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Patients who are considering undergoing custom LASIK surgery might be interested in learning more about the pieces of equipment which are approved for use in these procedures. These approved pieces of equipment include the LADARVision System, VISX Star 4 and Bausch & Lomb's Zyoptix.
The Food and Drug Administration (FDA) approves equipment for custom LASIK surgery with certain restrictions. The LADARVision System by Alcon is approved by the FDA for patients who have up to -7.00 D of nearsightedness and less than -0.50 D of astigmatism. The VISX Star 4 is approved by the FDA for patients 21 years of older who have myopic astigmatism up to -6.00 D. Zyoptix is approved for patients with -7.00 D of nearsightedness and less than -3.00 D of astigmatism.
Wavefront-guided, or custom, laser eye surgery may be required if you have significant "higher-order" aberrations in your eye. These go beyond simple nearsightedness, farsightedness, and astigmatism, and can affect your vision even once these lower-order conditions have been treated.
Another group of people who require custom LASIK are patients who have had refractive surgery in the past, but are suffering from side effects or complications that keep them from achieving their best possible visual acuity.
If you are too nearsighted or farsighted, have too much astigmatism, or have thin corneas, you may not be a candidate for custom LASIK.
Custom LASIK typically costs more than traditional LASIK, in part because the manufacturers of wavefront devices take a royalty from the surgeon on each procedure performed. This extra cost -- perhaps $400 or $500 per eye -- is one reason patients are warned not to shop for laser eye surgery on price alone. If your eyes require a custom procedure for maximum visual benefit, you may not be happy with the results from a cheaper procedure.
Even with custom LASIK, there is a chance that you will require enhancement surgery afterward to fully correct your vision. As part of your research before the surgery, you should ask your surgeon what the cost of such enhancements will be if they are needed. Many practices offer them free or for a reduced cost.
Custom LASIK is now available with something called CustomVue. This CustomVue treatment allows those with nearsightedness, farsightedness and astigmatism to have their vision corrected. What is CustomeVue custom LASIK exactly?
-CustomVue uses Wavescan technology to measure any imperfections in the eye 25 more times better than previous methods.
-CustomVue will make a detailed map of your eye.
-CustomVue digitally transfers information to the laser, allowing for more accuracy.
-CustomVue uses Iris Registration Technology, which is a method that aligns treatment to the cornea without using any contact at all.
Custom LASIK uses a technology called "wavefront" to diagnose the unique shape of the patient's cornea, then to create a map that the surgeon can use to perform very precise LASIK adjustments.
The wavefront technology has been around for decades, used by astronomers to adjust the large mirrors in their telescopes to correct for distortions caused by the earth's atmosphere. Only recently has it been applied to the improvement of human vision.
Many surgeons will perform a wavefront diagnostic for all patients requesting vision correction surgery. Not all will use this diagnostic to create the surgical map, either because they do not find it necessary or because the diagnostic shows the patient is not a good candidate for laser surgery.
Most LASIK patients experience dramatic improvement in their pre-surgery eyesight within 24 hours of the surgery. After that, the improvements continue at a more modest pace. It may be six to eight weeks before you experience the full "custom" effect of the surgery. You may even find that after the custom surgery, you are able to see better than you could with your old glasses or contact lenses.
Otherwise, the recovery from custom LASIK is the same as for standard LASIK surgery. Patients will need someone to drive them home, and will need to wear a protective shield for 1 to 3 days, but should experience little discomfort after the first few hours.
You should have a thorough consultation with your eye surgery professional, including the wavefront scan. For this part of the process, you will be asked to look at a target light while the laser sends a beam into your eye and measures its refraction to get a precise diagnosis of the aberrations in your eye.
You should then have the opportunity to ask questions of the surgeon about your diagnosis, why custom LASIK is appropriate in your case, and what the process looks like. You should also find out what laser will be used on your eyes, and whether the process is truly "custom" (designed specifically for your eye defects) or merely "optimized."
Wavefront technology is a fairly new technology that is improving LASIK surgery. Wavefront technology allows for LASIK surgery to be individualized for each patient's eyes before and during the surgery.
Before the LASIK procedure, wavefront technology is used to allow the surgeon more diagnostic information that was not available prior to wavefront. The surgeon will then know exactly what is needed for that specific patient prior to surgery.
During the LASIK surgery with wavefront, the surgeon is able to adapt the laser for a more customized and precise procedure. Wavefront allows for more precision and safety when performing LASIK surgery.
Custom LASIK can provide very precise correction of visual acuity, with fewer side effects than standard LASIK. This means that custom LASIK can in some cases achieve a much greater improvement in your vision than other forms of surgery.
The wavefront technology is especially effective for people with unusual or hard-to-fix vision problems, or in enhancement surgery for those who have had an unsuccessful experience with standard LASIK.
Custom LASIK also reduces the incidence of post-surgical vision problems such as ghosts, halos, and difficulty driving at night. Research is continuing into possible applications for this technology that could expand the range of conditions it can treat.
The wavefront technology used in custom wavefront LASIK surgery is highly precise -- more precise, in fact, than the surgery it is supporting, which means it may find optical defects that cannot be corrected.
As with other laser procedures, the patient is asked to look at a target light. A laser beam sends a specific pattern of light waves into the eye, and the wavefront sensor measures the changes in that pattern as it is reflected back. To use a simple example, if a straight line is reflected back as wavy, it indicates there is an error in the eye's lens and shows the magnitude and nature of that error.
