Fern Britten and Philip Schofield interview Paul Ross and Dr. Dave Allamby about laser eye surgery.

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Download CAA Pilots and LASIK or PRK PDF file or visit the CAA website

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LASIK surgery is no different from any other operation, despite how it may be pitched by some clinics, in that it IS a surgical correction and should be approached as such. However, and fortunately, most complications are in fact minor and easily resolved.

Technology

LASIK risk continues to drop as doctors and engineers perfect the equipment used in the treatment. Advances in technology have made a big part of the difference here so make sure you are getting that latest equipment and not an older fashioned approach.

The risks drop as doctors continue to screen for the right candidates to have the procedure, and screen out those with any chance to have a problem. Research also shows that with the right pre-testing and surgical handling, the risk of complications in LASIK surgery is less than 1% and most of these are minor problems which will be fully corrected afterwards without undue ongoing problems.

The most common risk with LASIK surgery is a complication with the flap, created by the surgeon in the first part of the procedure.

In the original LASIK procedure, the flap is cut by a surgical blade device known as a microkeratome. The blade cut is, however, less precise than those from newer femtosecond lasers.

Blade Free LASIK

LASIK risk is reduced by the newer “bladeless” dual laser technique.

In bladeless (blade free) LASIK surgery, the risk of complications is lower because the blade or microkeratome is no longer used. It is replaced by special type of infra-red laser that greatly reduces human or machine error.

The original laser to make a LASIK flap came from the USA, manufactured by Intralase. You may see this surgery called IntraLASIK or iLASIK.

The newer machine is from Switzerland and produced by the Ziemer Group of companies. There appear to be some advantages of the tighter focus of the Swiss laser. This procedure may be called Z-LASIK.

Summary

When assessing these LASIK risks it is recommended that when you are considering surgery that you ask your doctor what technology the clinic has and whether or not a blade free dual laser approach will be used.

Technorati Tags: AMO, choose, clinic, complications, eye surgery, femtosecond, iLASIK, Intralase, LASIK, Safety, surgeon, Z-LASIK, Ziemer

Preview post…

Some new research from Professor John Marshall has helped shed light on this key topic and is something that everyone who is thinking about LASIK laser eye surgery needs to know.

Check back next week for my post on this topic…

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YES, LASIK is fully acceptable for the police force, as is LASEK, PRK and ICRS (Intra-Corneal Ring Segments). The main criteria is whether or not the cornea is weakened following surgery and LASIK, PRK etc. are NOT considered to affect the strength of the cornea versus possible trauma from working as a police officer.

However, radial keratotomy (RK, ‘microsurgery’), arcuate keratotomy (AK) and corneal grafts are all procedures that do weaken the cornea and applicants who have had these treatments WILL be rejected by the police.

Get more information on eyesight requirements, LASIK and the police at the official police website here or download the eyesight police criteria PDF form here.

Technorati Tags: eligibility, entry, force, LASIK, police, PRK, requirements, Safety

BUT… even after the price rise, FOCUS will still be the best price in the UK. Plus offering the proven fastest and safest laser in the UK. Plus having a super-qualified NHS London teaching hospital corneal and laser specialist surgeon for your treatment. Plus a new state of the art facility in the Harley Street enclave.

This is the very best price for advanced wavefront LASIK laser eye treatment in the UK, saving you approximately £1,000-2,000 compared to most other clinics for an average prescription. FOCUS want everyone to be able to afford the very best that is available.

Simply a fantastic price, the best lasers and an expert NHS consultant surgeon.

Our laser eye surgery includes the world’s best laser based on official US FDA custom LASIK results, a fellowship-trained NHS London teaching hospital refractive consultant surgeon and the exclusive FOCUS Laser Vision laser eye treatment centre in London’s prestigious Wimpole Street.

What more could you want?! Contact FOCUS Laser Vision right now.

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These lenses are inserted inside the eye during a procedure very similar to that used for cataract surgery. The natural lens is removed and replaced with an artificial intraocular lens (IOL). The traditional IOL has a fixed focus and is unable to replicate the natural flexibility of the young human lens that allows us to zoom in on near objects to have clear close vision, e.g. reading a newspaper print.

