the eighth consecutive year, TLCVision®
has named RICHARD
LEVINSON, MD as
one of their Top 50 Laser Vision Correction Surgeons, selected
from over 1000 LASIK Surgeons, nationwide!
Frequently Asked Questions
How does the Custom Wavefront Lasik, PRK or Laser
Vision Correction surgery equipment and technology work in Denver
or Boulder Colorado?
1. SHOULD I CHOOSE LASIK OR
LASIK and PRK both give excellent
results. Both use an Excimer Laser to reshape your cornea. In PRK,
the correction is placed on the surface of the cornea; in LASIK,
a thin flap of corneal tissue is lifted and the correction placed
on the underlying corneal bed and the overlying corneal flap then
repositioned. 50% of my Laser Vision Correction patients select
LASIK, primarily because LASIK has minimal discomfort and the visual
improvement is evident within hours. However, if the thought of
the flap in LASIK makes you uncomfortable, I would strongly encourage
you to consider PRK! PRK is slightly safer and minimally more predictable
than LASIK, because no flap is being made. The risk associated with
the flap is small, but in 1-2% of LASIK patients, flap complications
occur. The vast majority of the flap complications are not visually
threatening and are easily treatable without resultant vision loss.
LASIK patients have minimal discomfort lasting for a few hours;
PRK patients experience mild to moderate discomfort lasting for
48-72 hours post-op; the vision takes longer to clear up after PRK
than LASIK. 98% of LASIK patients can see clearly within 24 hours;
PRK patients are very blurry for 2-3 days post-op, usually can see
about 20/40 3-5 days post-op (well enough to pass a drivers license
vision test and perform most daily activities), and slowly improve
over the following weeks to months. By six months, both LASIK and
PRK have the same visual results. PRK has a lower retreatment rate
(1-2% vs 2-5% for LASIK) and may have somewhat less glare and dryness
than LASIK. PRK may be slightly safer long-term for people under
30 years of age, You will not experience any discomfort during the
actual PRK procedure. During the actual LASIK procedure, you will
experience mild to moderate pressure on your eye for 15-30 seconds.
Once again, both LASIK and PRK give excellent long term results.
In summary, PRK is slightly safer than LASIK but is more uncomfortable
post-operatively and takes longer for the vision to stabilize. Custom
Wavefront is available with both PRK and LASIK.
2. CAN LASER VISION CORRECTION
HELP ALL VISION PROBLEMS?
There are 4 types of
1. Myopia (nearsightedness) occurs when the cornea
is too steep relative to the length of the eyeball. As light enters
the eye, the visual image focuses in front of the retina, resulting
in a blurred or distorted view. Without correction, nearsighted
people have blurry distance vision but can see well at near. The
FDA approved the use of the Excimer Laser for Myopia in November,
1995. Laser Vision Correction works extremely well for nearsightedness.
In myopia, the Excimer Laser flattens the central cornea, focusing
the image on the retina.
2. Astigmatism (asymmetrical cornea) occurs when
your eye is shaped like a football, unlike a normal eye, that has
a round shape similar to a basketball. Uncorrected Astigmatism causes
blurred vision both at near and far. In April 1997, the FDA approved
Excimer Laser correction of Astigmatism. The Excimer Laser works
extremely well for treating Astigmatism.
3. Hyperopia (Farsightedness) occurs when the cornea
is too flat relative to the length of the eyeball. Hyperopia requires
people to exert focusing power to see at near and far. The normal
eye only has to exert focusing power to see at near. When farsighted
people are young and have ample focusing power, they usually see
well both at near and far. However, with aging, people lose focusing
power; farsighted people will begin to notice difficulty seeing
at near and as they continue to age, will also note difficulty focusing
at distance, as well. In November, 1998 the FDA approved the Excimer
Laser for the correction of Hyperopia. The Excimer Laser works well
for correcting Farsightedness. In farsightedness, the Excimer Laser
steepens the central cornea, focusing the image on the retina.
