Corrective vision surgery moves to next level. (Health Care Services: Advertising Supplement).

The field of vision correction surgery has progressed significantly over the last 10 years. After LASIK received FDA approval in the late 1990s, millions of people have taken advantage of the procedure to improve the quality of their lives, including myself. LASIK (laser in-situ keratomileusis) is the process of creating a thin flap in the outer cornea of the eye with a specialized mechanical device. The flap is momentarily moved aside and an excimer laser (pre-programmed based on traditional eyeglasses measuring techniques) is used to sculpt the prescription permanently on the cornea and the flap is replaced where it bonds without the need for stitches. Patients typically return to work and drive by the next day. The primary reasons people are interested in LASIK result from the nuisances and hassles of contact lenses and glasses for distance and reading vision. People active in sports especially water-related activities are particularly motivated to pursue vision correction.

Many people are apprehensive about the thought of having a procedure performed on their eyes. That is a natural concern since we depend on our eyes more than any other sense in the body. I have heard countless times, "But it's my eyes. What if something happens? What are the chances of losing my vision?" Many people who are interested in LASIK become comfortable with the concept after being properly educated and researching the procedure's benefits and risks. One very important aspect of the educational process is recognizing that although one may use glasses or contact lenses it does not necessarily mean that one is a good candidate for LASIK. Virtually all significant adverse effects from LASIK can be avoided by meticulously screening patients beforehand and using proper equipment. I am not aware of anyone losing all of his or her vision or going blind from LASIK. Nonetheless, patients need to be comfortable with the procedure.

Custom Wavefront LASIK was FDA-approved last October 2002 for performing a truly "tailored" LASIK procedure. Wave-front is a technology that has been used in astronomy for many years to better visualize the stars. Within ophthalmology, wavefront technology has proven its ability to measure the "fingerprint" of the naturally occurring imperfections of each person's eye. My prior research demonstrated that customizing the laser for each person's eye can reduce these imperfections. After acquired, the "fingerprint eyemap" is transferred to the laser and is used to custom-tailor the laser sculpting process during the LASIK procedure. For years, 20/20 has been considered perfect vision. Custom Wavefront LASIK often results in vision better than perfect. It is beginning to prove equally powerful for repairing any problems that may have occurred after prior conventional LASIK. Custom Wavefront LASIK is a real breakthrough and patients are more comfortable with this type of LASIK since it can repair problems from pre vious conventional LASIK.

Not everyone will be a candidate for LASIK nor will everyone be comfortable for LASIK even if determined to be a good candidate. There is an alternative technology that is not laser-based: implantable contact lenses. Implantable contact lenses have been used to correct various degrees of nearsightedness in patients. These lenses are placed inside the eye through a small opening at the edge of the cornea. They rest behind the cornea where they are held in position with connecting struts.

The implantable contact lens is ideal for patients who may not be LASIK candidates or people who are not comfortable with LASIK. Some reasons for not being a LASIK candidate include too great amount of near-sightedness, the cornea may be too thin, or the pupils too large combined with a high amount of near-sightedness. Implantable contact lenses may be the ideal procedure in such patients.

There typically is no maintenance needed after insertion and vision is instantly improved immediately after the procedure. A significant advantage of these lenses is the heparin coating that prevents bacteria from adhering to them. This in part is the reason that there have been no infections in the FDA study to date. Patients who are apprehensive about vision correction surgery like the idea of a corrective procedure that is removable. Since implantable contact lenses are removable, this is an attractive aspect for patients. It is not uncommon that patients to report that they see better after the procedure compared to the vision with their glasses beforehand. Thicker glasses prescriptions often distort vision outside of the central area of the lens. The optical quality of implantable contact lens are often higher than glasses since the lenses are very small, which avoids the peripheral distortions of glasses.

The Boxer Wachler Vision Institute in Beverly Hills has been selected as one of the investigational sites in the United States for the FDA study of the implantable contact lens. A quick look at one's glasses or contact lens prescription can provide a sense if one is in the range for the implantable lens. The lens can treat nearsightedness between the ranges of -4 to -20 diopters with up to 3 diopters of astigmatism. As an FDA investigator, I evaluate prospective patients to determine candidacy for the procedure based on other measurements that are performed in the Institute.

We are presently enrolling qualified candidates in the implantable contact lens FDA study. Those interested should contact the Boxer Wachler Vision Institute to attend an educational seminar or schedule a complimentary consultation.

Brian S. Boxer Wachler, MD is located in Beverly Hills. He can be contacted at 310-860-1900 or via [e-mail]. For further information visit www.boxerwachler.com