Category Archives: Epi-lasik

LASIK (flap) versus Surface PRK (no flap)

By | Calgary, Dry eye, Epi-lasik, Epilasik, Intra-LASIK, Laser Eye Surgery, Laser vision correction, LASIK, Ophthalmologist, Ophthalmology, Opthamologist, Photorefractive, PRK, Refractive Surgery, Surgeon, VISX | No Comments

STAR S4According to some reports over 28 million laser vision correction surgeries have been performed worldwide since the excimer laser was developed in the 1980s.  Both PRK surface laser and LASIK surgeries use the excimer laser to reshape the corneal surface.  The main difference between the two types of laser vision correction methods is the creation of a corneal flap with LASIK and treatment on the surface of the cornea after removing the thin layer of epithelial cells with PRK.  eyelabeled

 

Advances in both the excimer laser and in flap creation technology have resulted in a variety of names for laser vision correction surgeries.  Flap surgeries include LASIK and IntraLase and no flap treatments include PRK, LASEK, and Epi-LASIK.  With LASIK a small oscillating blade in a device called a microkeratome is used to cut the LASIK flap.  With IntraLase the femtosecond laser is used to create a corneal flap.  Originally called “flap and zap”, with LASIK and Intralase the flap is lifted and the excimer laser reshaping is done on the underlying corneal tissue.  With no flap treatments the excimer laser energy is applied directly to the surface of the cornea.

PRK surface laser vision correction gained in popularity from it’s introduction in the 1980s over the next decade.  LASIK was introduced in the 1990’s  and became the most popular laser vision correction by the early 2000’s due to faster recovery.  Within the past several years there has been a shift back towards surface treatments due to the improvements in post operative management and in excimer laser technology.  It has also been determined that for some people PRK surface treatments may be a better choice.  The reasons that PRK may be recommended include:

1. Risk of flap shift or trauma with job or sports activities.

2. Thin corneas that may be a risk for ectasia (unstable cornea with progressive thinning) with LASIK flap.

3. Very steep or very flat corneal curvatures that may increase LASIK flap complication risk.

4. Previous injury or eye or eyelid surgeries that may raise the risk of LASIK flap complications.

5. Moderate dry eye might be worsened by the deeper disruption of corneal nerves with LASIK flaps.

Both LASIK and PRK have be demonstrated to produce equally good results over 6 months or more.  In the short term of days to weeks LASIK patients will recover vision more quickly.  So taking a short term perspective it makes sense that people may choose a LASIK flap laser vision correction method.

Taking a long term approach there are advantages to forgeting the LASIK flap and choosing a no flap PRK surface treatment.  Advantages of a no flap PRK approach include:

1. no LASIK flap = no flap complictions such as incomplete flaps, buttonholed flaps, partial flaps

2. no LASIK flap eliminates the risk for flap dislocation in the future

3. no LASIK flap means there can not be complications like epithelial ingrowth, diffuse lamellar keratitis, interface debris, flap wrinkles,  or other LASIK flap related complications.

4. Less risk of a weak and unstable cornea called corneal ectasia due to the LASIK flap disrupting the cornea more deeply than surface PRK.

5. Possibly less risk of severe dry eye with surface PRK.

To make the choice that is right for you, first find out if you qualify for laser vision correction and then learn the pros and cons of the treatments available to you.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

Vision & Vitamins: Ginkgo Biloba, Glaucoma, and Macular Degeneration

By | Epi-lasik, Epilasik, Eye health, FDA, Food for thought, Ginkgo Biloba, glaucoma, Health Canada, Laser Eye Surgery, Laser vision correction, macular degeneration, Mayo Clinic, Ophthalmologist, Ophthalmology, Opthamologist, Optometry, Pubmed, Refractive Surgery, science, Uncategorized, Vision & Vitamins | No Comments

Vitamins and natural herbs have become more and more popular for alternative treatment as additional treatments for medical conditions.  Ginkgo Biloba has been used for centuries as a traditional treatment which may help blood flow to the brain and aid in treatment of dementia or Alzheimer’s disease.  It might help treat leg pain that results from blood vessel disease, and there is some suggestion that ginkgo biloba might also help PMS symptoms, depression, multiple sclerosis, and ADHD.  Ginkgo Biloba is extracted from the leaves of the Ginkgo Biloba tree.  As far as vision and eye health are concerned, it is possible that Gingko Biloba might be helpful to eye health but as with many natural products the scientific studies show some favorable and some unfavorable results.

There are some scientific studies that have been reported in the peer reviewed literature which is a data base of articles that have been reviewed by scientists with expertise in the particular field of study before the article is allowed to be published.  Peer review helps to make sure that studies are done in a way that will provide strong statistical evidence for or against a specific area of study.  The most powerful studies are randomized and double-blinded which means the researcher and the subject who is taking the supplement do not know if it is the actual supplement or a placebo being taken.  The “placebo” effect has been well studied and up to 30% of people taking a fake pill who are told it will have beneficial effects will report that it helps whether or not there is any measurable effects.  By double-blinding and using large and randomized numbers of subjects the results will show with more confidence that a particular supplement is helpful or not for a specific condition.  Because there are a lot of different conditions that are being studied, so far there are only a few published peer reviewed scientific studies that have been done to find out if Ginkgo Biloba is good for your eyes.

