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|| LASIK || Down-Up LASIK || Benefits of Down-Up LASIK || || Benefits & Potential Risks || Other Procedures ||
To find out more about LASIK or to attend a free information seminar, please contact the San Diego Eye Center at (619) 278-9900 or toll-free at 1-888-95LASER.
Since 1989 when the first LASIK procedure was performed,
the procedure has improved greatly. Thousands of patients have been successfully treated
with the classical method of cutting the corneal flap, starting from the side and stopping
by the nose before a complete circle has been cut to produce a nasal hinge. Down-up LASIK
differs from the classical LASIK technique in that using the newest technology
microkeratome (the Hansatome). The cut is performed from the bottom upward. This creates a
flap with a superior hinge that is in a more natural position than the nasal hinge. LASIK is quickly becoming the state of the art in this field, preferred over PRK. There has been one glaring shortcoming of routine LASIK: The instrument used to lift the layer is based on old instrumentation and can add risk to a safe procedure. It is combining a old instrument with the laser. Down-up LASIK combines a high tech device to raise the layer(the Hansotome), It was first introduced by a European ophthalmologist, Dr. Berratto, and is the latest breakthrough in LASIK research. Down-Up LASIK was first pioneered in San Diego by Dr. Leung, and he even performed the procedure on his own wife! As a specialist in refractive surgery Dr. Richard J. Leung has already performed thousands of laser procedures and pioneered the Down-up LASIK technique in San Diego. Dr. Leung is experienced in assessing whether the LASIK procedure is most appropriate for the patient -- based upon the individual's eyes, range of correction and lifestyle needs. To find out more about Down-up LASIK or to attend a free information seminar, please contact the San Diego Eye Center at (619) 278-9900 or toll-free at 1-888-95LASER.
The new device has many safety features that the present one does not have. It creates the flap on the cornea from a different direction. The layer is lifted from the lower position upward, therefore it is called "Down-Up". a.. With the superior hinge, the up and down movement of the eyelids as well as gravity keep the flap in its "natural position" for better healing. b.. There is more comfort and less foreign body sensation post-operatively that may cause excessive tearing. c.. Safer. d.. Quicker return of vision. e.. Can create a flap large enough to be used on farsighted people.
RESULTS The majority of patients no longer need glasses or contact lenses for distance vision after laser vision correction. Almost all patients who have excimer laser see better without glasses after the procedure. Nationwide data shows that after the initial treatment, about 75% of patients will have 20/20 or better vision without glasses, and about 95% will have 20/40 or better vision without glasses. 20/20 is considered "perfect" vision; 20/40 vision is good enough to pass the driver’s vision test without glasses in the state of California. For patients with mild nearsightedness, the results are even better. If needed, the results can be further improved through an enhancement laser procedure. These results are very impressive, but it is impossible to tell a patient exactly what his or her results will be. No guarantees can be made about the outcome of laser vision correction in any individual case, because each person responds in a slightly different way. If a person will only be satisfied with "perfect" 20/20 vision without glasses after laser vision correction, then that person should not have the procedure. A person should avoid any doctor or clinic that promises a specific result, because that simply is not possible. The quality of vision after treatment is usually superior to vision with contact lenses or glasses. Patients generally have less glare than they had with contact lenses, and of course the inconvenience and discomfort of contact lenses is eliminated. The problem of contact lens allergies is eliminated. Peripheral vision isn't blocked, as it is with glasses, and there is no longer the problem of dirty, wet or scratched glasses. However, while glasses and contact lenses can almost always provide "perfect" 20/20 vision, this is not always possible with laser vision correction. RISKS AND COMPLICATIONS All eye surgery carries risk and not all possible risks can be listed here. Excimer laser treatment is subject to complications, but the complication rate is very low. By far the most common complication of excimer laser treatment is under-correction or over-correction. These complications occur because the patient experiences an abnormal healing response, or because slightly too much or too little tissue is removed from the surface of the cornea. Undercorrection may occur when not all of the patient’s prescription