4. Presbyopia is an age-related condition that causes
people from the mid-forties and older to need reading glasses or
bifocal lenses to read. Presbyopia is a result of loss of elasticity
in the lens of the eye. Presbyopia cannot currently be corrected
with the Excimer Laser. The Excimer Laser can, however, used to
create a condition called Monovision, where
one eye is corrected for near vision and the other is corrected
for distance vision. I know monovision may sound somewhat ridiculous,
but monovision actually works very well and allows most patients
over the age of 45 to function without glasses correction for both
reading and distance vision.
3. WHAT ARE THE ODDS OF
ELIMINATING MY NEED FOR GLASSES OR CONTACTS AFTER LASER VISION CORRECTION?
In the thousands of cases of
Laser Vision Correction I have performed, 90% of patients have 20/25
or better vision without correction, and 97% of patients will see
well enough to pass a driver's test (20/40) without correction.
Less than 3% of my patients are wearing correction for distance
after Laser Vision Correction.
4. WHAT IS THE
INTRALASE LASER AND iLASIK?
First of all, I think the IntraLase
is wonderful and, although it does add extra expense to the LASIK
procedure, the improved safety and visual results with the IntraLase
is money well spent.
What is the
IntraLase. This is a little tricky, so pay attention! In LASIK a
thin flap of tissue is lifted off the top of the cornea. The underlying
cornea is then reshaped with the Excimer Laser and the corneal flap
repositioned. Two technologies are presently available for making
the corneal flap. One, the older technology, is the Microkeratome,
a mechanical device that uses a metal blade to create the LASIK
flap. The other, newer technology for lifting the flap is the Intralase
Laser. (The Intralase is a separate laser from the Visx Star S4
Excimer Laser. Once again, we use the Excimer Laser to reshape the
cornea in LASIK and PRK. We use the Intralase to create the corneal
flap in LASIK). The mechanical Microkeratome works extremely well
and has been used safely and successfully in millions of Lasik procedures
for over ten years. However, the Intralase is better technology
because of increased safety and better visual results. The IntraLase
uses billions of little bubbles, instead of a metal blade, to create
the LASIK flap. Patients tend to see better (7% better to be exact)
after LASIK with the Intralase than with the Microkeratome. But
even more importantly, the Intralase is safer than the Microkeratome.
The Microkeratome is very safe but the Intralase is safer, having
a lower incidence of flap complications. And when the rare complications
do occur with the Microkeratome or the Intralase, complications
with the Microkeratome tend to be much more difficult to manage
than complications with the Intralase. There is an additional
fee for the Intralase.
iLASIK is the
name we use to describe LASIK when we use the Intralase femtosecond
Laser the VISX Star S4 CustomVue Excimer Laser together.
DOES 20/20 OR 20/40 VISION MEAN?
The 20/20 nomenclature is an old
system devised by Hermann Snellen, a Dutch Ophthalmologist, in 1862.
20/20 means the viewer can see at 20 feet what a "normal" person
would see at 20 feet. 20/40 means the viewer sees at 20 feet what
the "normal" person can see at 40 feet, i.e. the viewer can't see
quite as well as "normal". This system is somewhat misleading. 20/40
vision is not twice as bad as 20/20 vision. In fact, most people
with 20/40 or better vision can, and usually do, function without
wearing correction. 20/40 vision or better is required to pass a
drivers test in Colorado. After LASIK, 97% of patients have 20/40
or better vision and over 80% have 20/25 or better vision. In the
"real world" the difference between 20/20 and 20/25 vision is negligible.
Interestingly, Snellen used test subjects to determine what people
with "perfect" vision could see, and called that level
of vision "20/20". It turns out that his test subjects
were slightly nearsighted and, therefore, people with perfect vision
actually see better than 20/20. The "perfect" human eye
can see slightly better than 20/10!
