All posts by uppercut

Mission Eye Clinic: San Lucas Toliman

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San Lucas, Toliman is nestled between three vocanic peaks next to Lake Attitlan Guatemala.  I had the privilege to join a team from Minnesota for a week in November.

One of the most important things I learned is to appreciate the infrastructure in place in developed places like the U.S. and Canada.  All of the things that you might not think about as you go about your work day or as I go about my regular clinic days in Calgary are in short supply in this area of Central America.  The basics of clean air, clean water, transportation, animal control, working plumbing, safe roads, and for medical providers proper equipment and regular clinic staffing are in short supply.  Many people can not afford to buy medications even if they can be prescribed properly and for more complex problems or emergencies they can not afford transportation to a suitable medical facility that might be located an hour or more away.  One initiative of the San Lucas Mission is to provide an ambulance which will transport these patients in need to facilities that can provide proper care in emergency situations.

I supported the surgical team by doing pre and post-operative exams, ultrasound measurements, and YAG laser treatments.  The teams from Minnesota have been able to transport equipment to the San Lucas Clinic that allow for cataract surgery and eye examinations.  The mission clinic also does dental work and has outreach workers that visit the outlying areas to provide care for common problems such as high blood pressure and diabetes.

The pictures on the San Lucas Mission website show the beauty of the Lake Attitlan area and the unique local dress. In spite of the dismal living conditions the people of San Lucas were smiling and welcoming.  It is a place of contrasts with the local women carrying large parcels on their heads, dressed in their hand-woven skirts, talking on cell phones.  San Lucas at the intersection of ancient Maya and the modern world.

For more information about laser vision correction options contact Western Laser Eye Associates.


San Lucas Mission Guatemala

By | Charity | No Comments

Dr. Anderson Penno is please to be joining an ophthalmology group that will be providing eye care to the people of San Lucas, Guatemala.

The clinic at the San Lucas Mission has a long history in the community and is one of many projects supported by the San Lucas Mission to support the local community.  More information about the mission can be found at

General eye care and community service has been an important part of Dr. Anderson Penno’s practice over the years.  The opportunity to use specialized ophthalmology skills to provide care to underserved Guatemalan people is a privilege.  The San Lucas mission has the infrastructure to provide ongoing care, and there are regular visits from ophthalmology teams from Minnesota and other locations.  There are a number of ways to volunteer.  The following link provides more information about volunteering: 

For more information or to book a complimentary assessment for laser vision correction contact Western Laser Eye Associates.

US Trends In Refractive Surgery

By | Laser vision correction, PRK, Refractive Surgery | No Comments

ASCRS San Diego CA 2011  Dr. Richard Duffey and Dr. David Leaming reported on recent trends in refractive surgery in the US.

They are well known among refractive surgeons for their updates on trends in laser vision correction surgeries. A copy of their presentation can be found here.

They surveyed surgeons who are members of the American Society of Cataract and Refractive Surgeons (ASCRS).  Their results show an increase in surgeon preference for PRK in nearsighted (myopic) patients over the last several years with a sharp increase in surgeon preference for PRK in 2010.  Recommendations for LASIK declined slightly in 2010.

The VISX laser continues to be the preferred excimer laser and continues to gain in popularity among laser vision correction surgeons.  The use of wavefront technology has also continued to increase over the past 5 years.  An impressive 24% of refractive surgeons have had PRK or LASIK themselves, 34% of surgeon spouses have had refractive surgery, and 52% of surgeons have a sibling who has had PRK or LASIK.  Overall there was a 27% increase in laser vision correction surgeries between 2009 and 2010.  Dr. Duffey and Dr. Leaming report that since 1996 ASCRS members have performed over 13 million laser vision correction surgeries.

To learn more about laser vision correction or to book a complimentary assessment, contact Western Laser Eye Associates.

May is CNIB Vision Health Month

By | Charity | No Comments

This May is the second annual CNIB Vision Health Month.