is corrected. For significant undercorrection, enhancement surgery or "touch-up" may be indicated. Overcorrection may occur when the surgery corrects more of the prescription than intended. At present significant overcorrection is treated with glasses or contact lenses. Once the laser is approved for hyperopia, this may be used to treat overcorrection. Under-corrections and over-corrections are the main reason that all patients do not have perfect uncorrected vision after the excimer laser treatment. No patient can be guaranteed perfect uncorrected vision after excimer laser treatment. If a person will be satisfied only with 20/20 uncorrected vision, then that person should not have the procedure, because this result cannot be guaranteed. In patients who are presbyopic, having vision corrected for distance in both eyes will result in the loss of the ability to see up close without glasses. This is treated with reading glasses. Side effects such as light sensitivity, haloes, ghost images and glare are seen in approximately 2% of patients and are usually gone within a few days after surgery but may persist for several months. Corneal scarring or haze may been seen with excimer laser surgery, but more commonly when PRK is used for higher levels of myopia. Extremely rare but possible complications include retinal detachment, eyelid drooping, glaucoma and cataracts. Complications specific to the microkeratome procedures include problems with the creation or healing of the flap, equipment problems, in growth of cells from the top layer of the cornea and irregular astigmatism. With any surgery in the body there is a risk of bleeding or infection. Dr. Leung uses every precaution to prevent infection at the time of surgery which includes the use of plastic sterile drapes around the eyelid, sterile gloves and technique. Antibiotics are prescribed after surgery to prevent infection. Following physician's orders will decrease the infection rate to far below 1%. Even if infection does occur, the use of antibiotic eye drops will almost always control the infection. This is not meant to provide an informed consent, and it is important for a patient to discuss all risks and complications in detail with his or her physician.
OTHER PROCEDURES INTACS: This procedure for correcting nearsightedness involves the implantation of two plastic arcs, several millimeters apart, in the stromal tissue layer of the cornea outside of the central zone. One of the major advantages of the procedure is that the refractive result may be adjustable or reversible. Thermokeratoplasty: This procedure has shown promise for the treatment of farsightedness and astigmatism. The curvature of the cornea is changed with heat that shrinks protein structures within the cornea. This is performed by a special laser called the Holmium YAG laser. Clear lens extraction and intraocular lens implants: This procedure, also known as lensectomy, is used to reduce severe nearsightedness or farsightedness. Similar to cataract surgery, a plastic intraocular lens is inserted after the natural crystalline lens of the eye is removed. Intracorneal Lens: This procedure involves implanting a tiny plastic prescription lens, similar to a contact lens, within the corneal tissue for treatment of myopia. Another intracorneal lens currently being investigated is for treatment of presbyopia. 10 Reasons to choose SAN DIEGO EYE CENTER
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Laser Assisted In Situ Keratomileusis (LASIK) combines PRK with
elements of ALK. LASIK is considered most effective for patients with higher levels of
nearsightedness, but can be done for low-to-moderate levels as well. A surgeon uses an
automated microkeratome to create a thin, flap cornea tissue. He then uses the excimer
laser to vaporize a thin layer of the underlying cornea, and the top flap is carefully
placed back in its original position. The procedure is painless and patients usually have
minimal to no pain postoperatively. Studies have shown that 70% of patients see 20/40 or
better on the first post-operative day. The main risk is related to the making of the
corneal flap, but in expert hands the risk is only 1 to2%. With LASIK, both eyes may be
operated on the same day if the patient desires and the physician concurs. LASIK is
currently being evaluated by the FDA for safety and efficacy at clinical trial sites, but
is quickly becoming the procedure of choice by refractive surgeons all over the world. Dr.
Leung chose bilateral LASIK as the procedure of choice to correct his own nearsightedness,
and now he enjoys vision better than 20/20!
As a specialist in refractive surgery Dr. Richard J. Leung has
performed thousands of laser procedures and pioneered the Down-up LASIK technique in
San Diego. Dr. Leung is experienced in assessing whether the LASIK procedure is most
appropriate for the patient -- based upon the individual's eyes, range of correction and
lifestyle needs.