6. WHOM SHOULD
I CONTACT WITH MORE QUESTIONS?
Please feel free to contact my office to have
any questions answered, or to schedule a free, Laser Vision consultation. The
phone number is 303.393.0347 and the toll free phone number is 877.393.0347.
7. WHO IS A CANDIDATE
FOR LASER VISION CORRECTION?
Laser Vision Correction is well
suited for active people who find glasses and contacts to be a nuisance
and those who simply don't want to be so dependent on corrective
lenses. If you wear glasses or contacts and are over 18 years old,
you are probably a good candidate. Your lens prescription should
be stable at distance for at least one year and you should be free
of medical problems related to your eyes, primarily cataracts. You
should also make sure you have realistic expectations about Laser
Vision Correction. Although Laser Vision Correction has the potential
to greatly reduce or eliminate dependence on corrective lenses,
there can be no assurance that you will obtain perfectly corrected
vision. The vast majority of patients can function without glasses
or contacts after Laser Vision Correction, although, occasionally,
Laser Vision Correction patients may wear a mild glasses correction
to fine-tune their distance vision. People who are most satisfied
with the results of Laser Vision Correction clearly understand the
potential risks and side effects and have realistic expectations
of what their vision will be like after surgery.
IS THE DIFFERENCE BETWEEN THE DIFFERENT EXCIMER LASERS? WHICH EXCIMER LASER DO
All Excimer Lasers are identical in one respect
only; they all use an argon/fluoride gas laser source which delivers
energy to the cornea at 193 mm wavelength. However, each Excimer
uses a different "delivery system", i.e. spot size and
firing frequency to apply the Laser energy to the corneal tissue.
For nearsightedness, Laser delivery systems can be divided into
two groups based upon the "spot size" of the laser beam;
the large spot-size lasers, called "broad beam" lasers
(VISX and Summit Lasers) and small spot-size lasers, called "flying
spot" lasers (Nidek, Technolas and Autonomous-LADAR Lasers).
The VISX Star S4 actually uses a combination of "broad beam"
and "flying spot" delivery. The broad beam lasers deliver
a large, homogeneous, uniform energy pulse to the cornea. This results
in very smooth tissue removal. The flying spot lasers apply energy
in very small "dots" and create a tissue removal pattern
similar to pixels in a digital image. The flying spot tissue removal
is "grainier" than the "broad beam" laser pattern
but has the advantage of being able to apply energy to very small
areas with pinpoint accuracy. This is useful in Custom Wavefront
treatments. The VISX Star S4 is the only Excimer Laser available
that uses both a "broad beam" and "flying spot"
technology on each patient. This offers the advantage of both laser
systems. The VISX Excimer Laser has had three significant upgrades
in the last 18 months and is, in my opinion, the "state-of-the-art"
Excimer Laser. The VISX Star S4 Excimer now has an "auto-tracker",
insuring that the Excimer Laser stays centered on your cornea even
if you have difficulty holding your eye still. I have used the Technolas
Excimer Laser, a "flying spot" Laser, but found it to
be slow and it removes too much corneal tissue. The long treatment
time results in increased dehydration of the cornea, and inconsistent
Laser outcomes. Also the Technolas removes up to 50% more corneal
tissue than the VISX for any given power and diameter optical zone.
The extreme amount of tissue removed by the Technolas can structurally
compromise the cornea and is a major reason most Laser Surgeons
have stopped using the Technolas. The Autonomous (LADAR) Excimer
Laser takes almost twice as long as the VISX for treating nearsighted
patients, and this is somewhat of a problem. Also, the Autonomous
is a more expensive laser to operate, costing about $250 more per
this time, I only use the VISX Star S4 with CustomVue (Wavefront) Technology.
I consider this to be the most advanced, state-of-the-art Excimer laser available.
