By Yichieh Shiuey, M.D.
House Calls
Suzanne Elbert, a 34-year-old physical therapist, had been wearing glasses since age 5 when she was unable to see the big “E” on the eye chart. She recently came to me for a LASIK (Laser Assisted In-situ Keratomileusis) laser vision correction consultation, carrying a stack of Internet printouts and her glasses’ prescriptions from the past 10 years.
Suzanne told me she had nearsightedness and astigmatism, a condition that occurs when the cornea is slightly irregular in shape. She hated wearing glasses because they hurt her nose and she could no longer comfortably wear her contact lenses. She wanted to know if she was a good candidate for LASIK surgery.
After an extensive eye examination, including computerized mapping of her eyes and infrared measurement of her pupils, I told her the answer was “Yes.” The day after the surgery, she drove herself to her follow-up appointment and was able to read the 20/20 line with each eye. A month later, she had occasional dry eyes but maintained 20/20 vision and said her golf game was better than ever.
LASIK has been around for more than 10 years and several million people have been successfully treated with this life-enhancing procedure. With the powerful combination of preoperative examinations and the latest technology for LASIK laser vision correction, success stories such as Suzanne’s are increasingly becoming the norm.
Better Preoperative Diagnostic Testing
The first step in achieving a successful LASIK result is a thorough preoperative examination by a surgeon. The cornea, the clear covering of the eye on which the laser treatment is performed, must be examined carefully for any subtle signs of disease that could affect the surgery results. An essential part of the examination is a state-of-the-art computerized corneal mapping device that can detect the earliest abnormalities in the cornea, even when they’re invisible with a microscope.
It’s also critical that we accurately measure the pupil size to avoid possible side effects such as nighttime glare and halos. The pupil, the dark center within the colored part of the eye, is the opening for rays of light to enter. To avoid glare and halos, the size of the laser-treated area must be at least as large as the size of the pupil in the dark. We now use an “infrared pupillometer” to accurately measure the pupil size even in complete darkness.
Advances in Laser Technology
The Food and Drug Administration recently expanded approval of LASIK laser treatment to include hyperopia (farsightedness) with astigmatism, in addition to nearsightedness with astigmatism. The FDA has also approved larger zone laser treatments, so that people with large pupils can be treated with a decreased risk of glare and halos. With these developments, more than 90 percent of people who currently wear glasses or contact lenses are now good candidates for LASIK.
The newest lasers can track the eye precisely during treatment and safely continue even if the eye moves. Knowing that the eye tracker is present has been a great relief for many patients, because many are concerned about accidentally moving their eyes during treatment.
Despite all the technological advances, there is no substitute for the clinical skills of a well-trained, experienced LASIK surgeon. When choosing a site for laser vision correction, think of it as a lifetime investment in your sight. Carefully pick a surgeon and facility willing to invest the time, effort and technology necessary to give your eyes the best sight possible.
Dr. Yichieh Shiuey is a cornea and LASIK specialist at Camino Medical Group, a division of the Palo Alto Medical Foundation, in Sunnyvale. He was formerly associate chief of ophthalmology at the Harvard Medical School Department of Ophthalmology. For more information, call (408) 859-LASIK or visit www.LaservisionMD.com.