According the to CNIB every 12 minutes someone in Canada starts to lose their vision and more than 800,000 Canadians live with vision loss.  The majority of vision loss is preventable.  From regular eye examinations, to eating healthy foods, to spotting vision loss in your elderly parents the CNIB has tips on their website to help you prevent vision loss.  For those considering vision correction surgery you should have a careful assessment by a qualified provider and educate yourself about the risks and benefits of the different options available.

The CNIB has been dedicated to education about vision loss and support for people living with vision loss since 1918.

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  or .

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 and in Kindle edition at

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:

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:  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.

New Botox (Allergan Inc) Research From University of Calgary

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Clostridium botulinum type A neurotoxin complex – otherwise known as Botox (Allergan, Toronto Canada) – has gained popularity as a cosmetic anti-wrinkle treatment.

It has been marketed for cosmetic use for the prevention of wrinkles in younger people and for the treatment of wrinkles due to aging.  Allergan introduced Botox in 1989 and it was approved by the US FDA for moderate frown lines in 2002.  More information about the history of BOTOX can be found here.

New research from the University of Calgary shows that in their model muscle atrophy was detected far from the injection site.  Information about the study can be found on the University of Calgary website.

As they point out in their article, Botox has non-cosmetic uses in conditions such as cerebral palsy and blepharospasm.  As with any treatment, the risks and benefits need to be well understood and considered carefully before proceeding.  There are studies that document the safety of Botox for cosmetic use, however this new research raises concerns about possible side effects in muscles that are far away from the injection site.  Since Botox is a treatment that will need to be repeated to maintain the effects, it is important for those who are undergoing treatments to be aware of new findings.  Asking your provider about new research will help to make an informed choice each time you are considering a treatment.

This same approach is recommended for people considering laser vision correction.  Surface no-flap PRK has been performed since the 1980’s in North America and has an excellent long term safety record.  Over the past 25 years there have been a number of advances and numerous studies which have improved the safety and results of laser vision correction.

To book a complimentary laser vision correction assessment with Dr. Anderson Penno, contact Western Laser Eye Associates today.

Epi-LASIK and PRK : Why Choose Surface Laser Vision Correction?

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Lower risk and outstanding results are driving the trend back to the surface with an increase in popularity of surface laser vision correction in recent years.

More surgeons worldwide and in Calgary are recommending Epi-LASIK and PRK as a safer no-flap alternative to LASIK and more people are choosing surface treatments for laser vision correction.  To understand these trends it helps to know a little bit of the history of laser vision correction.

In the 1980’s several investigators were involved in the development of the excimer laser for use in laser vision correction.  Research confirmed that the excimer laser could be used to accurately reshape the cornea (the cornea is the clear outermost layer in the front of the eye which is analogous to a windshield).  Margueritte McDondald was credited with performing the first PRK in 1987.  PRK involves removing the corneal surface cells called the epithelium and then applying the laser energy to the corneal surface.  PRK gained in popularity very quickly in the late 1980’s.  With these early cases there were some reports of significant haze (a scarring type of reaction), which in some cases affected the vision and needed additional treatments.

By the early 1990’s Dr. Pallikaris had combined an older flap making technology called a lamellar flap with the new excimer laser treatments.  In this procedure a corneal flap was created, the flap was lifted, and then the laser was applied to the corneal surface under the flap – this was called “flap and zap” and later called LASIK.  LASIK quickly became very popular since the vision recovered more quickly and there was less discomfort in the first few days after surgery.

Over the next two decades excimer laser technology advanced along with flap making technology, and the use of bandage contact lenses following PRK.  Over this same time period there were many reports about complications that could happen with LASIK surgery, many of which are discussed in the book LASIK COMPLICATIONS: PREVENTION AND MANAGEMENT published by SLACK Inc.  This book was written for LASIK surgeons and went into three editions.  Complications with LASIK include partial flaps or buttonhole at the time of surgery, flap interface inflammation, and shifted flaps in cases of eye injuries even months or years after LASIK surgery.  There is no book about PRK complications.  This is not because there are no complications, but because PRK is a simpler procedure with less potential for complications.

