot laser beam your cornea is reshaped while addressing both higher and lower order aberrations.	Small spot beam precisely reshapes cornea.

Posted by RustedMan at 8:18 AM | Permalink | Comments

Phakic IOLs

The word "Phakic" refers to those who have not undergone cataract surgery and still have their eye's natural internal lens. IOL stands for "intra-ocular lens." In the Phakic IOL procedure, an intra-ocular lens is placed inside the eye. The patient's natural lens is not removed, as it would be in cataract surgery. There are three lens designs under development. The NuVita lens is placed in front of the iris. The Verisyse™, or iris claw lens is attached on the front of the iris. The Implantable Contact Lens, or ICL, is placed between the iris and crystalline lens.

Phakic IOL procedures are being used on severely nearsighted and farsighted patients who may not be candidates for the more common laser procedures such as PRK , LASEK, and LASIK. However, unlike laser vision correction procedures that permanently change your vision, it is possible to remove Phakic IOLs.

Phakic IOLs is for those who:

• want to reduce or eliminate thir dependence on glasses or contacts
• are extremely nearsighted or farsighted and not yet presbyopic
• have had a stable eye prescription for at least one year
• have no health issues affecting their eyes

What to expect on surgery day:

You will arrive at the surgery center about an hour prior to your procedure. Once you have been checked in you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye. Powerful eye drops or a local anesthetic will be used to numb your eyes. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

Next, a very small incision will be made and the intra-ocular lens will be inserted. The small incision will bond itself using the natural outward pressure in your eye, without the need for stitches. The Phakic IOL procedure is very quick, typically taking less than 20 minutes. There also is a short recovery time. The results of the surgery are almost immediate, however your vision will probably be a little blurry from the anesthesia, so someone will need to drive you home. You should relax for the rest of the day. You may experience some discomfort, but this is usually alleviated with an over-the-counter pain reliever. Most patients resume normal activities within a day or two.

Posted by RustedMan at 8:38 AM | Permalink | Comments

Wavefront

vefront technology was originally pioneered in the field of astronomy and physics to aid in reducing 'aberrations' or imperfections in the multiple lenses of telescopes. In much the same way, we use LADARWave® CUSTOMCORNEA® to provide us with an accurate assessment of the optical imperfections found in the entire eye's optical system.

First, flat waves of light are passed through your eye using a computerized wavefront measuring instrument called LADARWave®. As the light waves travel through your eye's optical system, the imperfections in the eye distort the flat light waves. LADARWavey® captures the distorted waves as they exit your eye and compares them to the perfectly flat light waves that would have been reflected if your optical system had no distortions.

Higher order abberation.

Ideal wavefront map.

Next, a 3D map is generated representing your unique visual distortions, including both lower and higher order aberrations. This map is then transferred to the LADARVision® 4000 Excimer laser, and guides the laser as it reshapes your cornea, providing you with a truly customized laser vision procedure.

Posted by RustedMan at 8:34 AM | Permalink | Comments

PRK (Photo-Refractive Keratectomy)

PRK was the first procedure performed using the Excimer laser. It corrects vision by reshaping the cornea. The difference between LASIK and PRK is that with LASIK a corneal flap is created and the laser is applied to the inner tissue of the cornea. With PRK, the epithelium (or outer skin of the cornea) is removed and a laser is applied to the surface of the cornea. PRK can be used to correct low to high levels of nearsightedness, farsightedness and astigmatism.

PRK

LASIK

To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.

To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.

Posted by RustedMan at 8:23 AM | Permalink | Comments

NearVision CK^SM (Conductive Keratoplasty)

CK makes the cornea steeper and increases its focusing power

Posted by RustedMan at 8:20 AM | Permalink | Comments