Technology Update
This section is dedicated to keeping our patients up to date on the latest technology and helps you discern what is “hype” from what is a real advance.
First of all, LASIK is still king!! It replaced RK and PRK as the standard of care in 1998 and is still going strong. Since 1998, several new technologies have come and gone because they did not provide the safety or results that LASIK did.
INTACS – originally touted as better than LASIK and would replace LASIK because it was safer and didn’t disturb the center of the cornea over the pupil. Intacs never grew popular because of the high infection rate and inability to treat astigmatism or myopia greater than 2 diopters. Intacs currently are only used in treating a condition called keratoconus.
Holmium laser ( Sunrise tech., inc.) – only treated farsightedness and induced astigmatism. Most patients regressed after several months and had to be redone with LASIK. Sunrise technologies went bankrupt
LASEK – this is similar to LASIK but only the epithelium (superficial layer) is made into a flap. LASEK is losing popularity among surgeons as it’s more difficult than LASIK and patients have a slower recovery of vision. Dr. Walter prefers PRK in cases of thin corneas.
CK – or Conductive Keratoplasty . See Holmium Laser, same basic technology. CK only treats hyperopia and induces astigmatism. It has been marketed aggressively and touted to correct presbyopia so patients can get rid of reading glasses. The truth is you must do this in a monovision (making only one eye nearsighted) fashion. So LASIK can do the same thing, safer and more reliable.
Lens Replacement Surgery – Dangerously bordering on malpractice, surgeons are replacing the human lens with an artificial multifocal implant. While this is standard procedure for cataract patients, this is ill-advised for younger healthier patients. The reason is because of the high complication rate of lens replacement surgery in the younger (less than age 50) population. This surgery requires that the eyeball be opened and the middle part of the eye be manipulated. Numerous studies have show that there is a 4-5% chance of retinal detachment, a potentially blinding condition. There is also the 1% chance of endophthalmitis, or infection of the inner part of the eyeball. The cost of this surgery exceeds $5000 per eye. It does not treat astigmatism.
Intraocular contact lens(ICL) – This requires an implant to be placed into the front part of the eye and typically runs $5000 per eye. ICLs recently were FDA approved but there is limited data on long term results. Potential long term problems include cataracts, glaucoma and corneal swelling requiring a corneal transplant. Similar technology has caused these problems over 10 to 20 years after surgery.
Intralase - This is the name of the company that makes the femtosecond laser. This laser can be used to cut the cornea much like a microkeratome. It requires a separate procedure prior to the excimer laser and usually adds about 30 minutes per eye and $300 to $500 per eye in costs. It has not been shown to improve LASIK results beyond a mechanical microkeratome. However, it does have several disadvantages. The femtosecond laser has been shown to cause a higher rate of flap slippage after surgery in the order of 3 to 5%. It has also caused a syndrome known as TLS or transient light sensitivity. Some patients have had permanent light sensitivity beyond 6 months, requiring them to wear glasses indoors. The laser creates a “sticky flap” which is difficult to lift and may tear and prevent proper excimer laser treatment. Because of all of these problems and the controversy that has been generated, Wake Forest University Eye Center is not adapting this new technology until further investigation. The problem is the surgeon’s that have this Intralase have marketed it aggressively, and the general public concept is that since its “laser” it must be better than the blade; when in fact the opposite is true.
Orthokeratology - Often touted as "new" but has been around for 30+ years. It has been hyped as a non-surgical way to correct nearsightedness and astigmatism. It requires that you sleep in hard contact lenses that warp your cornea into a flatter and rounder shape, so that when you remove them in the morning you seen clearer without them. Ortho-K has several major risks and drawbacks and is not recommended by the American Academy of Ophthalmology or the Contact Lens Association of America. It only works as long as you sleep in the lenses EVERY night. Your vision may start out clear in the morning but gradually blur as the day goes on. You may be able to drive to work but not be able to see to get home. Wearing hard contact lenses at night cause blood vessels to grow into your cornea and increase your risk for infection. Ortho-K may warp your corneas so badly that you won't be a candidate for LASIK in the future.
See Clearly Method - Snake oil in it's purest 21st century form. Totally bogus, no scientific basis. Prays victim on people who want a non-surgical option to correct their vision and think that eye exercises and concentration will correct all optical misalignments. This simply defies the laws of physics. What they really want is your $9.95 for the "risk-free" trial period of 30 days. Just think if one or two million people sent you $10 for pamplets and CD's??? If you forget to send it back then you get billed... "the program cost is 5 easy payments of $69.80. The first installment will be billed 30 days from the order date." Don't be a sucker.