About Dr Boothe and eye surgery

March 2008

3/10/08

« March 2008 Archive

Monday, March 10, 2008
12:37:00 PM EDT

About Dr Boothe and eye surgery

Dr Boothe, LASIK eye surgery is the most popular refractive laser eye surgery. LASIK involves the use of a laser to change the shape of the cornea to correct refractive errors such as nearsightedness, farsightedness and astigmatism. Dr Boothe, LASIK is a permanent vision correction procedure since it is a type of surgery which is not reversible. Thanks to advanced technology, LASIK provides an excellent safety profile and results when performed by experienced LASIK Surgeons for carefully selected patients.

LASIK is not right for everyone and requires careful evaluation and consultation.Today more people are routinely electing to have LASIK to correct their vision as it is a suitable substitute for eyeglasses and contact lenses for most common vision problems. LASIK is a quick eye surgery procedure that provides good vision with few postoperative complications for most people. LASIK is not suited for everyone including people with certain health problems, eye diseases, and other situations that an eye care professional can help to explain in detail as part of your consultation.

Dr Boothe, LASIK Laser Eye Surgery Process
The LASIK eye surgeryprocess requires that a series of careful measurements be taken to be sure that you are a good candidate. This process should begin with a discussion regarding what your expectations are and what you wish to achieve by being less dependent or eliminating eyeglasses or contact lenses. Then a careful review of you health and eye history should be taken by the doctor's office. Next, in order to determine the exact prescription that will need to be treated, a refraction should be performed to measure the amount of nearsightedness or farsightedness and astigmatism. This will require the use of eye drops to get the best possible measurements. It will be necessary to map the surface of the eye, called the cornea, with a corneal topographer that gives the doctor a blueprint of the shape of your eye. An important step is to measure the corneal thickness, called pachymetry, in order to help determine whether the anatomy of your corneal is appropriate for LASIK orperhaps another laser eye surgery procedure. Once all of these steps have been completed, the doctor will examine the health of the retina and inside structures of your eyes as a final check.

On your day of surgery, a technician will clean the area around your eyes with a hygienic but gentle cleansing pad. The technician will place a series of drops into your eyes in order to get them ready for your treatment. Some of these drops, antibiotic drops, will prevent germs from entering your eye and therefore help to prevent any possibility of infection. Other drops will be placed in your eyes to lightly numb the cornea so that you are comfortable during your treatment. After you recline on the bed-like chair under the laser, an eyelid holder called a speculum, is gently placed between your eyelids to remind you not to blink. Next the LASIK surgeon will use an instrument called a microkeratome to create a very thin, circular layer, called a flap on the front of the cornea. Since you have had numbing drops placed in your eyes, this will not be uncomfortable, but will feel like a slight pressure around your eyes. The surgeon will instruct you to look at a small light during your procedure. Don't worry if you cannot stay perfectly steady-just do your best. Today's laser technology uses a tracking system which will actually follow your eye movements if you can hold pretty still during your procedure. To correct nearsightedness, farsightedness or astigmatism, your surgeon will use an Excimer laser. The Excimer laser is programmed based on calculations made from the measurements taken during your consultation. The laser then delivers the exact correction needed and send tiny spots of light beams to certain predetermined positions on your cornea in order to change the shape to what is required for you to see well. The eye surgeon has full control of the laser and monitors the position of the laser on the cornea as well as the tracking system monitoring the position of your eye in order to make sure the beam is in the correct place. The creation of the flap and the application of the laser usually takes 5-7 minutes per eye depending on the complexity of the of correction that you need. Finally, the flap is replaced in its original position and because it has extraordinary bonding properties,it acts like Velcro to just stick right back down in place without the need for sutures. The technician will often place additional eye drops in your eyes as the procedure is finished just to give you some added comfort and protection and to help your eyes heal quickly. Most often a protective clear plastic shield will be applied-like safety glasses-to prevent you from rubbing your eyes or in case you get bumped accidentally. Pay careful attention to the detailed instructions your doctor gives you regarding additional drops to use at home and when to return for your first visit.

You will need someone to drive you home. To be most comfortable, you should go home and take a long nap. When you awaken you will notice several things. First you will notice a dramatic improvement in your vision. It will most likely not be as good as it will get in a few days as your eyes will need to continue to heal. You should expect to feel some mild "grittiness" or like a little sand or dust has gotten into your eyes for up to a day or so. This is normal. As your eyes heal it is normal and expected to be a little sensitive to light and perhaps see some glare or even haloes around lights at night. This too will diminish as your eyes heal.

Dr BootheLASIK Laser Eye Surgery Candidates
The best candidates for LASIK Eye Surgery are people with healthy eyes have not had previous eye surgery and are looking to correct myopia, hyperopia, or astigmatism. They must also have stable vision for at least a year. People with medical conditions and taking certain medication may not be eligible for LASIK eye surgery. Also some people with thin corneas may best be suited for other laser surgeries.

