Since it began in the 1940s, the world of laser eye surgery has changed dramatically. One experimental operation has evolved into many viable procedures. Today, you can correct your vision to 20/20 or better.
Still, many choices spawn many questions.No all laser corrections are the same. To make things even more confusing, a laser system like the WaveLight EX500 can have different procedures performed on it such as normal wavefront-optimized LASIK, or the newer Contoura LASIK/PRK. Even Contoura topographic guided ablations can be done differently because the technology is so powerful that it is changing surgeons’ understanding of how to correct vision. Many exploring the latest vision correction procedures wonder what they are and which is right for their eyes.
Of course, it’s easy to call an eye doctor and ask. Knowing all the options ahead of time, however, enables you to determine whether the doctor is using the latest equipment. Research increases the likelihood that you’ll get the right doctor, the right procedure, and optimal results. Look at the doctor’s website. If it talks about different procedures and educates you about the different technologies, this may be a better choice for you than one that just focuses on marketing their LASIK procedures.
Technically speaking, most vision correction is performed on one part of the eye: the cornea. This transparent membrane acts like your eye’s window to the outside world. And as such, it’s also the source of near and far-sightedness as well as astigmatism. All of these common disorders relate directly to the cornea’s shape in some way. Therefore, in most cases, to correct your vision, you must reshape your cornea. How the cornea is re-shaped determines your visual outcomes. Not all LASIK is the same, the term LASIK just means making a flap and lasering the cornea. How the cornea is lasered and the shape created makes a huge difference in how you end up seeing afterward.
Imagine for a moment that your eye’s cornea is made of clay. As the “artist,” your doctor can use a variety of treatments to “sculpt” your cornea into the proper shape and restore your vision. However, unlike with clay, no tissue can be added to the cornea once taken away. Therefore, the best possible carving must occur on the first attempt. And just as important, to make the ideal corneal shape, you must have enough tissue to begin with. Keep this analogy in mind as we explore today’s most common vision correction procedures.
The following corneal correction procedures are some of the most common on the market today:
LASIK is by far the most common correction procedure. If your vision is laser-correctable, chances are you’ll receive it. However, the lasers used today vary widely. Newer almost always means better. Delivered by the Alcon Wavelight EX500, Optilasik is the fastest laser approved in the US, running nearly five times faster than VISX, the most common laser on the market.
Why’s that important? During LASIK surgery, your doctor cuts and folds away part of your cornea. The exposed inner cornea has fluid inside it that allows laser reshaping to take place without damaging the eye. Because when opened, the cornea can dry up quickly, the speed of the laser is crucial. The quicker the laser can get its job done, the better the corneal “sculpture” it can make.
Also, lasers differ not only in speed but in how quickly they track eye movements. In order to be effective, a laser must keep up with the eye’s every move. For certain eye conditions like severe farsightedness, most LASIK lasers can’t track fast enough to perform surgery. That is, except the Wavelight EX500 laser. The commonly-used VISX laser tracks at about 60 times per second, whereas the EX500 can follow at a blazing 1000 times per second.
To be a good candidate for Optilasik, you must be 18 years or older and be free of uncontrolled diabetes, autoimmune, and eye diseases. Finally, your cornea must be at least .5mm thick.
As mentioned above, the shape of your cornea largely determines the quality of your eyesight. The challenge for some patients is that their cornea does not meet the minimum .5mm thickness. It’s like not having enough clay to make the sculpture. As a result, these patients cannot receive Optilasik or traditional LASIK surgery.
Known as the only genuinely flapless LASIK procedure, Epi-LASIK or E-LASIK can be the answer. Instead of using part of the cornea to make the flap, it uses the epithelium. This clear skin-like substance naturally covers the outside of the cornea. Overall, Epi-LASIK removes 35% less tissue than standard LASIK.
And while addressing thin corneas is important, Epi-LASIK also offers the added benefit of treating abnormally-shaped corneas. Therefore, patients that require extreme vision corrections can find relief.
Candidates for Epi-LASIK are similar to those choosing Optilasik, except they can have thinner corneas than .5mm. Epi-LASIK can also be performed utilizing topographic guided ablation, or Contoura. This type of correction can lead to even better vision afterward.
Contoura is the name for topographic guided ablation on the WaveLight EX500 laser system. It maps the cornea and uses that map to treat and make a better smoother shaped cornea. It doesn’t just treat the nearsightedness/farsightedness/astigmatism, but also the normal irregularities (the lumps and bumps) that occur in your cornea because it was made in a womb, not in a machine. By reducing these irregularities a much smoother cornea can be sculpted that scatters less light and makes for better, clearer vision. Patients describe clearer more vivid colors, little to no night glare or halo, and vision that is so sharp it is better than 20/20. As this procedure is more complex, not as many doctors perform it and even fewer doctors fully understand its power to the cornea even better than normal.
As you can see, today’s laser vision procedures treat a variety of needs. No two patients are the same. And thanks to modern medical science, we have customized, sophisticated machines to address this.
However, very few optical surgeons offer this many options, let alone use the latest equipment. Each of us has a limited amount of cornea to work with so we must be selective of who we trust to reshape it.
Dr. Motwani believes life is too short not to see it in full detail. That’s why he offers a wide array of the latest treatments. Before you go another day struggling with blurry vision, schedule your free consultation with his office today at (858)-554-0008.
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