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Laser eye surgery available at Health Center

by Maureen McGuire - October 31, 2005

If you’re tired of wearing glasses, it may be time to give laser corrective eye surgery a second look, according to Health Center experts.

“Refractive surgery is absolutely ready for prime time,” says Dr. William Ehlers, a corneal specialist and director of refractive surgery with the division of ophthalmology at the Health Center.

“Overall, these are some of the most successful procedures available today,” he says, noting that 95 percent of people in a recent national survey say they were very happy with their surgical results.

Laser refractive surgery includes three procedures – Lasik, Lasek, and PRK (photorefractive keratectomy) – that reshape the cornea and change the way the eyes refract light. For people who are far-sighted, eye surgeons make the central cornea steeper and for those who are near-sighted, the central cornea is leveled.

The goal is to correct vision problems and dramatically, if not completely, reduce the need to wear glasses or contact lenses.

The procedures have been available in the United States for about 10 years and at the Health Center since 2002. Through the years, the procedures have benefited from steady improvements in lasers and computer-guided equipment.

“We now have the technology to measure and track the movement of the eye up to 4,000 times per second,” Ehlers says, noting that it is the same technology used in missile tracking.

“We also have extraordinarily precise tools to reshape the surface of the cornea, as well as computer-guided equipment to create a topographic map of the cornea to accurately locate areas of irregularity before surgery,” he says.

“There have also been substantial enhancements to healing and comfort after surgery.”

Ehlers says many corneal specialists now favor a laser-enhanced version of PRK, which was the   first option for laser vision correction.

In PRK, the surgeon removes a thin layer (the epithelium) on the surface of the cornea, then uses a laser to reshape the cornea – either flattening it or making it steeper, depending on the patient’s needs. This layer is replaced normally every three to five days, so healing is fairly rapid.

In Lasek, the same thin layer is removed but it is replaced after the procedure, if possible. The epithelium is very delicate and it is not always possible to reposition it. In Lasik, the surgeon cuts a flap in the corneal stroma and folds it back before reshaping the tissue. The flap is then replaced.

“There are advantages and disadvantages to each procedure, so it is an individual choice made by the patient and the surgeon together,” Ehlers says.  

Conditions such as ongoing eye disease, retinal problems or health issues, including diabetes or rheumatoid arthritis, can preclude some people from these procedures. “We follow FDA parameters and criteria for the procedures,” he says.

For patients who are eligible, corneal surgeons may correct both eyes on the same day or one eye at a time, depending on the procedure selected and the needs and wishes of the patient.

Ehlers says patients over 45 years old who have successful distance vision correction will likely require glasses for reading. “For some patients, we have the option to correct one eye for distance and one eye for close-up,” he says. “They might need glasses to get their best vision for near and distance, but it is a compromise many people find very workable.

“I don’t tell people they will never wear glasses again. Our eyes change over time as a natural part of the aging process,” Ehlers says. “But I do tell people they will go without glasses for many activities such as sports, swimming, and social events. Patients tell me this can be a very positive change.”

Ehlers recommends that people who are thinking about corrective surgery follow FDA recommendations, and consider a trained corneal specialist. Both he and Dr. Jeanine Suchecki, director of the division of ophthalmology at the Health Center, are corneal specialists.

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