Accommodating lenses are designed to mimic the natural zoom ability to not only provide clear distance vision but also to restore good near vision. This loss of near vision with age is called ‘presbyopia‘ and affects 20 million people in the UK alone.

The Crystalens HD is designed for enhanced depth of focus and features something called “proprietary optical focus,” B&L stated in a press release. This optical ability is claimed to be capable of improving near vision without reducing distance or intermediate vision. In the research study from B&L, 125 eyes were implanted with the new Crystalens HD. These patients had a visually significant cataract (usually age related clouding of the lens inside the eye), less than 1 D of corneal astigmatism, and the potential for best corrected visual acuity of 20/25 or better in both eyes. Of this study population, four out of five patients (80%) had vision of J2 (equivalent to small ingredients lists on food packets) or better at 4 months. B&L said it plans to begin sending out the Crystalens HD in early July.

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Traditional LASIK has used a microkeratome to cut a flap. The microkeratome is a hand-held device, which contains a steel blade that moves back and forth to create a cut as it travels across the cornea. A microkeratome is only capable of making a single, one-dimensional cut across the cornea. As it cuts, the blade oscillates back and forth, which can leave an irregular surface after the flap is lifted. This can affect the quality of your postoperative vision.

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 only 58 percent of microkeratome patients

Because of the unique way in which the All Laser Method (femtosecond laser) creates a precisely positioned layer of micro-bubbles just beneath the surface of your eye, it creates a smooth even surface after your flap is lifted. With this method, a blade never touches your eye.

Tags: LASIK

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Most people start to need reading glasses after the age of 45 and previously were not eligible for laser eye treatment. All that has changed with advances in technology. FOCUS Laser Vision has been very active in this increasingly popular area of laser eye correction.

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FOCUS Laser Vision specialises in the correction of loss of reading vision, either through advanced LASIK laser eye surgery or through the use of lenses inside the eye (IOLs)

Several approaches to LASIK are showing promise in the treatment of reading vision problems (presbyopia) for patients with otherwise normal distance vision, or long or short sight, according to studies presented at the 12th Winter Refractive Meeting of the ESCRS.

In research presented by Kenneth A Greenberg MD, all patients achieved good distance vision of 20/25 or better and were able to read telephone directory sized print, 12 months after undergoing customised LASIK treatments. The multicentre study involved 28 presbyopic long-sighted patients with an average age of 56 years.

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The Cambridge Eye Laser Clinic was created in 2002 by eye surgeon and clinical director Chris Stephenson as part of the Allclear Group of clinics. Stephenson bought out the clinic from the group in 2006.

The Cambridge centre add to Ultralase’s 23 UK clinics as part of the group’s ambitious expansion plans. Ultralase recently opened a new consulting room in Sheffield, with plans to open 3 more in 2008.

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WaveLight AG, based in Erlangen, Germany [who make the excellent Allegretto eye laser] increased its sales for the first nine months of 2007/8 accounting year by 31% to €65 million. The previous year’s turnover was €49.5 million for the same period.

The company’s market position in the U.S. has also expanded. In the worldwide sales-strong US market, which has been of great importance for WaveLight for the refractive surgery area, the company exceeded the turnover of the comparable period in the previous year by 66%.

WaveLight make the Allegretto Eye-Q 400 Hz excimer system for laser eye surgery. You can see the FDA results for the WaveLight laser versus other systems here.

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My name is Carlo and I have recently discovered this great blog. I would like to ask a couple of questions regarding eye surgery:
Question: Is it true that the LASIK procedure has not been approved for air-force pilots and astronauts in the US but PRK and LASEK has?

No, this is not true.

LASIK was approved for use on consumers a decade ago and reportedly more than 11 million LASIK procedures have been performed in the US. This means LASIK laser eye surgery is the most-common American elective surgical procedure.

