Posts Tagged ‘lasik’

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Did Your LASIK Provider “Skip Town”?

Saturday, January 28th, 2012

Some LASIK providers have left town.

   We see them with some regularity.  The LASIK patient who had their surgery performed a few years ago is looking for their provider to take advantage of their “lifetime guarantee”.  The story goes like this: the patient gets an incredible deal on their LASIK eye surgery and the kicker?  Free enhancements for life.  But the center has used a lower quality technology known to require a higher enhancent rate and now the patient needs a “touch up”.  The patient assumed that “LASIK is LASIK”.  They called around and went for the lowest price.  The LASIK center had an impressive “franchise” type name.  They used slick advertising, touted that they used the best LASIK technology, had the best doctors and had the most experience.  Theydrew the patient in with their claim of having the lowest price and the patient was reassured with the unsubstantiated claims and the promise of a  ”lifetime guarantee”.  
  Now the patient is unable to excercis their LASIK guarantee.  In some cases the center and the surgeon have left town.  In other cases, the doctor remains in town but now practices under a different practice (corporate) name.  When confronted with the “guarantee”, the surgeon will usually disavow any responsibility.  “That was the guarantee of the corporation, not me,” the’ll protest.  The deal that seemed too good to be true, really was.
  In our 14 years of practice, we’ve seen a number of discount LASIK providers come and go.  We’ve long tried to educate the patients who come in for consults but many just can’t resist the draw of a discounted price.  Unfortunately many are left “holding the bag” like the used car buyer who, after buying a lemon, returns to the auto dealer only to find an empty lot.

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Which is Better, One or Two?

Sunday, January 22nd, 2012

Today we use centuries old technology to determine what eyeglasses to prescribe eyeglasses and contact lenses for patients. A series of different powered lenses are held in front of a patient’s eye and the patient is asked to judge, subjectively, which lens makes their vision clearer. “Which is better, one or two?”. The patient guides the doctor to the prescription that allows them to see best in medicine’s version of “hotter or colder”. Most of the time, the result is successful, but occassionally the result is a prescription that the patient can’t wear. In this scenario, glasses are simply remade. But this ancient technique of determining prescriptions is also used in standard and wavefront-optimized LASIK eye surgery. The result of an incorrect prescription determination used in LASIK eye surgery is also a “remake”, but this remake is a second eye surgery. This aspect of pre-operative planning before LASIK eye surgery points out but a couple of advantages of wavefront-guided LASIK over conventional or wavefront-optimized LASIK.
In wavefront-guided LASIK, a wavefront analyzer is used to determine the treatment. This takes away the subjective nature that can be affected by patient fatigue, fogged lenses, rash or hurried judgement or indecisiveness. How much better is wavefront analysis over conventional means of determining prescriptions? Twenty five times more accurate. And the affect on “do-overs”? About four times less likely. Wavefront-guided LASIK yields better results than wavefront-optimized LASIK. Don’t be fooled by confusing by centers that advertise “wavefront LASIK”. Insist on wavefront-GUIDED LASIK.

How good are you at determining which is better?

A wavefront analyzer is used to determine treatment in a wavefront-guided LASIK.

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LASIK vs Contact Lenses

Saturday, January 14th, 2012
LASIK beats contacts in cost and safety.

LASIK beats contacts in cost and safety.

