LASIK today is far advanced from where it was 10 years ago.  A simple look at the FDA results of excimer lasers just 10 years ago, shows that major improvements have been made in LASIK eye surgery.  What changes have occurred?

Eyetracking - Early lasers did not have eye trackers.  Eye tracking technology has improved over the past decade.  Turner Eye Institute has upgraded all lasers to the newest eyetracking technology.

Wavefront - Early lasers could only correct for near-sightedness and sometimes astigmatism.  Newer upgrades can now correct for many types of corneal aberrations and can provide a level of accuracy that was impossible just a decade ago.

Smaller spot size - smaller laser treatments increase the accuracy of the entire treatment.

Faster treatments - the frequency of the excimer laser has increased to shorten treatment times.  Shorter treatments are safer for the patient and cause less dehydration of the tissue.

Better nomograms - excimer laser manufacturers have improved the formulas they use to offer a more exact treatment to LASIK patients.

Better surgeons - Surgeons who started a decade ago have now been performing the procedure for 10 years.  Experience is important in any procedure, including LASIK.

Dr. Stephen Turner has been performing LASIK since it was introduced to the San Francisco Bay Area.  Turner Eye Institute has continually upgraded its LASIK equipment and offers the newest and most accurate LASIK treatment available.

Turner Eye Institute celebrated its staff appreciation party.  The Turner Eye Institute’s well-trained staff have received the highest marks from LASIK and cataract surgery patients from across the San Francisco Bay Area.  They deserve to be commended on their great reviews.  Patients have always expressed the highest level of satisfaction with the Turner Eye Institute staff. 

Dr. Turner would like to personally thank the staff for their great support and their willingness to go the extra mile to give patients a pleasant experience at Turner Eye Institute.  Without the help of the technicians, LASIK counselors, and the excellent office support, TEI would not have been as successful as it has. 

Excellent results and high patient satisfaction require a team effort.  TEI congratulates all its staff for their hard work and friendly attitudes.

Stephen Turner, M.D. was chosen as the official LASIK surgeon for the Golden State Warriors for the 2008-2009 NBA season.  Many NBA players have LASIK surgery as it is a safe accurate procedure for correcting near-sightedness, far-sightedness, and astigmatism.  It also allows a higher level of performance than cumbersome prescription goggles that can fog up and hamper peripheral vision.  Most NBA players select LASIK rather than use contact lenses or glasses.  High profile athletes around the world select LASIK surgery in order to compete at their highest level.

Presbyopia affects everyone.  Throughout our lives we gradually lose our ability to focus up close.  Young children can focus on objects just a couple inches from their face.  Teenagers can read something a few inches from their nose.  College students see clearly at less than a foot away.  By forty years of age, however, books must be held farther back to be read comfortably.  The eyes didn’t suddenly go bad at forty.  The eye had been gradually losing the ability to focus since birth due to growth of the lens inside the eye and a resulting loss in flexibility.

Since LASIK treats the cornea (on the outside), it has often been assumed that it does not affect the onset of presbyopia.  Older LASIK patients have commonly been told that either they wear reading glasses like everyone else, or they correct one eye for near vision and the other eye for distance vision, a treatment known as monovision.  While this is acceptable to some people, most people would prefer to avoid glasses entirely.

There exists an opportunity for LASIK (or some other refractive surgery) to correct vision for both near and far.  Several companies have experimented with multifocal LASIK corrections but none have managed to show significantly satisfying results.  Many of these LASIK treatments rely upon concentric rings of different prescriptions to provide a multifocal correction.  Unfortunately, the cornea is human tissue and doesn’t react like plastic when treated with a laser.  It can be sculpted but cannot adopt the same shapes and zonal profiles as a transparent plastic would.

Newer treatments are looking at using natural corneal shapes in order to provide a more subtle blend of near and far vision.  Researchers have long realized that higher order aberrations can cause an increase in the depth of focus of optical systems.  These aberrations can also lead to a degradation of image quality however.  Many researchers believe that there exists a compromise between perfect vision and a good depth of focus.  Such a compromise would result in good (but not perfect) vision at a wide range of distances.  Currently several intraocular lenses (used in cataract surgery) provide such a solution.  The question is whether LASIK could also provide for such a solution.