According to the Mayo Clinic there is some scientific evidence suggesting that Ginkgo Biloba may be helpful in preventing worsening in age related macular degeneration which can lead to central vision loss, but there is little evidence to suggest it might be helpful for treatment of glaucoma.  In the peer reviewed literature there are a few studies including this 2012 study by Cybulska-Heinrich, Mozafferieh and Flammer that suggests supplementation with Ginkgo Biloba might be helpful in addition to traditional medical treatment in cases that are not responding as well as needed to these traditional treatments.  They suggest that antioxidant effects along with a variety of other effects on blood flow might be responsible for the beneficial effects of supplementation with Ginkgo Biloba.  The American Academy of Ophthalmology reported there was a single small randomized trial that showed promise for using Gingko Biloba to slow macular degeneration.

A commonly reported dose of Ginkgo Biloba is a standardized extract, standardized to 24% flavone glycosides and 6% terpene lactones starting at 40 milligrams of that extract three times daily, but there does not seem to be enough evidence in the scientific studies to prove the most effective doses for a specific condition.  Risks and side effects of Ginkgo Biloba supplements include headaches and dizziness, bleeding, and other side effects.  If you are on a blood thinner or aspirin, or are on other medications you should talk to your pharmacist and/or doctor to make sure that there won’t be dangerous interactions.  There is also some question about the quality of the products in some cases and as with all supplements it is important to be sure you are getting a high quality product.  In Canada a DIN or NPH number can be found on products that have been reviewed by Health Canada.  In the US the FDA does not require approval of supplements before the product is marketed but does collect information on adverse events.  The other thing to consider is the cost of a product like Ginkgo Biloba versus the proof that it will be helpful for your health.

Whether you already had LASIK, Intralasik, EpiLasik, PRK, wear glasses or contacts, reading glasses or no glasses at all you should be sure to get regular checks with your eye care specialist (optometrist or ophthalmologist) in order to optimize your vision for the rest of your life.  If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

 

Welcome Dr. M. Purba: experienced in pre & post LASIK, PRK care and general eye health checks

By | Customvue, Epi-lasik, LASIK, Optometry, PRK, Refractive Surgery | No Comments

Western Laser Eye Associates is pleased to welcome Dr. M. Purba to our eye-care team alongside Dr. Anderson Penno, Dr. Boadi and experienced ophthalmic technicians.

Dr. M. Purba brings years of optometry experience in the field of pre & post PRK and LASIK care as well as extensive experience in optometric eye health care to the practice.  She will be available to do general eye exams, prescribe glasses, and provide specialized treatment for conditions such as dry eye, blepharitis, and glaucoma.

Optometrists specialize in the treatment of many eye problems.  They are complimentary to ophthalmologists who are Eye MD’s and often work together with ophthalmologists to co-manage patients.

More information can be found at:

http://www.optometrists.ab.ca/

For more information about services provided by Dr. Purba or to book a complimentary refractive surgery assessment with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

Over $1,000 Raised For Right To Play!

By | Charity, Epi-lasik, PRK, Refractive Surgery | No Comments

I am very excited to have raised over a thousand dollars for this great charity, Right to Play, by participating in the Guinness World Record soccer game attempt from October 5 though 7.

Every dollar raised is matched three times by Right to Play partners with the overall goal of raising 25 thousand (which will result in 100 thousand dollar to support every child’s right to play.

To donate follow this link to my personal page on the Right to Play website:

http://righttoplay.akaraisin.com/soccerquest42/westernlasereye

Many people who are interested in considering PRK, LASIK, Epi-LASIK or other types of refractive surgery are motivated by the desire to participate in sports without the hassle of contacts or glasses.  Many children around the world do not have the resources or opportunity to participate in sports at all so it is a privilege to be able to donate to a charity that gives them the chance to benefit from involvement in athletics and team activities.

Please help me support the Cochrane Rangers Soccer Club (Cochranerangers.com ) and the Right to PlayFoundation in setting a new Guiness World Record on October 5 to 7, 2012.

For information about booking a complimentary laser vision correction assessment with Dr. Anderson Penno contact Western Laser Eye Associates.

5 Steps to Successful LASIK, PRK, Epi-LASIK or Intra-LASIK vision correction

By | Epi-lasik, Epilasik, Intra-LASIK, LASIK, PRK | No Comments

Step 1:  Do your research.

The more you know about the different procedures available the better you can understand which choice might be right for your eyes.  Look for information from trusted websites such as http://www.geteyesmart.org/eyesmart/  or http://www.mayoclinic.com/health/lasik-surgery/MY00375 .

Dr. Anderson Penno’s book Laser Vision Correction:  What You Need to Know has information about who can safely have laser vision correction, what types of procedures are available, and how to choose a surgeon or surgery center.  This book is available at http://www.amazon.ca/Laser-Vision-Correction-Anderson-Penno/dp/143926497X and in Kindle edition at http://www.amazon.com/Laser-Vision-Correction-What-ebook/dp/B003F77DV4.