Which is Better?  LASIK or Contact Lenses?
For many patients, the choice of vision correction comes down to LASIK or contact lenses.  Eyeglass correction may be undesirable, impractical or impossible.  But which is better?  For many, the determination is one of cost and/or safety.  Your assumptions about the superiority of LASIK vs contact lenses may be tested by the facts.  Today’s  prizefight is LASIK vs Contact Lenses.
Round 1: Safety
Over the years of providing LASIK consults I’ve learned that nothing draws a blank expression from a patient like making the statement “The risk of vision loss from LASIK eye surgery is less than the risk of vision loss from contact lenses.”.  The overwhelming majority of patients when informed of this will look at you in stunned amazement and appear to be studying the statement to determine whether they heard you right or attempt to figure out what the catch is.   The thought of vision loss from contacts seems to never have occurred to them.  Yet, every year, dozens of patients lose vision from contact lens wear.  The most common cause?  Corneal infections.  Some patients may protest: “Well, yes, some people abuse their contacts.” or “But I always disinfect my contacts.”  Obviously patients who abuse or don’t disinfect are at greater risk, but the truth is, all patients who wear contacts are at a greater risk of vision loss than patients who do not.  The safest way to correct vision is with eyeglasses. Of course, the risk of vision loss from contact lenses is quite small but the risk of vision loss from LASIK is even rarer.  Numerous studies  confirm that LASIK carries a lower risk of vision loss than contact lenses and, as laser technology improves, the disparity in safety can be expected to become greater.  Round 1 goes to LASIK
Round 2: Cost
“But LASIK is expensive.  I can’t afford it.” says a typical skeptic?  Expensive? Think about how much you spend every year in exams, contacts and supplies, and eyeglasses.  The typical LASIK patient will save thousands of dollars in just a few years.  Not to mention the additional time savings in not having to go in for contact lens exams, eyeglass fittings etc..  Even if you have vision insurance, you can come out ahead.  No, LASIK is not expensive, it’s a worthwhile investment that pays for itself many times over.  And, because most LASIK providers provide financing, you won’t have to pay for the entire procedure all at once.  The final knock-out blow?  LASIK is a tax deductible expense and can be paid for in pre-tax dollars or via a flexible spending account.  Round 2 goes to LASIK.
Both LASIK and contact lenses are effective and safe ways to correct vision.  But, if you are a good candidate for LASIK eye surgery, LASIK beats contact lenses for both cost and safety.

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Would Your Competitors Admit Your Product is Superior?

Sunday, January 8th, 2012

Someone has to offer the best product. But everyone has competition. And, no one has a monopoly on products and services. So if there is always a best, how do competitors continue to stay in business? By distracting the consumer by focusing on some other factor other than quality such as price or convenience and unfortunately at times, by misrepresenting or making false statements.
We have seen some of our competitors make the claim that they offer the best LASIK technology at the lowest price. Obviously if this was true, we would be out of business.
The two things most important in LASIK is safety and results. We have invested in the technology that has proven to be the safest with the lowest risk of complication. In addition, our technology offers the highest rate of 20/20 vision results. So if these two facts are true, what criterion is a competitor using to claim “being the best”?
We will readily admit that it is possible to offer a lower price by using less expensive technology and a lesser level of service but we challenge any competitor to back up their claims of being better with hard data. We have the proof and authoridative data to back our declaration of superiority. All they have are hollow assertions.

Would you buy a Rolex from this man?

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LASIK Now vs LASIK Then

Sunday, December 18th, 2011

Improvements in technology have improved video games and the LASIK procedure.

One truth about medical procedures is that with time, things get better. Cataract surgery used to involve a week stay in the hospital with sandbags around the head after to prevent movement. Newer technology has changed this to a 10 minute outpatient procedure with most patients returning to their normal daily routine within a day.
LASIK has undergone a similar evolution. The LASIK procedure hardly resembles the original procedure first described 20 years ago. The original procedure involved making a flap with a mechanized, geared flap-maker with a blade and a crude (by today’s standard) laser with an aperature that was centered on the pupil by the surgeon using a joystick.
Today’s most sophisticated LASIK procedure involves totally customized flaps, preplanned on a dashboard using a high-frequency laser and a second pupil-tracking laser to reshape the cornea to correct not only refractive error but corneal aberrations.
The result? A much safer procedure with better outcomes. Many patients describe even better night vision than previously obtained with glasses or contact lenses. LASIK has gained a new popularity as patients have taken a second look at the procedure because of the newer innovations in LASIK technology. Want to find out if LASIK is right for you? Consult with an ophthalmologist who performs LASIK eye surgery and ask about risks and benefits. Maybe you will join the millions of patients who are now free of eyeglasses and contact lenses.

A Geared LASIK flap maker.

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What Causes Myopia?

Sunday, November 13th, 2011

  The debate about what causes myopia (nearsightedness) rages on. The fact that myopic parents tend to produce myopic children seems to indicate that myopia has a genetic basis. There is abundant evidence, however, that environment plays a role.