The human eye is imperfect, so no one's eyes will reflect back the exact pattern that is beamed in. Wavefront diagnostics are a vital tool for today's laser eye surgeons.
LASIK wavefront technology enables the surgeon to create a 3D image of the cornea in an effort to tailor a LASIK procedure for each patient. This technology utilizes an abberometer, which is a device used to beam light through the eye. This beam of light takes measurements of the eye as it is bounced back and these measurements are used to detect imperfections in the patient's visual ability. These measurements are stored in a computer which can be used to guide the laser during the LASIK procedure. This guidance makes it possible for the surgeon to produce better results in terms of both visual acuity, as well as quality of vision.
Patients who are considering custom laser eye surgery are likely investigating this type of procedure because of the greater probability for success combined with the diminished possibility for complications. However, patients who are interested in this type of procedure should also realize they will pay a premium for this type of procedure. There are a couple of reasons why patients can expect to pay more for custom laser eye surgery than they would for traditional LASIK. Higher success rates are one of the reasons for this increased cost, but surprisingly it is not the only reason. The other significant reason is, in most cases, the surgeon is required to pay a fee to the device manufacturer for each use of the device.
According to statistical data for the year 2004, patients were charged $200 to $500 more per eye for custom laser eye surgery than they would have paid for traditional LASIK. However, savvy patients realize this increased cost is not as important as the opportunity to undergo a safer and more precise procedure which is customized to their own specific needs for vision correction.
Choosing a LASIK surgeon is never a simple process and the process of selecting a custom wavefront LASIK surgeon is certainly no exception. However, the process of finding potential surgeons for the procedure is much less complicated. There are a number of different methods for finding these surgeons including consulting with your insurance provider, seeking a referral from your eye doctor, reviewing advertisements online and in the print media and visiting the website for the American Academy of Ophthalmology. These methods for finding a custom wavefront LASIK surgeon can be used to compile a list of potential surgeons, but selecting one of these surgeons to perform the procedure should be based on extensive research and interviews which enable to the patient to gauge the surgeon's skill level, experience and success rate with previous patients.
A great deal of caution should be taken when selecting a wavefront laser vision correction surgeon. Some patients may mistakenly believe this form of LASIK is fully automated and the skill and experience of the surgeon is not as important as with traditional LASIK procedures. As a result of this misassumption, the patient may be tempted to select the most affordable surgeon but, as with other types of LASIK surgery, price should not be the deciding factor.
It is imperative for patients who are considering wavefront laser vision correction surgery to realize they must select a highly-skilled surgeon with a great deal of experience. This is important because although the computer can be utilized to create a highly customized LASIK procedure for each patient, the procedure is not fully automated. This means the skill and experience of the surgeon can still have a significant impact on the outcome of the procedure. Therefore, patients in search of a qualified surgeon should interview prospective candidates taking special note of the qualifications of each surgeon. They should then select from a pool of well-qualified surgeons who meet all of the patient's expectations.
In clinical studies, wavefront laser eye surgery success rates indicated the procedure was an overwhelming success. An overwhelming 90 percent of the participants in the study obtained vision of 20/20 or better after the procedure, while 74 percent obtained vision of 20/16 or better and 27 percent of the participants obtained vision of 20/15 or better. Additionally, 70 percent of the participants in the study reported their vision after the procedure was better than their vision with eyeglasses or contact lenses before the surgery. These statistics make it clear that wavefront laser eye surgery produces incredible results for patients.
Higher order aberrations typically occur in only 10 to 15 percent of the population. These higher order aberrations are always exclusive to the patient who has them. Due to the individuality of these higher order aberrations, less-advanced LASIK surgeries were not able to spot these aberrations.
Now, with the custom wavefront technology and a custom wavefront guided laser, the surgery is customized to the patient and the aberration.
Custom LASIK with the new wavefront technology is able to eliminate many vision problems compared to the standard LASIK procedure.
The new technology is now able to identify visual disturbances, such as halos, that at one time were not identifiable by previous laser eye surgeries. Due to this, halos are able to be determined as present and are thus able to be eliminated with the Custom LASIK procedure.
There are several conditions which make it impossible for a patient to receive the benefits of custom LASIK.
Because the custom surgery can involve removing more tissue than standard LASIK, patients with thin corneas may not be eligible for wavefront-guided LASIK surgery. In addition, those with strong nearsightedness, farsightedness, or astigmatism, as well as those with especially large pupils, may be discouraged from having this surgery.
If you are seeking monovision treatment for presbyopia, you will be better off with standard LASIK treatment, since current lasers cannot perform the undercorrection required for proper monovision.
If you have few higher-order aberrations and meet the other guidelines for refractive surgery candidates, the benefit of custom LASIK may not be worth the cost for you. You may wish to get more than one eye surgeon's opinion before making this choice.
Custom LASIK allows for a greater chance for having 20/20 vision. Custom LASIK even allows the patient for a chance of having better than 20/20 vision. A person choosing to have custom LASIK reduces the risk of losing your best-corrected vision. It also gives you a reduced chance of losing quality of vision and contrast sensitivity. Another plus for a person choosing this procedure is that you have a reduced risk of having night-vision problems.
There is also a chance with custom LASIK that a surgeon may be able to treat people who have, in the past, lost best-corrected vision from prior surgeries.