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Vision Engineering

What Differentiates Vision Correction Providers?

 

A laser is a laser. A computer is a computer. The technology is what improves our eyesight. Right?

 

Wrong. Equipment may be expensive and excellent, but it’s only as effective as the person operating it can make it be. Choosing a good eye surgeon is not something to do with an eye to saving money, so to speak.

 

As Dr. Griffin in Sacramento, California, says, “You’re not buying a TV. If you don’t like the picture, you can’t return the eyes.”

 

But excellent equipment is certainly a necessity, so let’s start there. The finest equipment is:

· Up-to-date

· Good quality

· Accurate

· Safe

 

The best vision correction can only be done on the best equipment and buying cheaper equipment in order to make a better profit can only be done at your expense, the patient.

 

Types of equipment

 

Laser – The best is the Visx Star S4 excimer laser, used by about 59% of eye surgeons. Visx was a pioneer in this industry and starting in 1986 they spent a great deal of time and money on research and development.

 

This laser can use CustomVue Wavefront technology and offers the best correction for all combinations of nearsightedness, astigmatism, and farsightedness.

 

Some other lasers are:

· Alcon Ladarwave (used by about 19% of eye surgeons)

· Bausch and Lomb laser (used 11%)

· Wavelight laser (used 4%)

· Nidek laser (used 4%)

 

Microkeratome – a hand-held little blade instrument used to make the corneal flap in a LASIK treatment. The best one on the market is the German engineered Hansatome microkeratome, which has the lowest malfunction rate.

 

Some other microkeratomes have been reported to have malfunction rates as high as 1 in 200 treatments, because of their design or engineering flaws.

 

No surgical procedures are ever completely risk-free, and outcomes can never be 100% guaranteed. But excellent equipment will surely decrease risks and enhance outcomes.

 

The best initial evaluation

Lasers used for vision correction are directed by computers. Your eye surgeon will program the computer to direct the laser according to your specific eye conditions and needs.

 

To program the computer your eye surgeon will examine your eyes in many ways. Some are fairly standard to any vision correction center:

· Refraction test

· Pupil exam

· Eye motility exam

· Confrontational visual field

· Slit lamp exam

· Intraocular pressure test

· Dilation

 

Others are more specialized for laser treatments:

· Ultrasonic corneal thickness test

· Corneal curvature measurements

· Optomap retinal photographic analysis

· WaveScan analysis

 

All this data is carefully correlated with information gleaned from talking to you about:

· How you typically use your eyes each day

· How you need to be able to use them for recreational times

· Your expectations of laser vision correction

 

May take two visits to gather data

 

Data from these different tests are compared to each other and calculations are done to create an individual correction program for you. The best eye surgeons can in this way offer you a 98% chance of gaining 20/25 vision.

 

Some eye surgeons take less time collecting data, and will proceed with less detailed information. This will be a less-customized treatment and may have less-than-optimum results for you.

 

Many use a “plug and play” approach:

· Enter the glasses prescription into the laser’s computer

· Sit back while the laser system does the calculations for you

· This gives you a better-than-even chance of gaining 20/25 vision, maybe as high as a 75% chance. You deserve better.

Patient follow-up

 

Besides all the data collected from testing each individual, the best eye surgeons will factor in information gained from their experience over the years. Laser eye surgery has only been in existence since the 1980. In the early years there were some poor outcomes, especially in Europe, Canada and Britain. Over the years, it became evident that the best outcomes are achieved by the surgeons who do the most careful patient follow-up.

 

Follow-up exams

 

Vision correction outcomes are more than just how your vision is on the day after surgery. The outcome is an ongoing thing: how well your new vision holds up over time. This can and should be assessed periodically.

 

With such data, collected from all patients after their procedures, a good vision correction center can program their laser’s computer more and more accurately.

 

Offering more options

 

In a vision correction center which operates on volume rather than quality, it’s in their interests to offer you fewer options. Some will have you sign a 20/40 waiver before treatment, which eliminates you from any re-treatments, if your outcome is less good than expected. Some don’t offer monovision as a possible way to go. Remember that LASIK is not necessarily the best treatment for everybody. Neither is monovision, but it’s an attractive option to some.

 

Claims of vast numbers of surgeries done

 

A highly-experienced eye surgeon is of course to your advantage as the patient. You don’t want an eye surgeon learning his skill on your eyes.

 

· But be cautious about high numbers and look further into it if possible.

· They may be including re-treatments in the number

· They may be taking safety short-cuts for the sake of higher numbers

· They may be short-circuiting the data-collection phase so as to get on more quickly to the treatments

· They may be doing no patient follow-up, to save money, and to push more patients through

 

The best laser vision correction centers are the ones that consistently put safety and quality ahead of profit and numbers of patients seen. If you’re looking for a laser eye surgeon, do your homework carefully.

imeche's vision: Improving the world through engineering


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