Question of the week

I've talked with several different laser centers, and it seems all of them have different machines for laser eye surgery, and each claims that their machine is the best. Why aren't all lasers the same?
For the same reason that all stereos are not the same, or all cars are not the same. All excimer lasers that are used in the United States must be approved by the Food and Drug Administration (FDA), but they are of varying quality. The top quality lasers are the Alcon LadarVision and the Visx Star. Lower quality lasers (like the Nidek or Summit Apex) do not produce the same level of accuracy of results. These budget lasers cost less money to buy and to maintain and are often used by discount centers. 


I have heard from several people that the Alcon LadarVision laser is the best laser. Can you tell me more about this?
At the Caster Eye Center we have extensively used both the Alcon LadarVision and Visx Star lasers, which are widely recognized as the two best lasers. In head to head testing in our practice involving over a thousand patients, we obtained the most accurate results with the Alcon LadarVision laser. In addition to obtaining the most accurate results, the Alcon LadarVision has the largest treatment zones of any laser (50% larger than the Visx), which virtually eliminates the halos and glare commonly associated with the Visx and other lasers. 


I had Lasik 6 months ago at another center, and now have problems with my nighttime vision. I see patterns around lights, which sometimes make it hard for me to drive at night. Does this happen to everyone who has Lasik?
No. These patterns, called haloes, are common in Lasik patients whose pupils are larger than the treatment area of the laser used in their Lasik procedures. This effect is no longer a serious problem with the arrival of the Alcon LadarVision laser. This laser allows us to set the diameter of treatment as wide as necessary to avoid this effect. 


Can Lasik eye surgery correct my reading vision? 
Lasik alters the shape of the cornea, which is the clear tissue in the very front of the eye. The need for reading glasses that comes as we get older (known as presbyopia) is a result of the aging of the lens deep inside the eye, behind the colored part of the eye. So Lasik cannot correct presbyopia. However, Lasik can be used to create monovision, just as glasses or contact lenses do, in which one eye is adjusted for distance and one for near. Many people have monovision with their contact lenses and prefer it to the alternative of using reading glasses. We can produce the same effects with Lasik. If you are considering monovision, we highly recommend that you try it first (we do this as part of our routine, pre-op consultation). 


I wear rigid contact lenses, and have been told that I will have to wear glasses for a few weeks before I can have Lasik eye surgery. I hate the feel of my lenses, but I LOVE the vision I get from them. Why is it necessary for me to go without them for so long before surgery?
Contact lenses can alter the shape of your cornea, and cause corneal swelling. Prior to surgery, we do measurements that need to be very exact. So, we must allow adequate time out of contacts to be sure that our preoperative measurements of the cornea are as precise as possible. With soft lenses, we ask a patient to remain out of them for 7-10 days before the preoperative exam. With rigid lenses, the patient needs to discontinue their use for a longer period of time. We use the safe, conservative rule of thumb: 1 month of rigid lens discontinuation for every decade of rigid lens use. During this time you can wear soft lenses. So, if you've been using your rigid lenses for 20 years, you will need to stay out of them for 2 months. We also recommend coming in for a progress check every 2-4 weeks during this process to check on your corneal condition.