The NIDEK Excimer Laser is the Laser-of-choice
of "cut-rate" Laser Centers. They use the NIDEK because
it is a less expensive Laser than the VISX. I am not aware of any
Laser Centers, other than the "cut-rate" Laser Centers,
that use the NIDEK Excimer Laser in the Denver area. The only advantage
for the NIDEK is that it is less expensive to operate.
WHAT ARE THE LONG TERM RESULTS? WILL MY EYES DETERIORATE IN THE FUTURE?
Since 1987, millions of Excimer
Laser procedures have been performed worldwide. Laser Vision Correction
appears to be very stable, and recurrence of refractive error after
six months is uncommon. There does not appear to be any increased
risk of macular degeneration, cataracts, retinal detachments or
any other eye problem related to LASIK treatment. The one long term
risk that has been identified with Laser Vision Correction is "ectasia".
In approximately 1 in 2000 Laser Vision Correction patients, the
cornea will develop weakening and instability, ie ectasia, after
Laser Vision Correction. Ectasia results in progressive blurry vision
that may not be correctable with glasses, contacts or Laser retreatment.
With adequate pre-operative screening, we can identify, and not
operate on, patients that are at risk of developing ectasia. However,
ectasia has rarely been reported in patients after Laser Vision
Correction that have no known risk factors. Ectasia does occur in
the general population, ie people that have never had Laser Vision
Correction, in approximately 1 in 2000 people so not all cases of
post-op ectasia may be due to the Laser Vision Correction
The "K" in LASIK stands for
"keratomeleusis", which is the "flap cutting"
step in LASIK. Keratomeleusis, without Lasering, has been performed
since 1959, primarily in South American, as a treatment for extremely
high nearsightedness. So we, in fact, have over 40 years experience
with the most "invasive" step in the LASIK procedure,
the cutting of the flap. From this 40+ years of experience we have
learned how deep we can safely treat the cornea without causing
long-term damage to the cornea. Arguably, we have more "long
term" information on the "flap cutting" in LASIK
than we do with soft contact lenses, which have "only"
been available for about 35 years.
IS WAVEFRONT ANALYSIS AND CUSTOM CORNEA TECHNOLOGY? HOW GOOD IS IT?
Wavefront analysis is a new way of analyzing
the cornea. Wavefront technology was initially developed
by astrophysicists to improve the quality of optics in telescopes. Wavefront analysis
involves sending a reference light ray into a telescopic mirror system and measuring
the reflecting light ray as it exits from the mirror system. Sensors can detect
the location of the exit reference light ray. The difference between the position
of the reflected wave and the location of where the wave should theoretically
have been in a "perfect" system can be determined. Then, by adjusting
the reflecting mirror surface with small servo-mechanical "suction cups"
located on the backside of the mirror, aberration (distortion) can be removed
from the mirror system. Wavefront analysis has significantly improved the quality
of images in telescopes such as the Hubbell Telescope. Wavefront analyzers are
now available for analyzing human visual systems. I am have used both the VISX
CustomVue and the LadarWave Custom Cornea Wavefront systems. Both work well but
I found the results to be better with the VISX CustomVue Wavefront system. Wavefront
adds another level of accuracy and predictability to LASIK and increases the quality
of vision after LASIK, especially at night or in dim lighting situations. Wavefront
does add $500 per eye to the cost of LASIK and PRK, but I feel it is worth the
extra expense. Not every patient is a candidate for Wavefront or even needs Wavefront,
especially if you have small pupils (under 6 mm in dim light). Please contact
my office if you have more specific questions regarding Wavefront-guided Laser
I WAIT FOR THE LASIK TECHNOLOGY TO GET EVEN BETTER?
Anytime we deal with advanced technologies
we have come to expect continuous, ongoing improvements. And you
could argue why buy a new car, a new computer or undergo LASIK today
when the technology will be "better" in the future. However,
at least with Wavefront guided LASIK,
the Laser Vision technology appears to be stabilizing. We can look
3-5 years down the FDA "pipeline" for new technologies,
and there is presently nothing "revolutionary" on the
horizon. I would expect in the future for the FDA to approve the
use of Wavefront technology on a wider group of patients, including
Farsighted patients. However, the Wavefront-guided LASIK we have
today gives excellent results for 98% of patients and it appears
to me that waiting for future technologic improvements will not
give you access to significantly better visual outcomes.
