Chua, Philip S.
Filipino Reporter
10-25-2001
FOCUS@HEALTH: Vision correction surgery may stop use of eyeglasses
What is vision correction surgery?
Vision correction or refractive surgery is an operation on the eyes to
correct error of refraction, like nearsightedness, farsightedness and
astigmatism, to eliminate the use of prescription eyeglasses or contact
lenses.
What are the various procedures available today?
The advent of Excimer laser in 1988 ushered in a new revolutionary era in
vision correction. It provided added lifestyle choices made possible by the
freedom from, or dependence on, prescription eyewears. That important
technological advance resulted in major treatment modalities not possible
before then. The three popular procedures for refractive surgery today are
LASIK (Laser Assisted In-Situ Keratomileusis or Laser Vision Correction),
PRK (Photorefractive Keratectomy) and Intacs (Corneal Ring Segments)
implants.
What is Excimer laser?
Excimer laser is a computer-controlled ultraviolet beam of light that
reshapes the cornea (outer window of the eye), resulting in the light
focusing more directly on the retina at the back of the eye. Excimer laser
gives out a cool or nonthermal (not hot) light beam, making it ideal for
corneal surgery, eliminating the possibility of thermal burns to the
surrounding tissues. Each laser pulse is so accurate it achieves disruption
and removal of the molecular tissue bonds between the corneal cells up to
0.25 micons (or 0.00004 of an inch), which improves the vision. Usually,
only about 50 microns of tissue (about half the thickness of human hair)
are removed to achieve the correct amount of vision correction.
What does each procedure involve?
In LASIK, a thin layer of the corneal (outer covering) stroma is fashioned
using a microkeratome (cutting) instrument and this tissue is set back in
place after the laser procedure is done. LASIK reshapes the corneal tissue
underneath the surface of the cornea, while PRK uses laser to remove the
epithelium, a thin protective 'skin' on top that covers the cornea, before
the actual corrective treatment is performed. For Intacs, two tiny
incisions and tunnels are made on the outer edges of the cornea and the
Intacs (half-moon or C-shaped) ring segment is implanted in each tunnels
and a suture is placed.
What are Intacs?
Intacs are two mini half rings, made of biocompatible plastic that has been
safely used for about five decades in cataract operations and in contact
lenses. Intacs permanently corrects error of refraction when placed within
the outer edges of the eyes as described above.
What are the benefits of these procedures?
The corrective surgery decreases or eliminates the dependence on glasses or
contact lenses, increases safety while indulging in outdoor or sports
activities, provides more convenience, improves vision 24 hours a day and,
in some people, it may improve self-esteem, the look, or satisfy vanity.
Is general anesthesia used for this?
No, only topical anesthesia is used for these procedures. Eye drops to numb
the eyes are instilled prior to the surgery. This is enough to prevent the
patient from feeling any pain during the operation.
Does this correct aging vision?
Error of refraction in the elderly, usually starting from age 40, is called
Presbyopia. The three procedures mentioned above will not correct
Presbyopia. Those undergoing any of those vision correction surgery will
still need reading glasses.
Are there potential risks and side-effects?
Just like any surgery, these vision correction procedures have possible
risks and side effects. Following the surgery around 5 to 25 percent of
patients will have some haziness of vision that is aggravated at night. It
peaks at 8 to 12 weeks after treatment and, in almost all of the cases,
this problem resolves with eye drops and the natural healing process. Some
patients may notice halos or glare when looking at bright lights or it
night. A few of them may feel increased intraoccular pressure, and many
will experience some discomfort that is relieved by home painkillers like
acetaminophen (Tylenol). Infection is rare bin possible, it is best to
discuss all the details about the recommended procedure, advantages and
disadvantages, timing and sequence of surgery, possible risks and
complications with your ophthalmologist performing the procedure.
Can this procedure be done on a pregnant woman?
Because of the nature of the procedure, these laser-assisted procedures may
not he done during pregnancy, until three months after delivery and
breastfeeding. After the procedure, the patient should wait six months
before becoming pregnant.
How effective are these procedures?
The statistics from the Department of Ophthalmology and Visual Sciences of
the University of Iowa Hospital in Clinics, one of the top eye centers in
the United States, provided to me by my daughter, Emily Chua-Greenlee,
M.D., a senior ophthalmology resident there, show that their results at
UIHC provided 95 percent of eyes treated improved 20/40 vision, the legal
driving limits in most states, following the procedure. One half to 2/3 of
the patients obtained a 20/20 vision (normal without prescription
eyeglasses) after the surgery.
What is the cost for refractive surgery?
The package fee is about $1,800 per eye for LASIK and PRK, and $2,000 per
eye for Intacs. This includes the hospital and physician charges and
follow-up visits for one year.
Who are candidates for this vision correction?
Those age 18 or older, with otherwise healthy eyes, with mild to moderate
nearsightedness (-1.00 to -14.0 dopsters), farsightedness (+1.50 to +4.00
dopsters) and astigmatism are good candidates for LASIK or PRK. For Intacs,
the best patients are those with nearsightedness (-1.00 to -3.00 dopsters).
These procedures will provide better vision without eyeglasses or contacts,
but none of them will give perfect vision. A realistic expectation is very
essential with this refractory surgery.
Where can on get more information?
A source of more information on these refractory surgery is the internet.
Go online at the following websites: www.webeye.ophth.uiowa.edu and
www.getintacs.com Telephones: For LASIK and PRK, dial 001-319-353-7625, and
Intacts, call 001-888-846-8227. The nearest source is, of course, your own
ophthalmologist in town.
Article copyright Filipino Reporter.
Article copyright Filipino Reporter.
