Posts Tagged ilasik
Does “Custom Lasik” mean “Blade-Free”?: The Power of Words and Understanding the Current Lasik Technologies
Posted by Dr. John Suson in Milwaukee Eye Care on January 8th, 2010
Advertising for Lasik can be somewhat deceptive. Often you’ll hear high tech words used to imply that a surgeon uses all of the latest technologies available, but that is not necessarily the case. “Custom”, “Customized”, or “Customvue” are terms that I’ve heard used in this way in Lasik advertising. Although customized treatments are a key component to most Lasik systems in use today, advertisers often emphasize the word “custom” while neglecting to mention that they use bladed systems when making the Lasik flap. In my opinion, that is a serious omission and misleading to the patient. The most current and safest technologies involve Lasik systems that are bladeless. Although the custom technology is still important, if the surgeon is not clearly using a blade-free system like the Intralase®, then they cannot truly say that they are using the most advanced, precise, and safest Lasik technology.
A Surgeon’s Reasons for Seeking Lasik Eye Surgery
Posted by Dr. John Suson in Lasik | iLasik, Milwaukee Eye Care on December 16th, 2009
What are your reasons for thinking about Lasik surgery now and what are your concerns? Many people that have been nearsighted since childhood dream of the freedom of being without glasses. Although people become accustomed to wearing glasses or contact lenses, at its core, it is never a totally natural thing to do. I started wearing glasses in the 4th grade and contact lenses in junior high. By the time I was an adult, it was just a subconscious part of my daily routine. As I grew up, my vision became worse until I couldn’t even see the alarm clock in the morning when I woke up. It wasn’t until I personally had Lasik myself in my 30’s that I fully realized what a handicap it was. I look back and remember all of the hassles with my inability to fully participate in simple activities that others took for granted. When I went swimming, I would have to go without my contacts and be essentially blind, or wear glasses which hampered swimming. Sports were always difficult because of sweat pouring onto the glasses and visual problems due to movement of the contacts. And I remember so many times losing a contact lens and crawling around on the floor desperately trying to find it.
Custom Lasik does not mean Blade-free Lasik
Posted by Dr. John Suson in Lasik | iLasik, Milwaukee Eye Care on September 23rd, 2009
I hear some Lasik surgeons talking up the fact that they do advanced Custom Lasik but they make no mention of the blades that they use in their Lasik surgery. That’s right, “Custom Lasik” and “Blade-free Lasik” are two completely separate things. Surgeons that continue to use the cheap bladed Lasik try to cover that fact by talking about their Custom Lasik but that is old news at Suson Eye Specialists in Wauwatosa. I don’t think there’s a Lasik center in the USA that doesn’t use a Custom Lasik system and it’s been that way for years. But the real technological difference has been in the advancement of the blade-free Lasik systems to make the Lasik flap. That’s the technological advancement that these cheap chain centers neglect and that they always fail to mention. So they cover it up by talking about Custom Lasik so you won’t know that they still use blades.
Should I consider Lasik Eye surgery?
Posted by Dr. John Suson in Milwaukee Eye Care on September 17th, 2009
Many people are curious about Lasik eye surgery as an option for vision correction instead of the traditional glasses or contact lenses that they’ve used for ages. Many people were told in the past that they were not good candidates but with current up-to-date technology, many of these people are actually very good candidates. The reasons for having Lasik eye surgery are very personal and each individual has to look at his or her own needs, desires, and lifestyle. Those things will be the major determinants on whether you should have Lasik eye surgery.
Accommodation for Near-Vision in Lasik and Cataract Eye Surgery
Posted by Dr. John Suson in Milwaukee Eye Care on September 3rd, 2009
Accommodation is a function of the eye which has long been overlooked in eye surgery because we just haven’t had the technology to do anything about it. The term accommodation refers to the ability of the eye to change focus from things that are very far away (like when we are driving) to things that are very close up and small (like reading or threading a needle). If you’ve used a camera before, you have probably been aware of hearing the auto focus feature or noticed the lens move as the camera adjusts to the distance of the main objects in your picture. If it didn’t do so, the picture would appear blurred. Your eye has the same auto focus feature which allows us to keep the main objects in sharp focus regardless of their distance.
However, as we age, the lens in our eye begins to harden and loses this auto focus capability. Eventually, everybody begins to wear reading glasses or bifocals because of this aging effect called presbyopia. Over the years, people have tried to figure out how to eliminate presbyopia surgically, but there is no perfect way to do so. Only recently have new developments in intraocular implants given us the ability to truly mimic accommodation as it occurs in the youthful eye. Most notably, the crystalens intraocular implant has been used very successfully in cataract surgery in elderly people. This surgery using the crystalens not only improves the patient’s distance vision by removing the cloudy lens (cataract) but it also gives improved near/reading vision. The crystalens is a premium lens implant that has the ability to move in a certain way after it is placed inside the eye which is similar to the auto focus of a camera. With careful preoperative measurement, calculation, and planning, this surgery can improve distance vision while reducing the need for reading glasses or bifocals.