Many surgeons made note of this lower complication rate with PRK.  As the laser technology advanced, the issues relating to corneal haze have almost been eliminated for PRK.  The use of bandage contact lenses has also improved the comfort during the first few days following surface laser vision correction.

Within the last five years a further advancement in surface no-flap laser vision correction was developed with the creation of Epi-LASIK.  Epi-LASIK is a variation of PRK that uses a separator to remove the surface epithelium.  The advantage of Epi-LASIK is the smooth edge to the epithelium which results in more rapid recovery of vision within the first three to seven days following surgery.

Both Epi-LASIK and PRK do take longer to recover the sharpest vision as compared to LASIK and there is more discomfort within the first three days following surgery.  The advantages of these surface laser vision correction methods include the lower risk (there is no flap that may be involved in a complication at the time of surgery or shifted at a later date).  Epi-LASIK and PRK do not invade the cornea as deeply so may not weaken the cornea as much as a flap procedure like LASIK.  There are some reports to indicate that there may be less permanent dry eye following Epi-LASIK and PRK due to this less invasive treatment.  Some investigators feel that the quality of the final vision may be better without a flap since a corneal flap may induce some optical aberrations.

Every person needs to make a choice of laser vision correction procedures that is right for their individual case.  LASIK remains a popular choice, but with the refinements in surface no-flap PRK and Epi-LASIK more people are choosing to have these surface no-flap treatment.  More information about laser vision correction  can be found in the book Laser Vision Correction: What You Need To Know which can be purchased at

For more information or to book a complimentary assessment for laser vision correction in Calgary with Dr. Anderson Penno, contact Western Laser Eye Associates today.

Find out about Epi-LASIK and PRK at our Calgary Women’s Show Booth on October 23 & 24

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We are excited to be participating in the 2010 Calgary Women’s Show on October 23 and 24th at the BMO Centre at Stampede Park.

Information about the show can be found here.

Come and find out why we are so excited to offer advanced custom surface laser vision correction in combination with the VISX S-4 IR Excimer laser with iris registration and cyclotorsion adjustment.   Our experienced staff can tell you if it may be worth your time to book an in-depth complimentary assessment.  We will have a screening questionnaire, lensometer to read your eye-glass prescription, and an informational video about Epi-LASIK and PRK.

At Western Laser Eye Associates our goal is to provide you with quality service and information that will help you to make your best choices about laser vision correction.

For more information or to book a complimentary laser vision correction assessment with Dr. Anderson Penno, contact Western Laser Eye Associates today or we’ll see you at the show!

“Epi-LASIK comes out ahead of LASIK in clinical trials”

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EyeWorld, the news magazine of the American Society of Cataract & Refractive Surgery, recently has reported on a clinical study involving 130 eyes comparing LASIK to Epi-LASIK.

This article can be found at

Epi-LASIK is a laser vision correction surgery that uses a separator to push the surface epithelium layer aside to prepare the cornea for laser treatment. A bandage contact lens is placed after surgery and removed after three or four days in most cases. Epi-LASIK is a no flap surface treatment. LASIK involves cutting a flap with a device called a microkeratome. The flap is lifted in order to treat the underlying tissue with the laser and then the flap is replaced. More information about these and other laser vision correction surgeries are available at Wesrerand in Dr. Anderson Penno’s latest book “Laser Vision Correction: what you need to know” which is available on kindle and

Many refractive surgeons are turning to surface no-flap treatments like Epi-LASIK as a safer and effective method of laser vision correction. In this report the final results were reported to be superior to LASIK, however vision recovery does take longer. Many surgeons and patients feel that the longer recovery is a worthwhile investment of time in return for added safety and excellent visual results. Most people will be able to resume usual activities including driving within 3 to 5 days, but will need to be patient with their visual recovery as the vision continues to be sharpening up over weeks to months. In the EyeWorld report the final visual results appear to be superior to LASIK.

For more information or to book your complimentary laser vision correction assessment with Dr. Anderson Penno, contact Western Laser Eye Associates today.