V.29;
Filipino Reporter
10-25-2001
FOCUS@HEALTH: Vision correction surgery may stop use of eyeglasses
What is vision correction surgery?
Vision correction or refractive surgery is an operation on the eyes to
correct error of refraction, like nearsightedness, farsightedness and
astigmatism, to eliminate the use of prescription eyeglasses or contact
lenses.
What are the various procedures available today?
The advent of Excimer laser in 1988 ushered in a new revolutionary era in
vision correction. It provided added lifestyle choices made possible by the
freedom from, or dependence on, prescription eyewears. That important
technological advance resulted in major treatment modalities not possible
before then. The three popular procedures for refractive surgery today are
LASIK (Laser Assisted In-Situ Keratomileusis or Laser Vision Correction),
PRK (Photorefractive Keratectomy) and Intacs (Corneal Ring Segments)
implants.
What is Excimer laser?
Excimer laser is a computer-controlled ultraviolet beam of light that
reshapes the cornea (outer window of the eye), resulting in the light
focusing more directly on the retina at the back of the eye. Excimer laser
gives out a cool or nonthermal (not hot) light beam, making it ideal for
corneal surgery, eliminating the possibility of thermal burns to the
surrounding tissues. Each laser pulse is so accurate it achieves disruption
and removal of the molecular tissue bonds between the corneal cells up to
0.25 micons (or 0.00004 of an inch), which improves the vision. Usually,
only about 50 microns of tissue (about half the thickness of human hair)
are removed to achieve the correct amount of vision correction.
What does each procedure involve?
In LASIK, a thin layer of the corneal (outer covering) stroma is fashioned
using a microkeratome (cutting) instrument and this tissue is set back in
place after the laser procedure is done. LASIK reshapes the corneal tissue
underneath the surface of the cornea, while PRK uses laser to remove the
epithelium, a thin protective 'skin' on top that covers the cornea, before
the actual corrective treatment is performed. For Intacs, two tiny
incisions and tunnels are made on the outer edges of the cornea and the
Intacs (half-moon or C-shaped) ring segment is implanted in each tunnels
and a suture is placed.
What are Intacs?
Intacs are two mini half rings, made of biocompatible plastic that has been
safely used for about five decades in cataract operations and in contact
lenses. Intacs permanently corrects error of refraction when placed within
the outer edges of the eyes as described above.
What are the benefits of these procedures?
The corrective surgery decreases or eliminates the dependence on glasses or
contact lenses, increases safety while indulging in outdoor or sports
activities, provides more convenience, improves vision 24 hours a day and,
in some people, it may improve self-esteem, the look, or satisfy vanity.
Is general anesthesia used for this?
No, only topical anesthesia is used for these procedures. Eye drops to numb
the eyes are instilled prior to the surgery. This is enough to prevent the
patient from feeling any pain during the operation.
Does this correct aging vision?
Error of refraction in the elderly, usually starting from age 40, is called
Presbyopia. The three procedures mentioned above will not correct
Presbyopia. Those undergoing any of those vision correction surgery will
still need reading glasses.
Are there potential risks and side-effects?
Just like any surgery, these vision correction procedures have possible
risks and side effects. Following the surgery around 5 to 25 percent of
patients will have some haziness of vision that is aggravated at night. It
peaks at 8 to 12 weeks after treatment and, in almost all of the cases,
this problem resolves with eye drops and the natural healing process. Some
patients may notice halos or glare when looking at bright lights or it
night. A few of them may feel increased intraoccular pressure, and many
will experience some discomfort that is relieved by home painkillers like
acetaminophen (Tylenol). Infection is rare bin possible, it is best to
discuss all the details about the recommended procedure, advantages and
disadvantages, timing and sequence of surgery, possible risks and
complications with your ophthalmologist performing the procedure.
Can this procedure be done on a pregnant woman?
Because of the nature of the procedure, these laser-assisted procedures may
not he done during pregnancy, until three months after delivery and
breastfeeding. After the procedure, the patient should wait six months
before becoming pregnant.
How effective are these procedures?
The statistics from the Department of Ophthalmology and Visual Sciences of
the University of Iowa Hospital in Clinics, one of the top eye centers in
the United States, provided to me by my daughter, Emily Chua-Greenlee,
M.D., a senior ophthalmology resident there, show that their results at
UIHC provided 95 percent of eyes treated improved 20/40 vision, the legal
driving limits in most states, following the procedure. One half to 2/3 of
the patients obtained a 20/20 vision (normal without prescription
eyeglasses) after the surgery.
What is the cost for refractive surgery?
The package fee is about $1,800 per eye for LASIK and PRK, and $2,000 per
eye for Intacs. This includes the hospital and physician charges and
follow-up visits for one year.
Who are candidates for this vision correction?
Those age 18 or older, with otherwise healthy eyes, with mild to moderate
nearsightedness (-1.00 to -14.0 dopsters), farsightedness (+1.50 to +4.00
dopsters) and astigmatism are good candidates for LASIK or PRK. For Intacs,
the best patients are those with nearsightedness (-1.00 to -3.00 dopsters).
These procedures will provide better vision without eyeglasses or contacts,
but none of them will give perfect vision. A realistic expectation is very
essential with this refractory surgery.
Where can on get more information?
A source of more information on these refractory surgery is the internet.
Go online at the following websites: www.webeye.ophth.uiowa.edu and
www.getintacs.com Telephones: For LASIK and PRK, dial 001-319-353-7625, and
Intacts, call 001-888-846-8227. The nearest source is, of course, your own
ophthalmologist in town.
Article copyright Filipino Reporter.
Article copyright Filipino Reporter.
V.29;
