Cabarrus Eye Center is dedicated to providing the latest, most effective and safest technology in laser vision correction to help our patients enjoy life more fully with less dependence on glasses or contacts. To that end we offer Advanced Surface Treatment as the latest innovation in laser vision correction. This exciting new alternative merits consideration by nearly anyone requiring vision correction. All preoperative, surgical and postoperative care will be personally provided by Gary Raflo, MD, FACS.
The Evolution of Laser Vision Correction
Laser vision correction is now in its second decade of providing excellent vision to millions of people. The FDA initially approved a procedure called Photo-Refractive Keratectomy (PRK) in 1995 to correct nearsightedness. PRK uses an excimer laser to remove small amounts of tissue from the surface of the cornea. Although effective, the procedure was painful for a few days to weeks after surgery, and vision recovery took weeks to months. In order to improve pain and vision recovery, the laser in-situ keratomileusis (LASIK) procedure was developed. Using a precise oscillating blade or laser, a flap is cut into the cornea and folded back. An excimer laser is used to remove a small amount of tissue from the middle layer of the cornea, after which the flap is replaced into its original position. This procedure gained widespread popularity due to rapid, nearly painless recovery and excellent visual results. LASIK, however, is not an ideal procedure for everyone. Patients with thin corneas, dry or itchy eyes, or those uncomfortable with the idea of having their corneas cut are not good candidates for LASIK. The LASIK flap may have complications such as wrinkles, chronic inflammation or tissue ingrowth. Eye trauma may cause the flap to dislodge, even years after the surgery.
Advanced Surface Treatment
Advanced Surface Treatment has taken laser vision correction to a new level. There is no cutting of the cornea. The surgeon gently removes the thin outer membrane (the epithelium) and then reshapes the surface of the cornea with the excimer laser. This makes Advanced Surface Treatment an excellent option for people who may have been told they are not good candidates for LASIK or those whose lifestyles may make having a corneal flap unadvisable.
Benefits of Advanced Surface Treatment
Since there is no cutting of the cornea and no corneal flap, the structural integrity of the cornea is preserved, making it a safer procedure for most patients. Most potential postoperative complications related o having a corneal flap are entirely avoided. For patients with active lifestyles, there is no possibility of a LASIK flap becoming dislodged in future years. This is particularly beneficial in occupations such as law enforcement, the military, fire fighting, and sports where blunt trauma to the eye is a real possibility. Many patients with thin corneas who were considered poor candidates for LASIK surgery are suitable candidates for surface treatment as there is much less thinning of cornea without the creation of a flap. Also there is less disruption of the corneal nerves, lessening the possibility of inducing or worsening dry eye syndrome. Evidence suggests that the visual outcomes of Advanced Surface Ablation are equal to and, in some cases, better than that achieved by LASIK surgery.
Standard Versus Customized Treatment
For many years surgeons programmed the excimer laser computer for each patient using measurements similar to those used to calculate and manufacture glasses. Two patients with the same glasses prescription would receive identical laser treatments. However, the glasses calculation captures only a small part of the information about the eye's focusing system. Recently, customized treatment using a testing system called a wavefront aberrometer has allowed patients to undergo truly individualized laser treatment. The use of customized, wavefront-guided treatment has decreased the frequency of side effects such as poor vision in low light. Customized treatment can be used with either PRK or LASIK.
Advanced Surface Treatment combines the advantages of surgery without cutting a flap and the precision of individualized laser tissue removal to provide the highest levels of safety and accuracy.
State-of-the-art Laser Technology
The full benefits of Advanced Surface Treatment can only be realized when used in conjunction with the latest and most sophisticated excimer laser technology. The VISX STAR S4 Excimer Laser and the WaveScan Wavefront System create the CustomVue Procedure, considered by many surgeons the "gold standard" in laser vision correction provides such precision. The CustomVue procedure tailors a unique correction for each individual. This new level of measurement provides 25 times more precision than standard measurement methods for glasses and contact lenses. WaveScan technology produces a detailed map of the eye and transfers it to the laser, enabling individuals to achieve the full potential of their vision.
The goal of any laser vision correction procedure is to reduce or eliminate dependency on glasses or contacts. It is important to understand that Advanced Surface Treatment does not always create perfect vision and we cannot guarantee the complete elimination of dependence on glasses or contacts. As with any surgical procedure, there are risks and possible complications that cannot be elaborated upon in this brief review. Recovery time with Advanced Surface Treatment is longer than LASIK and there may be more postoperative discomfort (easily managed with medications). These trade-offs, however, are temporary and certainly worth consideration in light of the long-term safety and potentially excellent visual results.
During your initial visit, Dr. Raflo will perform an extensive assessment of the health and unique characteristics of your eyes. A discussion regarding your lifestyle needs and visual expectations will help determine if Advanced Surface Treatment is the right procedure for you. He will also discuss additional information about the procedure, possible side effects and complications, the postoperative healing course, and possible alternative procedures that will allow you to make an informed decision.