Back to top
CK (conductive keratoplasty) is a refractive
surgical procedure somewhat similar to LASIK. CK reshapes your eye
by using a small needle-like probe that applies radio-wave energy
to the surface of the cornea. The radio-wave energy causes the corneal
tissue to slightly "shrink", thus reshaping the cornea.
By applying the energy in a specific pattern and inducing a controlled
"shrinking" of the corneal tissue, refractive changes
can be induced. CK is an outpatient procedure that takes less than
a minute to perform. The cornea is numbed with eye drops. The needle-like
probe applies the energy in a circular pattern approximately three
millimeters from the center of the cornea. Depending on how much
correction is required, anywhere from 6 to 18 "spots"
of energy are applied. There is mild to moderate discomfort after
CK. The refractive change is almost immediate.
can only treat mild amounts of farsightedness; it cannot treat nearsightedness
or astigmatism. This limits its usefulness. If you have good uncorrected
distance vision, (and are over the age of 45), CK can also be used
to create Monovision, allowing you to
read without glasses. In monovision your non-dominant distance eye
can be treated with CK, making it a reading eye. (This will blur
your distance vision in the treated eye, but with both eyes open,
you can see both distance and near.) CK does not give you back the
focusing power you lost with age.
has three major drawbacks. The first drawback is that CK's effect
regresses within 1-2 years, and CK is not as effective if reapplied
a second time. The second drawback is that CK not only cannot treat
astigmatism, but it can actually induce astigmatism, which then
is difficult to correct. The third drawback is the very limited
number of patients that are actually candidates for CK.
see no advantage to CK over LASIK. In fact, I would recommend LASIK
over CK. LASIK is much more precise than CK and can treat a much
wider range of farsightedness, astigmatism and nearsightedness.
LASIK uses an Excimer laser with 1/4 micron (1/200 of a hair) precision
to reshape your eye. CK uses radio-waves to shrink the corneal tissue
and does not have the precision of LASIK. LASIK can be repeated,
if necessary, to enhance the visual outcome. CK cannot be enhanced.
LASIK has a very stable long term effect; CK's effect regresses
over 1-2 years. LASIK can treat astigmatism (just about everybody
has astigmatism), CK cannot treat astigmatism. CK and LASIK cost
approximately the same, take about the same amount of time to perform,
regain vision at about the same rate, and are both performed with
only eye drops to numb the eye. LASIK has very minimal discomfort;
CK is more uncomfortable than LASIK, especially for 2-3 days after
the procedure. I don't really understand why anyone would choose
CK when LASIK is available.
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13. DIDN'T A CLIMBER
WHO HAD PREVIOUS REFRACTIVE EYE SURGERY HAVE A PROBLEM WITH HIS
EYES WHILE CLIMBING MT. EVEREST?
Yes. However, the climber had
Radial Keratotomy (RK) performed many years before he climbed Mt.
Everest. He did not have LASIK or PRK. In RK, deep incisions are
made in the cornea which flatten the cornea by structurally weakening
the cornea. At very high altitudes, such as Mt. Everest, the decreased
atmospheric pressure caused the cornea to pathologically flatten
further. This caused the patient to experience the onset of farsightedness,
making it very difficult for him to see. This would not occur with
LASIK or PRK because the cornea is not structurally weakened by
IF I DON'T GIVE THE RIGHT ANSWERS WHEN YOU MEASURE MY EYES? WILL
I GET A BAD RESULT?
