Surgery Options Available

Throughout history, mankind has experimented with ways to improve vision with external aids and instruments. Once, not that long ago, the only option for vision correction came in the form of glasses or contact lenses. The onset of laser-vision correction surgery widened those options, bringing people even closer to perfect vision.

Before the appearance of computers and lasers, the main tools available to an eyecare specialist were a scalpel, a steady hand, a medical background and perhaps some engineering knowledge. The premise was that if they could modify the shape of the cornea, then possibly they could effect permanent improvement to their patient's vision. The first procedure to show the possibility of achieving a positive result was called Radial Keratotomy or RK.

RK is a procedure in which a diamond blade is used to make micro-incisions in the cornea in a spoke-like pattern, to treat mild levels of nearsightedness and astigmatism. The number of incisions and their location is determined by the degree of nearsightedness. These incisions allow the sides of the cornea to bulge outward and thereby flatten the central portion of the cornea. This brings the focal point of the eye closer to the retina to improve distance vision.

The first in the line of laser procedures for vision correction was Photorefractive Keratectomy or PRK.

PRK is a laser vision correction procedure that uses an excimer laser to treat mild to moderate levels of nearsightedness, farsightedness and astigmatism. Rather than making cuts in the cornea, the PRK process uses an excimer laser to sculpt an area of 5 to 9 millimeters in diameter on the surface of the eye. Usually one eye is done at a time, as functional vision may not return to normal for several days to several weeks. There is usually discomfort with PRK until the cornea heals completely.

Then came one of the most promising and exciting developments in the world of refractive surgery - LASIK. LASIK, or Laser Assisted In Situ Keratomileusis, is an innovative type of laser vision correction. The procedure, which is performed on an outpatient basis under local anesthesia, corrects moderate to high levels of nearsightedness, farsightedness, and astigmatism. LASIK is a simple, fast and highly predictable surgical procedure, performed in an appropriate sterile environment. In this procedure, an automated microkeratome is used to create a corneal flap and the excimer laser is then used to ablate the cornea. LASIK certainly proved to be far superior than its predecessors because of minimal discomfort and faster recovery.

Until now, visual disorders including nearsightedness, farsightedness and astigmatism had been treated with excimer lasers. As a rule, this treatment had no effect on the visual acuity. Patients did after the surgery without glasses or contact lenses, as well as they did before the surgery with their visual aids.

But now, a new approach to refractive surgery - Wavefront Guided Custom LASIK - is primed to transform vision correction, yet again! It can be said that Wavefront technology is the magical "pot-of-gold at the end of the rainbow" to getting better than perfect vision. Instead of just correcting defocus (spherical and cylindrical) errors, we can now take a wavefront image - literally, a 'fingerprint' of each person's optical pathway - and use the information to reduce or even eliminate higher order aberrations. So, for the first time, we have technology that can potentially achieve better than 20/20 vision.

Acuity correction involves, first determining the individual irregularities of the human eye that limit the quality of the retinal image. Light rays enter the eye as flat sheets known as wavefronts. If the optical system is perfect (which is unusual), these wavefronts exit the eye as regular, flat sheets. When the cornea or other components of the optical system have imperfections, higher order aberrations are created, causing the wavefronts to exit the eye as irregular curved sheets of light. The ascertainment of these optical aberrations has been made possible with the use of a device known as the 'aberrometer'. Following this measuring procedure, the eye is reconfigured in abstraction from its irregularities. Then, with reference to the new configuration, the corneal surface is selectively reprofiled with the use of a high resolution excimer laser beam. This procedure allows for an optimal, eye specific correction that is unattainable without unique customization unlike previous techniques of laser surgery.

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So finally, the choices are numerous - some good, some not so good, and some, better than excellent. The decision is yours to take. Weigh your options with an open mind and walk into the world of good vision.