Wavefront LASIK has been used for nearly a decade now.  Wavefront LASIK has been marketed as a method of providing better-than-normal-vision by treating more than glasses or contact lenses.  In addition to treating near-sightedness, far-sightedness, and astigmatism, wavefront LASIK has sought to treat other optical aberrations (such as coma, spherical aberration, trefoil, and others).  Wavefront LASIK has achieved a moderate amount of success.  Studies have generally agreed that vision is better than conventional LASIK. 

But what if correcting all aberrations is not optimal.  Certainly an aberration free system would provide a perfect focus at one distance.  But it would also provide a worse focus at every other distance.  For young patients, this wouldn’t be a problem.  Older patients, however, would find that a perfect focus at distance leads to worse vision at near.  Perhaps in the future, wavefront LASIK will offer a new option for older patients.  It could offer a vision profile of good vision at distance and near by simply correcting the wavefront to an ideal pattern that expanded the depth of field without degrading vision below 20/20.  New evidence is showing that this future application might indeed by possible. 

Over the past ten years, excimer laser technology has improved tremendously.  Today’s lasers are faster, more accurate, more safe, and more efficient.  In the initial FDA studies laser surgery patients were content with 20/40 vision.  LASIK was viewed as a success when a patient could pass a driving test without glasses.

Today LASIK and laser eye surgery has reached a point where most patients consider their surgery a failure if 20/20 vision is not achieved on the first attempt.  While this may or may not be a realistic expectation, more and more surgeons are able to achieve 20/20 results with greater than 90% frequency.

Even more important however is that the complications which once plagued laser surgery patients are becoming less and less frequent.  Dryness is overcome with better pre- and post- treatment and improved patient selection.  Glare has been significantly reduced by better measurements and improved excimer laser patterns as well as larger treatment zones and less tissue use.

Surgeons have improved as well with experience.  As the technology allowed for better results, the LASIK specialist has adapted his or her own style and equipment choices to best serve the patients.

When choosing a LASIK surgeon, find someone with significant experience, advanced technology, and a good understanding of his or her limitations and the technology.  They should be aware of what technology is available and be able to address their choice of excimer laser.

They should also be making regular upgrades.  It is not unrealistic to expect a surgeon to upgrade their laser every 2 to 3 years.  The best LASIK clinics routinely evaluate the newest upgrades available on the market and make decisions based on the needs of their patients.

Turner Eye Institute maintains its position as the technology leader in LASIK in the San Francisco Bay Area by becoming the first LASIK center in Northern California to use the advanced 400 Hz Allegretto Excimer Laser System with Optimized Wavefront performance.  This system even further improves the accuracy of LASIK treatment and reduces the number of enhancements.  The 400 Hz speed allows a faster treatment time for a more comfortable procedure.  Moderate near-sighted prescriptions can often be performed with less than 15 seconds of laser treatments per eye.

Dr. Turner has been very successful in treating LASIK patients with previous Laser systems but desires to improve with each advancement in technology.  He continues to offer his patients an expanded range of treatment options with Visian, Verisyse, Crystalens, Intacs, Restor, ReZoom, and many other choices.  LASIK is not the best choice for every patient so Dr. Turner offes a variety of FDA approved options to give the best options to his patients.

The Allegretto Laser system is available in the San Leandro office.  If you are interested in LASIK or refractive surgery treatment options contact the Turner Eye Institute office.

Dr. Turner and Turner Eye Institute would like to wish everyone a happy 4th of July.  We would like to remind everyone to use proper safety precautions, including protective eyewear when handling pyrotechnics or other fire related holiday traditions, such as grills.  While fireworks can be enjoyable they can also be potentially dangerous if handled improperly.  Fireworks can cause significant eye injuries and safety goggles are advised.

Have a happy and safe 4th of July.

Turner Eye Institute is the first LASIK center in Northern California to begin using the advanced new Allegretto Excimer Laser System.  It is the fastest laser system available and can perform LASIK treatments in 50% less time than its leading competitors.  Faster treatments lead to less surgery time and less chance of complications.  It also allows for speedier recovery and more accurate healing.

Turner Eye Institute is a leader in LASIK surgery and has introduced Visian, Crystalens, Wavefront LASIK treatments, and more the the San Francisco Bay Area.  Dr. Stephen Turner provides experience and reliability and has a long record of providing safe and accurate procedures.  With more than 30,000 treatments, Dr. Stephen Turner is one of the preferred surgeons in California.

Turner Eye Institute has offices in San Francisco, San Leandro (in the East Bay between Oakland and Fremont and Hayward), Concord (near Walnut Creek), and San Jose.