not!!! I realize some people get extremely nervous that they will
give the "wrong" answer when I do the "which is better,
1 or 2" measurements. This measurement, which is called the
is used for calculating the amount of tissue the Excimer Laser will
remove, so it is important. However, when I am doing the refraction
on you I am not obediently following your responses. Before I even
start your refraction, I will take computerized measurements of
your eyes which will give me an extremely precise "objective"
refraction. I then give you the opportunity to "fine tune"
my objective measurements. All you need to do is tell me which of
the two choices I give you make the letters look clearer. If neither
choice is better, that is actually the end point I want; that means
the refraction we have attained is precise because any subtle adjustment
to your refraction is making your vision blurrier. To add even more
precision, I will have my ophthalmic assistant refract you, and
I will refract you myself, twice. These three "human"
measurements, and the computerized "objective" refraction
are then compared, and they better be extremely close, otherwise,
I will keep rechecking your refraction until I get a consistent
refraction result. And to add even more precision, consider Custom
measurements use a scanning Laser mapping of your eye; we avoid
having to depend on the the refraction, and your responses.
Back to top
15. I HAD
A LASER VISION CONSULTATION WITH A "LASER CENTER" AND
THEY CLAIMED THAT THEY HAD ACCESS TO "SPECIAL" TECHNOLOGY
AND USED "SPECIAL" TECHNIQUES THAT NOBODY ELSE USED AND
THAT THEIR RESULTS WERE BETTER THAN EVERY OTHER LASIK SURGEON'S
RESULTS. WHAT MAKES THEM BETTER?
of any Laser Vision Center that makes unreasonable claims, including
claims that they are the "best", were the "first",
or that they are the "only one" to do something "special".
Laser Vision Correction is not a secret, magical, mystical procedure.
Laser Vision Correction is a highly predictable, reproducible procedure
based on the research and shared experience of thousands of extremely
smart scientific investigators and surgeons who have collectively
performed over 20 million Laser Vision procedures. I attend two
major Laser Vision meetings a year - The American Academy of Ophthalmology
meeting every fall and the American Society of Cataract and Refractive
Surgeons meeting every spring. These meetings present to all Laser
Vision Surgeons the most up-to-date information on Laser Vision
Correction, based on the shared research and clinical experience
of the top Laser Vision Surgeons in North America, Europe and Asia.
This information is widely disseminated and readily available to
all Laser Surgeons, around the world. The goal is to continuously
improve Laser Vision Correction results by sharing information and
experience about what works, and what doesn't work, in Laser Vision
my opinion, any Laser Vision Surgeon who claims to do something
"special" is either arrogant and making exaggerated, boastful
claims (remember, this is Laser Vision Surgery, not the World Wrestling
Federation!), or is exposing you to unnecessary risk by using techniques
that are "special" only because no other experienced Laser
Vision Surgeon deems those techniques safe and/or beneficial.
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NASA ALLOW ASTRONAUTS TO HAVE LASER VISION CORRECTION?
Yes! The following is a press release
from AMO, the manufacturer of the VISX Excimer Laser and the IntraLase
Femtosecond (Bladeless Lasik) LASER, which, when used together,
is called iLASIK.
NASA approves iLASIK for
astronauts SANTA ANA
Calif. Sept. 21, 2007 / PRNewswire
/ - Advanced Medical Optics, Inc. (AMO) today announced that the
National Aeronautics and Space Agency (NASA) has approved the company's
LASIK technologies for use on U.S. Astronauts. The NASA decision
was made following review of extensive military clinical data using
AMO's Advanced CustomVueT LASIK with the IntraLase® Method, which
showed the combination of technologies provides superior safety
and vision. Approved for use on consumers almost a decade ago, more
than 11 million LASIK procedures have been performed to-date, making
it the most-common elective surgical procedure in the U.S. But it
wasn't until LASIK developed into an all-laser procedure that NASA
approved it for use on pilots, mission and payload specialists who
face extreme, physically demanding conditions in space. The all-laser
LASIK technologies, which utilize wavefront guided and femtosecond
lasers, have also been cleared for U.S. Military personnel, including
most recently Air Force pilots. NASA's approval is further evidence
that today's LASIK exceeds all established standards of safety and
effectiveness," said Steven Schallhorn, M.D., Retired captain of
the U.S. Navy, investigator in multiple studies involving use of
LASIK and other refractive surgeries for treatment of nearsightedness,
farsightedness and astigmatism, and Medical Director for Optical
Express. "NASA followed the Naval Aviation clinical studies closely
with a particular interest in both safety and quality of vision
under extreme conditions. Wavefront guided and femtosecond lasers
were proven to provide excellent safety with consistent visual results
of 20/20 or better. LASIK was able to withstand even the most extreme
rigors of warfare and flight. All surgical procedures have risks,
but with this exceptional track record, the average consumer has
nothing to fear from LASIK."
