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Advances in Ophthalmology




New technology and treatment modalities for visual acuity and major eye diseases have revolutionized the field of ophthalmology.

New technology and treatment modalities for visual acuity and major eye diseases have revolutionized the field of ophthalmology.

As more people opt for laser-assisted In situ keratomileusis (LASIK) procedures for vision correction, new technological advances are enhancing patient outcomes.

Tracking Success

Advanced control eyetracking allows patients with astigmatism to receive more effective LASIK treatment. For the first time, this revolutionary technology allows the laser used during LASIK surgery to compensate for eye movements during the procedure by adjusting for subtle rotations in the eye.

“During the LASIK procedure, the eyetracker technology can follow micromovements of the patient’s eye in more directions than any other available tracker,” says Amit Chokshi, M.D., a board-certified ophthalmologist at the Chokshi and Coluccelli Eye Institute in Jacksonville, FL, one of only 25 physicians offering this technology in the country. “The eyetracker ‘locks on’ to the eye’s unique iris pattern just before the laser treatment begins and monitors the pattern throughout the procedure. The rotation of the iris pattern is detected during the laser pulses, which immediately adjusts to the procedure, ensuring each laser pulse is directed to a specific place where the physician wants it on the cornea.”

This innovative technology compensates for any eye movement that may occur as the patient changes position, as well as any pupil movement that may occur due to exposure to light and dark. The technology also decreases the chance of future enhancement procedures for patients with astigmatism.

Surgical Solutions

To correct vision problems, more than 3 million people have undergone IntraLase Method LASIK surgery. This innovative procedure uses a computer-controlled excimer laser to correct myopia, astigmatism and hyperopia. The IntraLase Method is a blade-free technique used to perform the critical first step for LASIK — creating the corneal flap.

Traditional LASIK surgery uses a microkeratome, a hand-held instrument with a steel blade that moves back and forth to create a cut as it travels across the cornea. A microkeratome can only create a single, one-dimensional cut across the cornea. The blade oscillates back and forth as it cuts, which can leave an irregular surface after the flap is lifted. This process can affect the quality of a patient’s postoperative vision.

However, the unique IntraLase Method creates a precisely positioned layer of bubbles just beneath the surface of the eye, leaving a smooth surface once the flap is lifted. With this advanced method, a blade never touches the patient’s eye.

The IntraLase Method also allows physicians to tailor the dimensions of the flap based on what’s best for a particular patient’s eye. A physician can precisely determine everything from the diameter of a patient’s flap to the angle of its edges. Creating a corneal flap that’s individualized to each patient contributes to better patient outcomes.

“This leading-edge technology allows for the safest and most technologically advanced LASIK procedure,” says Dr. Chokshi.

An Alternative Option

Less well-known than LASIK, advanced surface ablation (ASA) is the preferred method for correcting nearsightedness, farsightedness and astigmatism in patients with thin corneas and various other eye characteristics. Although ASA was introduced before LASIK, the procedure has improved over time, offering high levels of precision and safety.

During a LASIK procedure, the created corneal flap is moved back to allow a laser to reshape the cornea, correcting the eye’s power to focus. The flap is then replaced, where it attaches naturally.

With ASA, the cornea is exposed through a process called surface ablation. A very thin segment of the eye’s outer epithelial layer is removed, revealing the cornea. Once the layer is removed, the cornea can be reshaped with the laser to improve vision.

Within weeks of surgery, this layer will regenerate naturally. ASA is recommended for patients with thin corneas because the technique does not penetrate as deeply into the eye’s surface as the LASIK flap.

A Review of Eye Health

According to the National Eye Institute, the most common eye conditions for people 40 and older include:

  • Cataracts cloud the eye’s clear lens and are the leading cause of blindness.
  • Glaucoma gradually damages the optic nerve responsible for carrying visual signals from the eye to the brain. More than half of all people with glaucoma are unaware they have it because a person only loses vision after a significant amount of nerve damage.
  • Macular degeneration damages the eye’s macula, causing loss of sharp, central vision needed for driving and reading.
  • Retinal diseases, such as diabetic retinopathy and retinitis pigmentosa, are a group of hereditary disorders that cause deterioration of the rod and cone cells in the retina.

The most common cause of vision problems for patients 50 and younger are refractive errors such as:

  • Astigmatism occurs when the cornea has irregular curvature.
  • Hyperopia or farsightedness is usually inherited.
  • Myopia or nearsightedness is inherited and often progresses through the teenage years when the body grows rapidly. People with higher degrees of myopia have a greater risk of detached retina.
  • Presbyopia may impact people after age 40 when the lens of the eye becomes more rigid and does not fl ex as easily. The result is that it is more difficult to read at close range.

MD News September 2010


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