About the Author

Mr. Dave Allamby FRCS FRCOphth is a London-based LASIK laser refractive surgeon and heads up FOCUS Laser Vision. You may have seen him on the This Morning TV show with Phillip Schofield and Fern Britton or read one of several articles in the national press, recently for treating rock giant Rick Wakeman and broadcaster Paul Ross. FOCUS is a world-leading clinic in the treatment of presbyopia, or age related loss of close vision and offers LASIK laser eye treatment for short sight or long sight.

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There Are 7 Responses So Far. »

1. 

   Comment by George Matz on 6 June 2008:

   Hi David,

   Surfing on the Internet I have discovered some refractive surgery techniques. I never heard about them and on internet there is very little information.

   The tecniques are the following:
   A) No. PRK laser Touch 100%
   b) Supralase (Made by first colonial eye center, USA)
   c) C-TEN (Trans-custom Epithelial No-touch)

   I found information on this youtube video and in its comments. http://it.youtube.com/watch?v=Wnpe1NHPPR8

   Do you know them?

   A post on those tecniques would very appreciated.

   All the best

   George
2. 

   Comment by Dave Allamby on 7 June 2008:

   Hi George. Thanks for your mail.
   a) and c) seem to refer to a technique called trans-epithelial PRK, where the laser is used to remove the top layer of skin cells, about 50 microns deep, rather than using traditional alcohol.

   I prefer alcohol based PRK for the following reason. If you watch the youTube video and look out for the blue glow as the laser removes skin cells, you can see the laser is already removing central corneal tissue before it has finished removing the surface skin (the middle stops glowing blue but the periphery continues).

   This means the laser treatment to correct vision is no longer accurate, unless you can precisely compensate for this effect. Better to physically remove the skin layer and get a very precise result.

   b) “Supralase” is a brand name coined by this particular clinic. From the video, they seem actually to be lasering onto the surface skin cells only. These cells are replaced every 7 days, so whatever effect is created will be fully lost over a pretty short time period.

   Overall, a waste of time and money. People have looked at this before and you can safely forget about it.

   Hope this helps! David
3. 

   Comment by Carlo M. on 8 June 2008:

   Hi David,

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

   a)Why some surgeons keep saying that the creation of a flap in the eye could potentially lead to problems? To that respect should PRK and LASEK be better in the long run for patient as no flap would have been created? Regardless the recovery time I know that prk and lasek could take up to 1 month for full recovery..

   b)Is it true that LASIK procedure as not been approved for air-force pilots and astronauts in the US but PRK and LASEk yes?

   So far on the web there is a lot of confusion about those issues could you spend some time for clarifying that?

   Thanks very much

   Best Regards,
4. 

   Comment by John M. on 10 June 2008:

   David,

   I think Carlo wanted to know the following:

   a)PRK and LASIK in comparison to LASIK for the flap issue.

   b)Which procedure of eye surgery in the is approved for air-force pilots and astronauts. I am pretty sure that lasik in 2000 was not approved, what about now? Do you know why it was not?

   I am very interested as well on those topics, please if you have some info on that share it with us

   Best,

   John
5. 

   Comment by Dave Allamby on 15 June 2008:

   Hi John
   I have posted a reply to part a). Part b) to follow in a couple of days. thanks

   Dave
6. 

   Comment by Dan on 18 June 2008:

   Hi George

   I have recently had the “no touch” procedure with Accuvision leaving me with excellent 20/15 vision. Their name for it is Transepithelial All Laser correction. The medical name for it is Transepithelial PRK (T-PRK) which is more inforamtive because it is infact an updated version of PRK. I did quite extensive research in to this procedure before going ahead. It has been around since 1991 and has not really gained popularity among surgeons since then who tend to favour LASEK for the reasons that Mr Allamby has outlined; that it is more difficult to accurately remove epithelium to the correct depth. This factor results in more overcorrection for T-PRK on average although only by a very small degree; the skill of the surgeon and the laser technology platform is important in this regard. Advantages of T-PRK are that it does not use alcohol which may cause some minor damage to the cornea. Also, there is evidence for less keratocyte apoptosis which is a cause of haze post surgery and should ultimately lead to more accurate corrections because there is less remodeling of the ablated surface. Time will tell as to which procedure is favoured in the future. Part of my reasoning for choosing it was that it is favoured by Chad Rostron with Accuvision who really does have a tremendous reputation as a corneal specialist.
7. 

   Comment by Dave Allamby on 18 June 2008:

   Hi Dan
   Thanks for your post. FOCUS and Accuvision have the same laser - we both choose it as the best of breed that is out there, a fantastic machine with #1 results for vision and safety from the FDA.

   The T-PRK technique works well in the treatment of short sight, where we typically aim to over-correct by a small degree for people in their 20s and early 30s, which still leaves fantastic vision. This is because the the lens inside the eye is still flexible and can easily compensate. So T-PRK is effective here without worrying about the exact final amount corrected.

   I assume the use of the term “all laser” in this instance for PRK is for marketing reasons, as this phrase is now generally used by other clinics to refer to ‘all laser LASIK’ where a (very expensive) femtosecond laser is used to create a corneal flap rather than a blade. Accuvision dont yet have a femtosecond laser in London I believe.

   You can check my ‘clinic maps’ pages (for London and separately for the UK) which show UK laser eye clinic locations and whether or not they can offer blade free (all laser) LASIK. Just click on the clinic button to see the text and information.

   Thanks, Dave

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