LASIK is a two-step procedure.
The IntraLase® FS (femtosecond) laser replaces the hand-held microkeratome
blade historically used in creating LASIK corneal flaps -- the first
step of the procedure. The computer guided, ultra-fast laser virtually
eliminates almost all of the most severe, sight threatening LASIK
complications related to microkeratomes. The laser creates an optimal
corneal surface below the flap, allowing for better visual outcomes
from the second step of the procedure where wavefront guided technology
maps, and then custom-corrects vision based upon the unique characteristics
of an individual's eye. This sophisticated measurement provides
25 times more precision than measurements using standard methods
for glasses and contact lenses. LASIK'S FINAL FRONTIER Though LASIK
has been around for almost a decade, concerns about the harsh aviation
environment prevented its use. To date, aeromedical professionals
have been cautious of employing the procedure on Military aviators
who frequently encounter environmental extremes such as high altitude,
dry air, wind blast and "G" forces. In space, these and other conditions
add even higher levels of concern due to the extreme precision needed
during flight and space walks. Dr. Schallhorn, himself a Retired
naval aviator, spearheaded the majority of the Defense Department's
research in laser vision correction. Some notable results of the
many clinical trials conducted include: An evaluation of Custom
LASIK in 100 Military personnel showed that 95 percent achieved
20/20 uncorrected vision or better; these patients, on average,
were previously only able to read the first line (the big "E") of
the vision assessment chart.
1 In a study of different methods
to create the LASIK flap, 370 naval personnel underwent bilateral
wavefront-guided LASIK with either the femtosecond laser or microkeratome
blade. One week after surgery more than 76 percent of femtosecond
laser patients achieved an uncorrected visual acuity of at least
20/16 (better than 20/20) compared to 58 percent of microkeratome
2 In an evaluation of 785 aviators,
89% of Navy pilots rated their ability to land on an aircraft carrier
as moderately to significantly better after laser vision correction.
None said it was worse after surgery.
3 A separate study determined
that over 90 percent of marksmen had improvement in marksmanship
skills after laser vision correction; a significant result given
the visual precision of marksmen.
4 "Today's news further validates
AMO as the global leader in laser vision correction technologies,"
said Jim Mazzo, AMO chairman, president and CEO. "Our Advanced CustomVueT
LASIK with the IntraLase® Method is the only procedure in the U.S.
to incorporate the technologies specifically approved for use by
NASA." In the U.S. Laser vision correction
market, the Advanced CustomVueT LASIK procedure with the IntraLase®
Method has become the new standard and is rapidly becoming the most
widely performed laser vision correction procedure. In fact, the
majority of premier ophthalmic teaching institutions, including
Duke University Medical School, the Wilmer Eye Institute at Johns
Hopkins, the Bascom Palmer Eye Institute at University of Miami,
and Stanford University, totaling over 16 domestic and international
teaching institutions use Advanced CustomVueT LASIK with the IntraLase®
Method to train the next generation of LASIK surgeons. Advanced
CustomVueT LASIK with the IntraLase® Method The Advanced CustomVueT
laser vision correction procedure stands in a class of its own with
the broadest range of FDA-approved indications. When combined with
the power and precision of the IntraLase® Method, the Advanced CustomVueT
procedure represents the most advanced LASIK procedure available
to patients today. The IntraLase® FS laser, the first technology
for a blade-free LASIK procedure, replaces the handheld microkeratome
blade historically used in creating LASIK corneal flaps -- the first
step of the procedure -- with a computer guided, ultra-fast femtosecond
(fem-to-second) laser. The IntraLase® laser virtually eliminates
the majority of the most severe sight-threatening LASIK complications
related to use of the microkeratome.