Wavefront technology in LASIK Eye Surgery
Wavefront technology is major advance in LASIK laser eye surgery, especially for people who have complicated prescriptions. It may sound a bit funny, but your eyes are like your feet. Shoes usually just come in sizes that measure how long the feet are. With normal LASIK surgery, vision correction is measured by the visual acuity of a person, 20/20, 20/40, 20/100 and how it is altered by the refraction of their eye. This method corrects how much a person can see but not the details of everything else. Imagine if shoes were made exactly for your feet by measuring how wide, how long, comfort level, arch, and so on. The result would be a great pair of shoes that fit perfectly. Wavefront technology does this for the eyes by measuring the whole eye and providing a three-dimensional corneal map. All abnormalities and irregularities, called optical aberrations, from front to back are present in this map and allow the eye surgeon to correct your vision to a "perfect fit". This allows correction for not only nearsightedness or farsightedness and astigmatism and its impact on visual acuity, but also for other aberrations that can affect contrast sensitivity, night vision, depth perception, and light sensitivity. By correcting all these factors, each individual's vision can be improved dramatically by correcting for the individual's specific problems.

LASIK is a surgical procedure intended to reduce a person's dependency on glasses or contact lenses. The goal of this Web site is to provide objective information to the public about LASIK surgery. See other sections of this site to learn about what you should know before surgery, what will happen during the surgery, and what you should expect after surgery. There is a glossary of terms and a checklist of issues for you to consider, practices to follow, and questions to ask your doctor before undergoing LASIK surgery.

LASIK stands for Laser-Assisted In Situ Keratomileusis and is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser. A mechanical microkeratome (a blade device) or a laser keratome (a laser device) is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middlesection of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced. There are other techniques and many new terms related to LASIK that you may hear about.

The eye and vision errors
The cornea is a part of the eye that helps focus light to create an image on the retina. It works in much the same way that the lens of a camera focuses light to create an image on film. The bending and focusing of light is also known as refraction. Usually the shape of the cornea and the eye are not perfect and the image on the retina is out-of-focus (blurred) or distorted. These imperfections in the focusing power of the eye are called refractive errors. There are three primary types of refractive errors: myopia, hyperopia and astigmatism. Persons with myopia, or nearsightedness, have more difficulty seeing distant objects as clearly as near objects. Persons with hyperopia, or farsightedness, have more difficulty seeing near objects as clearly as distant objects. Astigmatism is a distortion of the image on the retina caused by irregularities in the cornea or lens of the eye. Combinations of myopia and astigmatism or hyperopia and astigmatism are common. Glasses or contact lenses are designed to compensate for the eye's imperfections. Surgical procedures aimed at improving the focusing power of the eye are called refractive surgery. In LASIK surgery, precise and controlled removal of corneal tissue by a special laser reshapes the cornea changing its focusing power.

William Boothe, other types of refractive surgery
Radial Keratotomy or RK and Photorefractive Keratectomy or PRK are other refractive surgeries used to reshape the cornea. In RK, a very sharp knife is used to cut slits in the cornea changing its shape. PRK was the first surgical procedure developed to reshape the cornea, by sculpting, using a laser. Later, LASIK was developed. The same type of laser is used for LASIK and PRK. Often the exact same laser is used for the two types of surgery. The major difference between the two surgeries is the way that the stroma, the middle layer of the cornea, is exposed before it is vaporized with the laser. In PRK, the top layer of the cornea, called the epithelium, is scraped away to expose the stromal layer underneath. Dr William Boothe, in LASIK, a flap is cut in the stromal layer and the flap is folded back.

Another type of refractive surgery is thermokeratoplasty in which heat is used to reshape the cornea. The source of the heat can be a laser, but it is a different kind of laser than is used for LASIK and PRK. Other refractive devices include corneal ring segments that are inserted into the stroma and special contact lenses that temporarily reshape the cornea (orthokeratology).

Dr William Boothe, what the FDA regulates
In the United States, the Food and Drug Administration (FDA) regulates the sale of medical devices such as the lasers used for LASIK. Before a medical device can be legally sold in the U.S., the person or company that wants to sell the device must seek approval from the FDA. William Boothe, to gain approval, they must present evidence that the device is reasonably safe and effective for a particular use, the "indication." Once the FDA has approved a medical device, a doctor may decide to use that device for other indications if the doctor feels it is in the best interest of a patient. Dr Boothe the use of an approved device for other than its FDA-approved indication is called "off-label use." The FDA does not regulate off-label use or the practice of medicine.

The FDA does not have the authority to:

Regulate a doctor's practice. In other words, FDA does not tell doctors what to do when running their business or what they can or cannot tell their patients.
Set the amount a doctor can charge for LASIK eye surgery.
"Insist" the patient information booklet from the laser manufacturer be provided to the potential patient.
Make recommendations for individual doctors, clinics, or eye centers. FDA does not maintain nor have access to any such list of doctors performing LASIK eye surgery.
Conduct or provide a rating system on any medical device it regulates.
The first refractive laser systems approved by FDA were excimer lasers for use in PRK to treat myopia and later to treat astigmatism. However, doctors began using these lasers for LASIK (not just PRK), and to treat other refractive errors (not just myopia). Over the last several years, LASIK has become the main surgery doctors use to treat myopia in the United States. More recently, some laser manufacturers have gained FDA approval for laser systems for LASIK to treat myopia, hyperopia and astigmatism and for PRK to treat hyperopia and astigmatism.

What are the risks and how can I find the right doctor for me?
William Boothe, most patients are very pleased with the results of their refractive surgery. However, like any other medical procedure, there are risks involved. That's why it is important for you to understand the limitations and possible complications of refractive surgery.