NASA has approved LASIK for use on pilots, mission and payload specialists who face extreme and often physically demanding conditions in space. The all-laser LASIK technologies, using a blade free femtosecond laser approach, 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.

Though LASIK has been around for a long time, concerns about the harsh environment in aviation prevented its use. To date, aero-medical professionals have been cautious of employing the procedure on military pilots who often encounter environmental extremes such as high altitude, dry air, wind exposure and “G” forces. In space, other conditions further add even higher levels of concern due to the very high level of precision needed during flight and space walks.

Defense Department’s research into laser vision correction included the following results:

# In a study of different methods to create the LASIK flap, 370 naval personnel underwent bilateral (both eyes) wavefront-guided LASIK with either the femtosecond laser (blade free) 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 only 58 percent of microkeratome patients

# In an evaluation of 785 pilots, 89% of Navy aviators evaluated their ability to land on an aircraft carrier as moderately to significantly better after laser eye surgery. None said it was worse after treatment

# A separate study determined that over 90 percent of marksmen had improvement in marksmanship skills after laser eye surgery; an impressive finding given the visual precision of marksmen

LASIK, particularly blade free femtosecond LASIK, appears to have established itself as a very effective and reliable procedure. The move from blade to laser blade free has allowed another significant improvement in results (now targeting better than 20/20 as a standard of care) according to the above research findings.

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My name is Carlo and I have recently discovered this great blog. I would like to ask a couple of questions regarding eye surgery:

a) Can the creation of a flap in the eye potentially lead to problems? Should PRK and LASEK be better in the long run for patients?
b) Is it true that the LASIK procedure has not been approved for air-force pilots and astronauts in the US but PRK and LASEK has?

There is a lot of confusion on the web about those issues. Could you spend some time clarifying that?

Let’s look at the first question now and I will address the second in a subsequent posting.
The majority of surgeons use the LASIK technique, where a thin flap is created in the top part of the cornea before applying the vision correction laser. More than 90% of laser eye surgery procedures are LASIK rather than surface laser treatments (PRK or LASEK).

There has not been any research to show signifiant differences in results between LASIK and PRK for short sight so whichever you choose to have, the final outcome will be the same. However, for long sight or reading vision correction, LASIK appears to give a more stable results and this is my preferred method for these types of prescription.

But let’s stay with short sight for the moment, where the vision and stability are not affected by the choice of procedure. It then comes down to safety. I personally used to prefer PRK over LASIK due to the small but measurable complications arising from using a blade to cut a flap. At that time, when I asked myself which procedure I would have, it would have been PRK.

However, with the arrival of the very safe and predictable laser flap makers (femtosecond lasers) I no longer subscribe to that view and would personally now choose to have all-laser LASIK. The femtosecond lasers create a very predictable and thin flap time after time, with greater precision and safety than the mechanical keratomes could. Early research also shows improved vision results, especially in reaching the very high target of better than 20/20 vision.

You still need an expert surgeon and a very thorough examination and consultation because there are points we can detect which do predict a bigger chance of having a problem in the long term. Such patients need to be screened out of the LASIK or PRK process and should not have surgery.

So choose an expert centre with an expert surgeon and you will have a safe and predictable experience and result. You can comfortably opt for LASIK over PRK/LASEK without worries for the long term.

Certainly, patients much prefer LASIK as vision is very good within a few hours (even quicker with our Z-LASIK approach) and they can be back at work the next day, rather than needing to take several days off work. Also, most patients find PRK or LASEK to be a pretty painful experience for 2-3 days after correction (the procedure itself is painless).

Technorati Tags: complications, flap, LASEK, LASIK, risks, Safety

You can still read Rick’s story about his treatment with me, online at the Daily Mail’s website. Rick talks about the whole process in a very interesting article from Rachel Kaufman.

Follow the link below to read the full article.

http://www.dailymail.co.uk/health/article-404859/New-laser-surgery-cured-long-short-sight.html

Technorati Tags: FOCUS Laser Vision, laser eye surgery, London, long sight, news, presbyopia, surgery, wavefront