Refractive eye surgery: Even better results, even more options.

With incredible success and results, chances are you know someone who has undergone refractive eye surgery. Or maybe you’ve done it yourself.  So if you’re one of the 150 million Americans who depend on glasses or contact lenses, read on.

Beyond the statistics, you’ll find a common descriptive word among refractive surgery patients: Miraculous.

John Vukich, MD, Davis Duehr Dean Ophthalmology, talks about the success rate: “More than 96% of patients undergoing refractive surgery will achieve a 20/40 or better level of visual acuity. That’s excellent functional vision that should liberate patients from full-time dependence on eyeglasses or contact lenses.”

So how exactly does refractive surgery improve eyesight? And what options are available? A basic understanding of how the eye functions provides the answers, according to Stephen Boorstein, MD, of Davis Duehr Dean Ophthalmology.

“In ‘normal’ eyes,” explains Dr. Boorstein, “there is a near perfect balance between eye length and the curvature of the cornea–the clear front covering of the eye. That means images are brought into sharp focus on the retina and transmitted to the brain that way.”

In contrast, refractive errors like nearsightedness, farsightedness and astigmatism result from an imbalance between eye length and curvature. This means the shape of the eye does not properly bend the light, so images sent to the brain appear blurry. Contact lenses and eyeglasses correct these errors externally and help the eye properly focus light on the retina.

Using the same theory, refractive surgery corrects the refraction imbalance by changing the curvature of the cornea. This can be done with a laser, or by implanting a small lens in the eye.

The results are impressive, as Davis Duehr Dean Ophthalmologist Christopher Croasdale, MD, explains. “With increased experience and advances in technology, outcomes for corrective eye surgeries have greatly improved and more surgical options are available than ever before.”

Let’s take a look at those options.

• For many years, LASIK has been the dominant refractive surgical procedure, accounting for more than 97% of the vision correction performed in the United States. During traditional LASIK surgery, a surgical instrument is used to create a flap in the cornea that, when lifted, allows access to the deeper corneal layers. The vision correction, which takes just 10-60 seconds, is then performed using an excimer laser, a computer controlled laser capable of extremely precise movement. Finally, the flap is reset, without stitches, returning the eye to its natural preoperative state.Dr. Vukich speaks to the convenience of LASIK surgery: “LASIK results are almost immediate and normal activities can usually be resumed the following day, making it an effective and convenient option for many patients.”

• A newer technology available for laser vision correction is the IntraLase^tm method, which is similar to LASIK but uses a blade-free technique to create the corneal flap. Instead of a surgical instrument, surgeons use tiny, rapid pulses of laser light that pass through the top layers of the cornea. This method allows the surgeon to more precisely determine the dimensions of the flap, which “locks” back into place following laser correction. As with traditional LASIK, the IntraLase^tm method can be performed on both eyes the same day, with little discomfort and almost no post-operative downtime.

• Photorefractive keratectomy (PRK), a forerunner to LASIK, was the first procedure available for refractive surgery and is still used under some circumstances. PRK involves vaporizing a thin disc of tissue (approximately the width of one to two hairs) from the surface of the cornea using multiple pulses of the laser. Removing the thin disc changes the curvature of the cornea, correcting the refractive error. Patients wear a protective contact lens for several days following surgery. While recovery time is slower than with LASIK, PRK is an option for certain patients.

• A new procedure involving optical implants may be an option for those who are not candidates for laser vision correction or who cannot tolerate contact lenses. In fact, in February 2006, Davis Duehr Dean was the first in the U.S. to perform the FDA-approved procedure. The implants, which resemble contact lenses and are made from a biologically compatible material, are micro-surgically placed between the cornea and the iris (the colored portion of the eye). The incision self-seals, meaning no stitches are needed.“This surgery might be a good option for someone with severe nearsightedness who wears glasses every waking moment of his or her life,” says Dr. Boorstein.

In most cases, these procedures are viable options for individuals who want less dependence on traditional eyewear for recreational, occupational, or cosmetic reasons. Those considering surgery should be at least 18 years old, with stable vision for at least 12–18 months, with excellent eye and general health. Because there are different surgical options, a consultation with a refractive surgeon quickly determines which procedure is best-suited to each individual.

While there are risks with any surgical procedure, refractive surgery is one of the safest eye surgeries. There is a very low incidence of complications, with the most common side effects including dry eyes, light sensitivity and glare at night. In most cases, these effects usually don’t last longer than a few months. Healing occurs quickly, and there are no major activity restrictions following surgery.

Says Dr. Croasdale, “We invite anyone who’d like to give up glasses or contacts to make an appointment and get an evaluation. After a thorough exam, we can determine if a patient is a good candidate for refractive surgery, and what the next steps will be.”

For more information about refractive surgery, please call (608) 282-EYES or toll-free at (800) 362-7796 or visit us online at www.deancare.com/ddd