ABC’s of Laser Vision Correction
With so many options available for laser vision correction in Manhattan and across New York, New Jersey and Connecticut, coming to a decision regarding your treatment can be a confusing experience. You may have heard various terms and phrases, whether from friends or in the media, that have left you feeling quite baffled. What are the differences between LASIK, LASEK, Intacs®, PRK, surface laser, intracorneal implants, and conductive keratoplasty? Which technology is best for me; Wavefront®, CustomVue®, IntraLase®, bladed or bladeless technology, excimer laser, topography, Pentacam, phakic implants, or clear lens extraction? It is an alphabet soup of choices!
Take a deep breath and let Dr. Eric Mandel explain the ABC's of your laser eye surgery options. For more information, contact our New York LASIK practice in Manhattan, serving greater New York, New Jersey and Connecticut at 888-866-3681.
Your Laser Eye Surgeon
Let’s start off this explanation of laser eye surgery with a metaphor. Imagine your LASIK surgeon as a master carpenter. A master carpenter who does not use the best tools will get suboptimal results. Similarly, a merely average carpenter, even when using the best tools, will also get suboptimal results. That said, the quality of your results will depend heavily on which doctor you choose to perform your laser eye surgery. Some patients mistakenly think that anyone with top-notch equipment can achieve a superior outcome. Laser eye surgery, the most popular form of which is LASIK surgery, is a surgeon-dependent procedure. No amount of high-tech equipment can replace a skilled surgeon. So, choose your surgeon carefully. A good surgeon will spend time with you during your evaluation, answer all of your questions and address any concerns you may have, in addition to providing you with a detailed guide to your post-operative care.
Click here to learn about why you should choose New York LASIK surgeon Eric Mandel.
Click here to understand How To Choose a Laser Vision Correction Surgeon.
New Technology in Laser Eye Surgery
Now, let’s move on to the laser eye surgery technology used in our New York LASIK location, serving New York, New Jersey and Connecticut. LASIK is the most commonly performed procedure for laser vision correction. It can correct visual errors in the vast majority of farsighted, nearsighted, and astigmatic patients. During laser eye surgery, a paper-thin flap in the cornea is created to give a custom-designed laser access to the corneal tissue underneath. The laser that is used is an excimer laser, which Dr. Mandel began researching at Columbia in 1984, more than a decade before it received approval from the FDA for use in human treatment. The replacement of the flap after the laser treatment allows for a fast recovery. In fact, the day after their laser eye surgery, most patients are able to return to work or even exercise. It is not just the laser, but the longstanding technique that makes LASIK so popular.
The same excimer laser used to correct vision in LASIK is used for PRK. Unlike LASIK, PRK does not involve the creation of a flap in the cornea. In both LASIK and PRK, Dr. Mandel reshapes the tissue beneath the epithelium, the very thin top layer of the cornea. In PRK, the epithelium is removed. Because the epithelium is affected, the healing time is longer with PRK than with LASIK. Patients usually have to wear a bandage contact lens for five to eight days following the laser eye surgery, during which time the vision is somewhat blurred. In addition, steroid eye drops are used, and Vitamin C tablets are taken for up to one year.
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Frequently Asked Questions about Laser Eye Surgery
Why would someone have PRK when quicker and more comfortable results can be achieved with LASIK?
Patients with thinner corneas and those in occupations in which they have a higher chance of sustaining eye trauma are usually better candidates for a surface laser procedure, like PRK, rather than LASIK. For example, when Dr. Mandel consults with patients about laser eye surgery at his New York offices, also serving New Jersey and Connecticut, he often recommends surface laser procedures for those in the armed services and law enforcement, as well as those engaged in contact sports like kick boxing.
For more informtion about the various types of laser vision correction, click here to view New York LASIK FAQ's.
I want the best technology in laser eye surgery; are custom treatments with Wavefront® technology the way to go?
For many of the patients we serve in New York, New Jersey and Connecticut, we do use CustomVue® Wavefront® technology in their treatments. This refined system provides an advanced analysis of the visual system of the eye using Fourier analysis. Fourier analysis captures 240 microscopic spots on the eye and uses all of them to accurately correct your prescription. Fourier analysis has eclipsed another method, called Zernike polynomial analysis, which can only capture 40 spots. Only the VISX® Star S4 CustomVue® laser uses Fourier analysis.
Click on the link to learn more about Fourier Analysis and Wavefront® technology at our New York office.
How do I know if I am a good candidate for laser eye surgery?
Combining two screening technologies, called topography and pachymetry, with a comprehensive eye exam enables us to determine your candidacy for laser eye surgery. Topography is a two-dimensional representation of the three-dimensional contour of a cornea. Pachymetry is a measurement of the thickness of a cornea. When patients from Manhattan and across New York, New Jersey and Connecticut come to our office for a consultation to determine their candidacy for laser eye surgery, we take both their eye exam and information about their lifestyle into consideration.
What is the difference between bladeless and bladed laser eye surgeries?
While it is a common misconception among patients that the bladeless laser technique does not involve the creation of a flap, both bladeless and bladed laser eye surgery requires the creation of a corneal flap that is reproducible in both diameter and thickness. During bladed laser eye surgery, the flap is created with a microkeratome, a precise microscopic blade oscillating at a very high rate. With bladeless surgery, the flap is created using a special laser. The laser that creates the flap is different from the laser that corrects your prescription. The laser used to create the flap is a femtosecond laser, called the IntraLase® laser, and the laser that corrects your prescription is an excimer laser. The femtosecond technology has evolved considerably over the past two years.
What if I am not a candidate for these laser eye surgery procedures, are there other options?
The answer may be yes. Patients with very high prescriptions can consider intraocular implants. There are two types of implants for patients who suffer from extreme nearsightedness or farsightedness. There are implants that can be inserted near the iris, the colored part of the eye, and therefore do not require the removal of the eye’s natural lens; however, this technology is still at an early stage of development. A clear lens extraction, in which the natural lens of the eye is removed and replaced by an intraocular lens, is a more reliable procedure. In addition to distance correction, the implants can improve near vision for reading. ReZoom® and ReSTOR® lenses are two types of multifocal intraocular lens implants.
Other alternatives to laser eye surgery
Conductive keratoplasty is a technique in which the collagen fibers of the cornea are heated with radio waves to induce a steepening of the cornea. One reason this procedure is quite popular is that it can be used to treat presbyopia, something that laser surgery is not yet capable of. Only small farsighted prescriptions can benefit from this technology, and it cannot correct astigmatic prescriptions.
Intacs® are thin, circular plastic strips that are placed into the cornea in order to flatten the central part of the cornea. They cannot correct astigmatism but may be helpful in patients with abnormally shaped corneas, which occurs in keratoconus.
The best way to get answers to all of your questions and information about your specific case is to talk to one of the caring professionals at Mandel Vision® by calling 888-866-3681. If you are searching for laser eye surgery information, and are a resident of New York, New Jersey or Connecticut, we encourage you to visit our Manhattan LASIK practice.
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In the News
June 2012: Dr. Mandel was named one of New York Magazine’s Best Doctors
Click here to learn more about New York Best LASIK Doctor, Eric Mandel, M.D.