Article by Kyle Roach
Founded in 1986, The Idaho Eye and Laser Center of Pocatello, Rexburg and Idaho Falls has consistently provided patients with top quality eye care since its beginning. Attributes that place Idaho Eye and Laser Center at the forefront of eye care include: top-quality doctors and medical staff along with cutting edge technology. In fact, The Idaho Eye and Laser Center was the first practice in Southeastern Idaho to perform Lasik eye surgery.
Dr. Bradley P. Gardner, of The Idaho Eye and Laser Center, has witnessed many advances in eye care technology since he first began practicing. Dr. Gardner performed a “fellowship” training program in 1992 and 1993 with the corneal research team at Louisiana State University that preformed the world's first excimer laser treatment. Dr. Gardner recalls that the first laser treatments only treated patients who had near-sighted vision. With new ablation profiles he can now easily treat farsightedness and astigmatism. Since then, eye care technology has continued to improve and The Idaho Eye and Laser Center offers various treatment options that take full advantage of technology for the treatment of a variety of eye corrections.
Lasik
Excimer laser vision correction can be divided into two categories: Photorefractive keratectomy (PRK) or surface ablation and Lasik (the same procedure, only performed under a thin flap of corneal tissue created by a blade or femtosecond laser).
The quality and safety of both eye treatments has increased dramatically since the first procedures were performed. Accordingly, The Idaho Eye and Laser Center is currently on their fourth laser upgrade in order to perform the best laser treatment available. These new laser technologies allow the doctors to perform blade free Lasik. In the past, cuts with a blade would open up a flap to allow an eye surgeon to perform the Lasik treatment. The blade has been replaced by a femtosecond laser to create the flap. The laser provides a thinner flap in order to maintain the strength of the cornea. The combination of two lasers during a laser vision correction will provide the highest quality, and safest Lasik surgery available.
Dr. Gardner notes that the newest laser technology has also significantly reduced the “halo affect”—a post eye surgery side-affect that can cause patients to see a halo around lights during the night. This is because of the new ablation profiles with larger optical zones and tapered edges. In addition, The Idaho Eye and Laser Center utilizes software and hardware that will provide a customized, or optimized, laser treatment to each individual patient. After the patient is evaluated a specific treatment plan is tailored just for them.
PRK
Lasik is limited in its correction abilities, however. When analyzing whether or not a patient is a candidate for Lasik, doctors will look at an individual’s prescription, thickness of cornea, shape of cornea and other potential factors that they believe will contribute or take away from the success of the Lasik procedure. One common option—if an individual is not a candidate for Lasik—is to perform another laser procedure called PRK.
All laser vision correction surgeries work by reshaping the cornea of the eye so that light traveling through it is properly focused onto the retina located in the back of the eye. During PRK, an eye surgeon will use the same laser of ultraviolet light as used in Lasik to reshape the cornea. PRK is used on the surface of the cornea, not underneath a corneal flap, as in Lasik surgery. In the end, the patient will have essentially the same outcome as Lasik.
ICL
Despite these many advances in laser vision correction, some patients are told they are not candidates for the procedure. This could be because their correction is too high, or their cornea is too thin or irregular. In these cases ICL’s or CLE procedures may be recommended.
ICL (Intraocular Contact Lenses) are approved for moderate to high amounts of nearsightedness. “Unlike Lasik, the procedure avoids altering the cornea” states Dr. Gardner while describing the process. “A small incision is made in the periphery of the cornea and the ICL is inserted over the natural lens.”
The advantage the ICL’s have – as with Lasik – is that they do not effect accommodation (the way the eye increases optical power). This is necessary to produce a clear image (focus) on an object when it draws near the eye. Presbyopia, loss of accommodation and need for reading glasses, usually manifests in the mid 40’s. Therefore ICL’s are only FDA approved up to age 45. For patients over 45, a CLE (Clear Lens Exchange) procedure may be indicated.
CLEAR LENS EXCHANGE
In this procedure the natural lens is replaced by a prosthetic intraocular lens. This is the same operation as cataract surgery, only with a clear lens, and not an opacified or cataractous lens. Cataracts are generally slow growing and present in an older population. Cataract surgery is the most common operation over age 65. “The advantage with this procedure is that the lens is removed, so the patient will not need cataract surgery in the future, unlike with a Lasik or ICL procedure,” said Dr. Gardner.
CLE procedures can correct nearsightedness, farsightedness and astigmatism. In addition, multifocal intraocular lenses in certain patients can be used to restore both near and far vision allowing even more freedom from glasses or contact lenses.
So while Lasik is the most popular—and the most preferred if the patient is cleared for the procedure—it is not the only option. If you were told you were not a candidate for Lasik but still desire better vision without glasses or contacts ask your eye doctor about some of the other options discussed above.