Bad eyes? Learn about Lasik, Lasek and PRK (from Mayo clinic)

Tribune Media ServicesPublished May 27, 2007
Q. I'm 48 and have been wearing hard contacts since I was 10. Apparently, as we approach 50, our eyes don't produce as many tears, so my lenses have become uncomfortable. What's the latest information on refractive surgery, and which kind has the best success rate?

A. Refractive surgery refers to procedures aimed at correcting "refractive error," an abnormality in the eye's focusing power resulting in nearsightedness, farsightedness or astigmatism. Nearsightedness occurs when the curvature of the cornea, the transparent membrane that arcs over the front of the eye, is too steep. Farsightedness results if the cornea is too flat. And astigmatism is the problem when the curvature varies.

If discussions with your doctor lead to refractive surgery, instead of eyeglasses, three time-tested procedures are available: laser-assisted in situ keratomileusis (Lasik), photorefractive keratectomy (PRK), and laser epithelial keratomileusis (Lasek).

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Laser Eye Surgery Video

The Discovery Channel show "How its Made" has produced an excellent beginning to end segment on laser eye surgery. This one is short on the gory close ups and hi tech and instead takes the viewer step by step through the process. Video is below

LASIK For Older Adults

A new University of Illinois at Chicago study appearing in the online edition of the journal Ophthalmology reports on the safety, efficacy and predictability of laser eye surgery (laser in situ keratomileusis or LASIK) in patients 40-69 years old.

"We are seeing an increasing demand for LASIK surgery for older adults, who present special challenges," said study co-author Dr. Dimitri Azar, Field chair of ophthalmologic research at UIC.

In LASIK surgery, adjustments in correction are routinely made to compensate for the cornea's strong healing responses in younger patients, Azar said. Increased age has been previously associated with poorer final clarity of vision, as measured on an eye chart (visual acuity).

"We were able to show that fine adjustments in the correction to the cornea in our older patients that compensate for differences in age-related healing resulted in reliable predictability of correction," said Azar, who is also professor and head of the UIC department of ophthalmology and visual sciences.

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Blade vs. Laser: Is There a Difference in Outcomes?

David J. Tanzer, MD, San Diego

Perhaps the largest study to date to compare microkeratomes gives the laser the edge.

In the past year, there have been numerous reports comparing the results seen with the femtosecond laser to the visual results when a mechanical microkeratome is used. But few of these studies have included a large number of eyes.

In our most recent LASIK study conducted at the Naval Medical Center in San Diego, we set out to evaluate three keratome devices for LASIK flap creation: the Amadeus Microkeratome (Advanced Medical Optics); the Hansatome Microkeratome (Bausch & Lomb); and the IntraLase FS femtosecond laser (IntraLase).

The results show that there are some definitive clinical benefits to using the femtosecond laser for LASIK flap creation, chief among them being a much more reproducible flap.

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