When we do Lasik surgery, however, we do not have the ability to implant a new lens inside of the eye. Lasik surgery is done on the cornea which is the outer surface or clear dome shaped structure at the front of your eye. In this case, your normal lens remains intact and if you have reached the age where your lens has stiffened, it will remain so. I often have patients that want some flexibility in terms of still being able to read after Lasik surgery and we do what we can to maximize their reading without significantly compromising their Lasik outcome for distance vision. Many surgeons do a “monovision” correction on their Lasik patients. Monovision is the practice of leaving the non-dominant eye nearsighted while fully correcting the dominant eye for distance. The concept goes as far back as the monocle, the one-eyed lenses seen worn in the 19th and early 20th century especially in Germany.
Often, in my opinion, surgeons will overdo the monovision effect and leave the patient too nearsighted. Although, it gives very good reading vision, the large difference between the two eyes often creates problems with depth perception or dizziness. Also the compromise in distance vision becomes very noticeable to the patient and the brain is not adequately able to fuse or coordinate the different images from the two eyes.
I have had a much higher degree of success using a mini-monovision technique where I leave only a small amount of residual nearsightedness in the non-dominant eye. With this technique, I target good intermediate distance vision rather than close reading/threading-a-needle vision. The residual correction is probably only -1/2 to -1 diopters at most for these patients. This allows much better distance vision and good intermediate vision and some close reading ability. In general, in the modern world, most of our close work is done at the computer distance. Mini-monovision accomplishes this goal and reduces confusion between the two eyes or loss of depth perception. Ultimately, my goal is to maximize the patients’ distance vision while giving them the ability to work on a computer, see their cell phone or watch, and read a menu. More extensive small print reading like sitting down to read the newspaper or a novel would probably require reading glasses. For most people, this set-up eliminates the use of glasses for 90+% of their day.
Surgical options for correction of accommodation have come a long way in recent times and continue to develop. If you have questions about accommodating intraocular lenses for cataract surgery, or about options when considering Lasik surgery, discuss them with your surgeon (not just a technician) prior to proceeding.
iLasik: Visual Function, Cosmetics, and Convenience
Posted by Dr. John Suson in Milwaukee Eye Care on August 27th, 2009
A patient sent me a note saying that his wife wanted him to be able to see through walls. Another said their spouse wanted to be able to see their pretty eyes. Whether these suggestions truly came from the spouses, they illustrate 2 of the major reasons for having Lasik eye surgery. Those reasons are 1) visual function and 2) cosmetic appearance. Another third category of reasons to have Lasik surgery falls under convenience, for example getting rid of the hassle of cleaning and disinfecting contact lenses.
Don’t Compromise: Have Blade Free Lasik or No Surgery at all!
Posted by Dr. John Suson in Milwaukee Eye Care on July 7th, 2009
I recently had a patient tell me the cost of Lasik was his biggest concern. He liked the idea of the top end blade-free technology, but if it wasn’t within his price range, then he couldn’t have it anyway. My answer to this patient: “Your choice is clear. Do NOT have Lasik at all…at least until you can save up some money to have it done right.”
12 Steps to Deal with Dry Eye After Lasik
Posted by Dr. John Suson in Milwaukee Eye Care on June 25th, 2009
Dry eye is something that can occur after Lasik eye surgery and every patient should be aware of it. Actually, studies indicate that tear production and blink reflexes are reduced in all patients that undergo Lasik, but it does not usually cause any symptoms. The cause of the dry eye is due to the disruption of the corneal nerves by the cutting of the Lasik flap and the excimer laser treatment of the cornea itself. The deeper the treatment goes, the more likely that dry eye symptoms will occur. Actually, recent studies have shown that contact lens wear also causes increase in dry eye over time. This contact lens effect is a slower, more chronic process. Because it happens so gradually, contact lens related dry eye takes longer to be noticed by a patient whereas a Lasik patient may be aware of it within days or weeks.
For those rare patients that experience dry eye symptoms, as the cornea heals over a three to six month period, the nerves regenerate and much of the dry eye problems will resolve. Nonetheless, there are a number of measures that can be taken to speed the process and make it a better overall experience for the patient. The sooner the dry eye resolves, the sooner you will be more comfortable and your vision will return to its crispest potential. I have even seen some second opinion patients that were 6 months to a year after Lasik that never had their dry eye problems aggressively treated and still had persistent discomfort and moderately diminished (although annoying) vision. It seems to me that many chain surgery centers and surgeons under treat dry eye because they perceive it as a minimal problem whereas the some patients may feel it is significant.
I use a number of strategies to minimize and treat dry eye in all of my Lasik patients:
Reading Vision After Cataract or Lasik Surgery. What should you think about?
Posted by Dr. John Suson in Milwaukee Eye Care on June 2nd, 2009
How to deal with reading vision after eye surgery?
Lasik Eye Trackers, Iris Registration, and Decentration.
Posted by Dr. John Suson in Lasik | iLasik, Milwaukee Eye Care on May 31st, 2009
In the early days of laser refractive surgery, the laser systems were relatively simple. The laser energy was produced in a relatively circular simple pattern which expanded outward. The surgeon maintained control of the treatment alignment manually while using an aiming reticle viewed through the surgical microscope. In those days, if a patient had excessive movement or oscillation of their eye, it could be quite challenging to maintain proper centration of the laser treatment. It is always best to maintain perfect centration of treatment in order to obtain the best optical results. Any significant deviation from center can lead to suboptimal results and even induced astigmatism or other optical aberrations. Decentration and related optical aberrations were actually a rare but important complication after Lasik or PRK in its early days. Innovations in technology have reduced their incidence considerably, however.