A 1968 investigation by Dr. Frances Young, who led a research team to Alaska to study Eskimo families that were being assimilated into the modern American lifestyle is cited as evidence of the role of reading in the production of myopia. This provided a unique opportunity to test the genetic theory because the parents were illiterate whereas their children were the first generation to go through school. According to the genetic theory, the parents and the children should have almost identical visual systems with little or no myopia.

What Dr. Young discovered stunned the eye care profession. Only 2 out of 130 parents were myopic and the amount of myopia was very small. This was expected because they were living the traditional Eskimo lifestyle of hunting and fishing. In contrast, more than 60% of the children had measurable amounts of myopia! The children obviously didn’t inherit the myopia so Dr. Young concluded that the myopia was caused by long periods of reading as the children went through school.

Another, more recent study, found an association between the use of night lights and the development of myopia. Whatever the environmental influence, the incidence of myopia is clearly increasing in our modern society. Various efforts to prevent or reverse myopia in children such as the use of reading glasses and bifocals have proven ineffective in affecting the course of myopia. Various eye exercise programs have also been a failure.

Thankfully, vision correction procedures such as IntraLase LASIK and implantable contact lenses are becoming safer and more successful allowing millions of patients afflicted with myopia freedom from glasses and contact lenses.

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When LASIK is “Iffy”

Sunday, September 18th, 2011

LASIK may not be your best option.

Some patients are great candidates for LASIK: they have an eyeglass prescription associated with a high success rate, they have no contradictory conditions and they have reasonable expectations. Other patients may not be a candidate for vision correction surgery and another, third group of candidates may be described as “iffy”. We’ve seen a number of these patients over the years. Many are seeking a second opinion or may have some misconceptions about LASIK eye surgery and need to be educated on why they are not ideal candidates.
The unfortunate truth is that LASIK cannot correct every vision malady. There are some prescriptions that cannot corrected with final good optical quality and there are some eyes for whom LASIK is not suitable and can even be dangerous. Most reputable LASIK providers will not offer surgery to patients when it is clearly contraindicated. Of course, there are various shades of gray. Some eyes may have a reasonable chance of having good results from LASIK but may not be ideal. Now suppose you are a “LASIK-only” provider dependent on high volume in order to be financially viable. Chances are you will be tempted to offer LASIK to a patient with less than perfect credentials under the assumption that the odds are in your favor.
But what if you were the patient? Wouldn’t you want to know that you were a less than ideal LASIK candidate and be interested in hearing about other procedures offering a safer side-effect profile and higher success rate? Today there are numerous options, besides LASIK, that are available to reduce dependence on glasses. Some of these options include PRK, OmniLase, Implantable Contact Lenses, CK and Refractive Lens Exchange. To insure you are offered all available vision correction options, our advice is to seek the opinion of a surgeon offering various procedures. Listen carefully to the risks and side effects of each option. If LASIK is “iffy” you might just want to cross it off your list and choose a procedure more suitable to you and your particular vision problem.

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LASIK: A Good Procedure Gets Better

Tuesday, August 2nd, 2011

LASIK has it’s roots in a procedure first performed over 50 years ago.  A Columbian ophthalmologist described performing a procedure termed “keratomileusis” or corneal reshaping procedure to correct extreme amounts of nearsightedness using a bladed microkeratome and a lathe.  Others began performing the procedure and refined it with better instrumentation and techniques to yield better results and improved safety.  Eventually the excimer laser was introduced to replace the lathe in the reshaping part of the procedure and the term LASIK (laser assisted in-situ keratomilieusis) was applied to the “new” procedure. With the improved precision brought about by the excimer laser came wider acceptance of the procedure and eventual FDA approval.
  As with most things in medicine, continued improvements and refinements have taken place.  Two of the bigger refinements were the addition of wavefront technology to improve the final optics of the reshaped cornea and the introduction of a second laser: the femtosecond laser (IntraLase).  Today’s LASIK procedure is far advanced from earlier generation procedures.  Outcomes are improved with higher levels of 20/20 vision, lower levels of side-effects such as night vision difficulties and a safety profile that surpasses that of contact lens wear. 
   If you are contemplating LASIK or any other vision correction procedure, you should not presume that you will automatically benefit from all the refinements that have taken place.  Upgrading and replacing equipment is an expensive proposition and some doctors and LASIK centers may not be willing to invest in new technology.  That puts the responsibility on you, the patient, to investigate and determine if you are comfortable with the technology to be used in your procedure.  If you have made the decision that improvements in the LASIK procedure have now made it a viable option for you, it is up to you to determine whether you, in fact, will be receiving this better procedure.