5 Additionally, by creating an
optimal corneal surface below the flap, the IntraLase® Method provides
for better visual outcomes -- taking patients to 20/20 vision and
6 More than one million LASIK
procedures using the IntraLase® Method have been performed.
Source: Captain (Retired) Steven
C. Schallhorn, "US Navy study: Custom PRK versus custom LASIK".
Presented at the European Society of Cataract and Refractive Surgeons
annual meeting; September 8, 2006; London, UK.
Source: Tanzer DJ, Schallhorn
SC. Comparison of visual outcomes with femtosecond and mechanical
microkeratomes for wavefront-guided LASIK. Presented at the American
Academy of Ophthalmology annual meeting; November 13, 2006; Las
Source: Schallhorn SC, Tanzer
DJ, 'Refractive Surgery in Naval Aviation', Presented at the Aerospace
Medical Association annual meeting, May 15, 2006, Orlando, FL.
Source: Captain (Retired) Steven
C. Schallhorn, "Refractive Surgery in the Navy", Presented at the
Aerospace Medical Association annual meeting; May 17, 1999; Detroit,
Michigan. Source: Binder PS: "One thousand consecutive IntraLase
laser in-situ keratomileusis flaps" Journal of Cataract and Refractive
Surgery. V32. June 2005.
Source: Durrie DS, Kezirian,
GM: "Femtosecond Laser versus Mechanical Keratome Flaps in Wavefront-guided
Laser in situ Keratomileusis: A Prospective Contralateral Eye Study"
Journal of Cataract and Refractive Surgery, V31, Jan. 2005.
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17. I was
told that the WaveLight wavefront "optimized" Excimer
Laser is more precise than the the VISX Star S4 CustomVue Excimer
Laser system. Is that true?
Excimer Laser systems are based on wavefront
measurement technology. The WaveLight Excimer averages
wavefront data from a large sample of human eyes to determine your
"wavefront" treatment. The WaveLight uses a "one-size-fits-all"
wavefront treatment profile. The WaveLight Excimer does not custom
treat each eye based on the unique wavefront profile for that eye.
The VISX CustomeVue Wavefront system actually measures your eye
and maps the unique, specific "higher order aberration"
(HOA) profile for your eye. The VISX Wavefront system generates
a specific wavefront treatment profile each patient. No two eyes
are identical and the VISX system identifies, and treats the unique
wavefront higher-order-aberration pattern for each eye. The WaveLight
Excimer Laser does not custom treat each eye. Is this significant?
In a study presented at the 2008 American Academy of Ophthalmology
meeting Nov 7, 2008 in Atlanta, Jack Holladay M.D. presented the
results of a study comparing the results of the WaveLight and VISX
CustomVue Excimer Lasers. Approximately 100 eyes were Lasered with
each system and the results compared. The VISX system had 88% of
eyes with higher order aberrations (HOA) the same or better after
treatment while the WaveLight had only 59% of eyes with HOA the
same or better. The conclusion of Dr. Holladay's study was that
"wavefront guided ablations (the VISX CustomVue Wavefront system)
provides the best optical results for the vast majority of patients,
especially with medium or high higher-order aberrations pre-op".
This suggests, at least in this study, that the VISX CustomVue Wavefront
system gave better results than the WaveLight wavefront "optimized"
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