Having the right expectations will make you happier with the results.

Step 2:  Have a laser vision correction evaluation.

An evaluation, also sometimes called an assessment, is a complete eye check that includes specialized testing in order to find out if laser vision correction is a safe option for you.  During this eye check a qualified eye care provider will usually give information about what options are available at that surgery center and tell you if you qualify for LASIK, PRK, Epi-LASIK or Intra-LASIK.

Sometimes serious eye conditions are detected during this evaluation and additional testing may be recommended.  This evaluation also includes a medical history since there are some medical conditions like rheumatoid arthritis that may disqualify you from laser vision correction.

Step 3: Get a second opinion.

It can be a good idea to have a laser vision correction assessment at more than one center.  This can give you more information about the types of surgeries available and also allows you to compare the style of care to see if it is a good fit.  Some centers may be lower cost but may not offer as much face to face time with the surgeon.  Other centers may have a higher cost but other features that are important to you such as specific technology or more individualized care.

Step 4: Talk to your friends and family.

It can help to talk you people you know who have had LASIK, PRK, or another type of laser vision correction.  Keep in mind that each person may have variations in healing and that the recovery times may be different between different procedures.  Ask them about their experience.  Was the staff courteous?  Were their questions answered?  Were they comfortable with the surgeon?

If you have a trusted optometrist or other health care provider like a family doctor, talk to them too.

Step 5: Take some time to consider your options.

Rushing to make a decision because your wedding is coming up or you want to squeeze in surgery before your vacation may not be a good idea.  You need to understand the healing process and book enough time to recover.  For some procedures you need to book more time off than others.  It is uncommon to have a complication but it is better to allow for the possibility of needing more time off ahead of time rather than having to cancel or change your plans if your vision recovery is slower than expected.

If you are a good candidate for LASIK, Epi-LASIK, PRK, or Intra-LASIK these steps will help you make the choice that is right for you and understand what laser vision correction can do for you.

For more information or to book a complimentary assessment, contact Western Laser Eye Associates.

 

Why choose CustomVue Wavefront PRK or Epi-LASIK

By | Customvue, Epi-lasik, Laser vision correction, LASIK, PRK, Refractive Surgery, VISX | No Comments

There are a number of things to consider when deciding whether or not to have laser vision correction and where to have it done.

It can be helpful to have more than one refractive assessment to meet staff, see the facility, and learn about the services offered at that center.  Most importantly a thorough refractive assessment will determine if laser vision correction is safe for you.  There are many factors that are considered during an assessment including corneal thickness, corneal shape, how high your correction is, and general medical and eye health issues.  More information about these factors can be found in Dr. Anderson Penno’s book Laser Vision Correction: What You Need To Know  available at: http://www.amazon.com/Laser-Vision-Correction-What-Need/dp/143926497X/ref=sr_1_4?s=books&ie=UTF8&qid=1296107050&sr=1-4

It is important to choose a surgeon you are comfortable with and a procedure that is right for you.  When choosing a procedure the laser vision correction options fall into flap and no-flap categories.  Flap procedures include Intra-LASIK (called I-LASIKby AMO)  and LASIK.  These treatments both involve the creation of a corneal flap and carry a higher risk than surface treatments.  No-flap surface treatments include PRK, Epi-LASIK, and LASEK.  For surface treatments the epithelium layer is removed and the laser is applied to the surface of the cornea.  Many refractive surgeons believe that a wavefront treatment will be most effective if used in combination with a surface laser vision correction rather than a flap treatment.  The reason is that the corneal flap created by LASIK or Intra-LASIK may induce additional vision abberations that may diminish the benefit of a wavefront treatment.

Wavefront laser vision correction involves measuring the higher order aberrations that are individual to each eye and then using that data to create an individualized laser vision correction.  The analogy that is often used is that for nearsighted eyes the cornea is shaped like a basketball that is too steep, for farsighted eyes the basketball is too flat, and in astigmatism the cornea is shaped like a football.  A standard laser vision correction will reshape the cornea into a sphere (basketball) that is just right.  Wavefront treatments will then smooth out any imperfections that may be present on the surface to produce maximum vision results.

There are many studies that indicate the benefits of wavefront treatment in maximizing uncorrected vision.  Due to the number of different laser manufacturers, variety of treatments (flap, no-flap, etc.), surgeon differences, and individual healing responses it is difficult to make an exact quantification of the benefits of wavefront treatments compared to standard laser ablation or between wavefront capable lasers.  Reliable scientific studies can be found in peer reviewed studies such as those available at the US National Library of Science online database:http://www.ncbi.nlm.nih.gov/pubmed  TheVISX S4 IR Customvue system is the most widely used custom wavefront system used in North America.  It has benefits of iris recognition and cyclotorsion (rotational) adjustment that enhances accuracy.  It also features a variable repetition rate and variable spot size which reduces heat generation and allows for a very refined corneal reshaping capability.

Wavefront custom laser vision correction can enhance visual results and is one of the factors that should be considered when deciding whether to have laser vision correction and where to have it.  For more information or to book a refractive consultation with Dr. Anderson Penno, contact Western Laser Eye Associates.