Dan's Papers - May 30, 2008 - A Clear Picture of Laser Vision Correction Surgery

Laser vision correction ranks as one of the most frequently performed elective surgery procedures in the United States. The treatment, designed to free patients from their dependency on glasses and contact lenses, has been around for 18 years. The technique was pioneered by a small group of doctors in the States that included Sandra Belmont, M.D. as an investigator for the FDA. In 1997, Belmont became the Founding Director of the Cornell Laser Vision Center at New York Presbyterian Hospital. At present, she serves as Director of the Resident Refractive Surgical Education/Laser Vision Correction program at NYU School of Medicine, and is in private practice in Southampton. Recently she offered her perspective on the current state of laser vision correction, beginning with the anatomy of the eye.

When the eye is ideally shaped, light enters through the cornea and continues through the pupil and the natural lens inside the eye to come into focus on the retina, the back of the eye. Nearsightedness results from an eye that is elongated or a cornea that is excessively curved, causing light to come into focus before it gets to the retina. Farsighted patients have eyes that are shorter than normal. Their corneas lack sufficient curvature, so light is being focused behind the retina. Astigmatism describes a cornea that is shaped more like a football than a baseball, so there are multiple points of light that are not focused on the retina. The net result for all three irregularities is blurred vision. Presbyopia is a bit different. It's the loss of reading vision that develops during the late 40s and 50s as part of the natural aging process.

Laser vision correction is used to restore a patient's ability to focus at near, among other things. The procedure uses an excimer laser to generate a cool beam of light that can gently reshape the cornea. It compensates for an eye that is not ideally shaped for allowing light to come into sharp focus on the retina itself. Initially approved for low levels of nearsightedness, as new technologies, products and surgical developments have been introduced, laser vision correction has evolved to treat a wide range of problems, including moderate to high levels of nearsightedness, farsightedness, astigmatism and presbyopia. Most patients are excellent candidates for this surgery and have ranged in age from 18 to 85.

The increased collaboration between physicians and engineers has produced great advancements during this decade, including a whole new family of devices. Instruments like the aberrometer, or wavescan, allow us to evaluate a person's entire optical system, allowing doctors to fine tune the treatment for each patient. And many patients once considered non-candidates can now benefit from these custom treatments. The most advanced lasers also use iris registration, a biometric identification technology that insures exact alignment for patients. This is particularly critical for correcting astigmatism. Diagnostic imagers like the Oculus Pentacam can produce high resolution, 3-D images of the entire front of the eye. This level of detail allows us to not only treat conditions that were difficult to address with glasses and contact lenses, it also provides superior visual outcomes for the great majority of patients with increased safety.

For more information on laser vision correction, contact Sandra Belmont, M.D. at her office in Southampton, located at 365 County Rd. 39-A, Suite 2, 631-276-6023.