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New iFS Laser Minimizes Dry Eye from LASIK

Sunday, July 24th, 2011

Most patients appreciate the improved safety afforded by the IntraLase laser in creating the flap during the LASIK procedure. An additional benefit of the latest model of IntraLase laser is the reduction in both severity and duration of dry eyes after LASIK.
Our last blog post discussed the mechanism of dry eye production from LASIK. Dry eye symptoms result from the severing of corneal nerves during the procedure. So how can the iFS minimize dry eye? By limiting the number of severed nerves and promoting quicker healing of the cut nerve fibers.

An Oval LASIK flap with a wider hinge will help to minimize dry eyes from LASIK

Like all lasers used to create corneal flaps, the iFS has the ability to create very thin flaps which helps to limit the number of cut corneal nerves. The IFS, in addition, has a unique surgical planning dashboard and customization features not available on other lasers. Surgeons using the iFS have the capability to create oval shaped flaps with wider hinges that are just large enough to cover the dilated pupil. This insures that an unnnecessarily large number of nerve fibers are not cut thus minimizing dry eye symptoms.
In additon, the iFS has the ability to create an inverse beveled flap edge assuring near-perfect alignment of the flap. Because the two ends of the cut nerve are apposed closely to each other, the nerve has only a short distance to grow before healing back together.
Thinner smaller flaps and wider hinges minimizes the invasiveness of the LASIK procedure which in turn minimizes the severity and duration of dry eye symptoms from LASIK. Dry eyes often last several weeks after a LASIK procedure and are an almost universal side-effect. If you are concerned about dry eyes and wish to limit its severity choose thin-flap LASIK with the iFS laser. And if you live anywhere near Raleigh NC there’s only one place to get this procedure: the Laser Eye Center of Carolina.

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Why Do Patients Get Dry Eyes After LASIK?

Thursday, July 14th, 2011

The LASIK procedure may cause many patients to experience dry eye symptoms after their surgery. This is especially true if there was tendency toward dry eyes before LASIK. But why do so many patients experience dry eyes after LASIK? The first step of the LASIK procedure is the creation of a corneal flap, a thin layer of tissue under which laser pulses are applied to reshape the cornea in order to correct nearsightedness, farsightedness and astigmatism. Anatomically, when the flap is created, the very fine cornea nerves may be severed as part of the LASIK procedure. These nerves detect how wet the eye is and signal the lacrimal gland to produce tears. So, sometimes, the temporary interruption of the corneal nerve impulses can actually cause a lesser amount of tears to be produced, resulting in dry eyes after LASIK. If the Dry Eyes after LASIK are moderate or severe, your vision may actually be blurry due to the tear film instability. Because normal sensation may not be present as a result of severed corneal nerves patients may not feel the sandy, gritty sensation normally associated with dry eyes. Fortunately, virtually all dry eyes symptoms after LASIK are temporary and gradually decrease over time as the corneal nerves grow back. Most patients will have a resolution of dry eye symptoms within a few months of having their LASIK procedure. In some extreme cases, symptoms may persist for over one year. All LASIK patients will need to use lubricating drops frequently during the first few weeks after their LASIK procedure. Other measures are occasionally necessary to improve comfort and visual clarity. These include the use of oral Omega 3 supplements, punctal plugs and prescription eye drops such as Restasis. During your consultation it is important to disclose any symptoms you may have of dry eyes and to disclose any medications you are taking that might predispose you to dry eyes after your LASIK procedure. Your LASIK surgeon can then take the necessary steps to prepare you for your LASIK procedure and minimize the severity of dry eyes from LASIK. Working together with your surgeon will maximize your chances of a smooth post-operative course and allow you to obtain the best possible results from your LASIK procedure. Watch this blog for further tips on how to minimize symptoms of dry eyes after LASIK.

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