Laser surgery for vision correction is safe

For anyone still on the fence about laser eye surgery to eliminate the need for eyeglasses or contact lenses, two recent studies offer compelling information about safety and effectiveness.
A study published in the journal Ophthalmology this year looked at the use of a laser versus a blade to create the corneal flap, the first step in LASIK surgery. Researchers found that the use of a laser led to slightly better visual results in patients than the use of a mechanical blade to correct nearsightedness. All patients in both treatment groups achieved 20/20 vision or better after surgery, but those who had the laser had better contrast sensitivity, the ability to perceive differences between an object and its background.
Researchers compared outcomes in 200 eyes of 100 patients who underwent flap creation with either the IntraLase laser or the microkeratome blade. &#8220We have long known that creating the flap with the laser was safer, but now there is another very important finding: visual results are slightly better with the laser,” said Dr. Marc Werner, an ophthalmologist at Stahl Eye Center. (Stahl did not participate in the study), which has offices in Garden City, Manhattan and Hauppauge, and specializes in refractive surgery.
&#8220Frequently in medicine, when you gain something such as safety, you can sacrifice results. Not in this case, where we get both improved safety and excellent results. In a sense, patients can have their cake and eat it, too,” said Dr. Werner.
In traditional LASIK, doctors use a hand-held device with an oscillating metal razor blade called a microkeratome to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middle section of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced.
Many patients skittish about having a blade put into their eyes have opted for the laser, Dr. Werner says. IntraLase replaces the hand-held microkeratome blade with a silent, ultra fast, computer-guided laser. IntraLase technology uses an infrared beam of light to precisely separate tissue through a process called photo disruption. In this process, the focused laser pulses divide material at the molecular level without the transfer of heat or impact to the surrounding tissue.”
There were 1.4 million LASIK surgeries performed in the United States last year, according to Market Scope, a market research company. With positive study findings and advances in technology, Dr. Werner predicts that number will grow.
Another study indicates the results of laser vision correction are long lasting. The first 10-year follow-up study of its kind showed that LASIK and the second most common refractive surgery procedure, PRK, provided stable, long-term improvement for nearsightedness. Researchers examined 200 eyes of 100 patients a decade after they had LASIK or PRK and found that patients averaged 20/25 vision 10 years after the surgery, with no long-term complications.
In LASIK, ophthalmologists use a laser to reshape the cornea without working directly on the outer surface of the cornea. PRK also uses a laser to reshape the cornea. However, PRK works directly on the outer surface of the cornea, and this entails a longer recovery period. Doctors determine whether a patient is a candidate for LASIK or PRK based on their corneal thickness or any irregularities on or near the surface of the cornea.
A measurement system customized for each individual called CustomVue is another draw for patients, according to Dr. Werner. The technology, originally developed for high-powered telescopes, uses a system called &#8220wavescan” to identify imperfections in an individual's eye 25 times more precisely than standard methods used for eyeglasses and contact lenses. This information is then digitally transferred to the excimer laser for the treatment, providing another level of precision and accuracy.
&#8220Each patient's eyes are different, and one's vision is as unique as his or her fingerprint,” Dr. Werner says. &#8220The combination of IntraLase and CustomVue allows individualized treatment to meet each patient's specific needs with an unprecedented level of safety and an optimal visual result.”