Turner Eye Institute is a comprehensive eye surgery center and provides a multitude of different procedures that are tailored to fit the needs of the patient.  Not every patient is a good candidate for LASIK and LASIK is not the best choice for every patient.  If oyu are interested in LASIK or laser eye surgery contact our office.

There are two common forms of wavefront LASIK.  These are known as Wavefront Optimized LASIK and Wavefront Customized LASIK.  Some excimer laser systems offer the surgeon the choice between either of these or even allows the surgeon to use both of them. 

Custom Wavefront treatment uses a measurement of the patient’s optical aberrations to create a laser profile that can reduce the total optical aberrations of the eye to zero.  While the system’s aim is to provide the best possible correction, the ability to actually provide this benefit is limited by the size of the laser beam, the accuracy of the beam, the accuracy of the eye tracker, the variability in healing, the variability in light absorption by the cornea, the variability in the laser beam strength, the variability in measuring the eye’s aberrations, the changes in the tear layer at the surface of the cornea, and many other factors.

Although the goal of a perfect correction for the individual eye is sought, it is in fact an impossible dream.  No measurements can perfectly match the eyes optical needs at all times and in all conditions.  Changes in humidity, light levels, environment, etc. can all cause a change in the eyes focusing.  Custom wavefront at best can only provide the correction that a patient needed at one particular time.  Despite this limitation, customized wavefront correction does in fact provide a benefit over standard LASIK.

Another LASIK correction that can be performed is wavefront optimized LASIK.  Unlike wavefront customized LASIK, wavefront optimized does not depend on a patient’s personal  aberration profile when it determines a patient’s needs.  Instead, it uses the patients glasses prescription and using a complex nomogram determines the most accurate profile that can incorporate many of the elements that can provide variability in custom LASIK.  It does not depend on measurements at any one time but uses the results of past patients to determine an ideal laser profile.

Wavefront optimized LASIK can be preferred in cases where a patient’s aberration profile is very variable or when a patient has very low levels of aberrations.  Wavefront customized LASIK would be preferred in cases where a patient has very unique aberrations or when a patient has had prior LASIK surgery.

Before having LASIK surgery ask your surgeon whether he/she will use waverfront LASIK.  Generally the answer should be yes.  Next ask your surgeon if he/she will use customized or optimized LASIK.  The surgeon should explain which one and why. 

Remember that it is always a good idea to seek more than one professional opinion.  Find the LASIK surgeon who you feel can provide the best treatment.  This includes finding out what technology that the LASIK surgeon provides and becoming educated about your choices.

LASIK Wavefront surgery continues to advance in technology and provides over a million eyes with excellent vision every year in the United States.  Despite its phenomenal success, LASIK surgery is not without its controversy and patients can often be confused by the marketing information that is provided to patients.  LASIK technology and the excimer laser systems used in LASIK surgery is one area of some confusion.

In regards to LASIK laser vision correction, there are several technologies that are important to consider.  The first is the excimer laser system that will be used.  All excimer laser systems are not equal.  It is safe to say that regardless of the skill of the surgeon, any excimer laser system in use prior to 2001 is definitely outdated and cannot provide an adequate level of accuracy and performance.  It is generally recommended for a patient to have wavefront correction unless the surgeon can provide a reason that this laser vision correction procedure would not be ideal. 

What is wavefront correction?   Wavefront measurements rely upon numerous rays of light to determine the correction needed for the entire optical system.  It creates a very detailed image of the eye’s optical system and is more exact than a glasses or contact lens prescription that can be obtained at an optometrist’s office.  These detailed measurements have been shown to provide an increased level of vision performance after LASIK surgery and patients who have wavefront LASIK correction are measured with fewer post-surgery optical aberrations.

Many LASIK surgeons no longer ask patients if they would prefer standard LASIK or Wavefront LASIK.  They have decided that wavefront LASIK provides a higher degree of visual success and therefore provide wavefront LASIK to every patient.

In fact, wavefront LASIK is not all equal.  With many different wavefront excimer laser systems on the market, you should find out the strengths and weakness of the various systems.  Ask your surgeon which system they use and why.  Find out what they feel are the strengths and weaknesses of the other systems. 

Come visit with Dr. Stephen Turner to determine if you are a good candidate for LASIK vision correction.  Turner Eye Institute is a leading vision correction clinic in the San Francisco Bay Area.  It provides treatment for near-sightedness, far-sightedness, astigmatism, cataracts, difficulty reading, and many other eye problems.  Call and talk to our friendly staff.