Category Archives: Laser vision correction

Blepharitis & PRK/LASIK

By | Laser Eye Surgery, Laser vision correction, LASIK, PRK, Refractive Surgery | One Comment

If you are thinking about having PRK or LASIK laser refractive surgery you should be familiar with the common conditions that can cause problems after surgery.  Most people who have PRK or LASIK are very satisfied.  For the small percentage of people who have problems following laser vision correction, dry eye is one of the most common complaint.

Dry eye can be a complicated problem, called “ocular surface disease” by eye care professionals.  Dry eye is not as simple as not enough tears.  A normal tear film is like oil and vinegar salad dressing – the oil, mucous, and water components need to be in the proper proportions and also mixed properly to form an emulsion.  An emulsion is what happens when you shake your oil and vinegar salad dressing.

Blepharitis is a condition that causes plugging of the oil glands that have openings just inside the upper and lower eye lashes.  Blepharitis can also cause redness and inflammation along the eye lashes and mattering of the lashes.  Without the proper oils the tear film does not wet the eye surface as well.  The mattering of the lids can also lead to a poor quality tear film which causes dry eye symptoms.

Blepharitis treatment is like treating dry skin or any other chronic condition.  Treatment of blepharitis means a change in habits – the treatments need to be done as part of your daily routine on an ongoing basis.  Daily warm compress with mild pressure on closed lids with a warm wet cloth for 3 to 5 minutes twice per day is the most important treatment.  The warmth will encourage the oils to flow, the mild pressure can soften and lift off matter, and the moist cloth will help lift off debris.  Other treatment are gently washing the lids with dilute baby shampoo 1:10 or with a lid care pad available at pharmacies.

The link between blepharitis and PRK or LASIK is that after surgery, without glasses or contact lenses, the eye is more exposed to wind and evaporation.  If you wear glasses you know that there moist air trapped between your eye and your glasses because when you go out in the cold the glasses fog up.  Even contact lenses can provide a barrier from evaporation.  Once the surface is exposed on a daily basis, people with blepharitis might find their eyes feel more dry than before PRK or LASIK.

Before you have laser vision correction your eye care provider will assess pre-existing conditions like blepharitis and give you advice about treatment of these conditions.

If you have questions about laser vision correction or wish to book a complimentary evaluation, contact Western Laser Eye Associates.

Eye-Whitening: do your homework

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

American Society of Cataract and Refractive Surgery has rescinded a clinical alert about complications that may result from eye whitening treatments

Eye-whitening procedures involve removing the outer layers that cover the white sclera and using medications which slow healing in order to result in a whiter looking eye.  In some early reports using specific surgical eye whitening techniques there were reports of complications.  For any elective surgery involving the eyes or other areas of the body there will always be some risk even if the procedure is done perfectly.  This is due to difference in responses to surgery and differences in healing for each individual.  Some health conditions such as smoking, autoimmune diseases, or diabetes can also affect healing.  When considering any type of elective surgery you need to find out the specific techniques that are being used, expected rates of complications, and any factors in your specific case that might raise your risk for a specific treatment.  In general most of the elective surgeries that are now considered routine (such as laser vision correction) will carry a low risk of significant complications.  When looking for information about a specific treatment it can be helpful to look at respected websites such as the American Academy of Ophthalmology , or the National Eye Institute.   The US National Library of Medicine National Institutes of Health has a data base with peer reviewed articles that can be searched for more in depth information called PubMed.

Red eyes are common and may be caused by anything that irritates the eyes, most commonly dry eye and allergies.  If the vision is not affected then most people can safely try over the counter artificial tears up to several times per day and warm compresses twice per day.  For many people regular use of lubrication drops can help to minimize red eye.  Over the counter allergy medications can also be used safely as directed for short periods of time. Red eye formulas are available over the counter but are not recommended for continuous every day use.

Whether you don’t need glasses at all, wear contacts or glasses, or have had laser vision correction such as PRK or LASIK, an occasional red eye that responds to artificial tears is most likely not serious.  Signs that you should see your eye doctor include a red eye with vision changes, significant pain or discomfort, or a large amount of discharge.  If you have any of these symptoms or a persistently red eye it is a good idea to consult your eye doctor.

If you have questions about laser vision correction or wish to book a complimentary evaluation with Dr. Anderson Penno, contact Western Laser Eye Associates.

Ophthalmologist & Optometrist: what does it mean when you are considering PRK or Epi-LASIK?

By | Epilasik, Laser vision correction, LASIK, Optometry, PRK, Refractive Surgery | One Comment

Whether you are looking for general eye health care, eyeglass prescriptions, or laser vision correction such as LASIK, PRK, or Epi-LASIK, it is important to understand who is caring for your eyes.

“Eye Doctor” can mean an ophthalmologist or an optometrist.  The main differences are:

Ophthalmologist

  • has an M.D.
  • has completed 4 years of medical school + 4-5 years of residency
  • some will have completed additional 1-3 years of fellowship training
  • may provide general eye care, surgery, or specialized care
  • sub-subspecialities include: glaucoma, retina, cornea, plastics
  • in addition to surgery, can prescribe a wide range of medications
  • can order specialized testing such as CT, MRI, X-ray, blood work
  • find an Eye MD

Optometrist

  • has an O.D.
  • has completed 4 years of optometry training  in addition to university
  • may provide general eye care as well as prescribing glasses and contacts
  • often will comanage with ophthalmologists
  • can prescribe glasses and contacts and some medications
  • can refer to sub-speciality ophthalmologists such as retina or glaucoma
  • find an optometrist

In many laser vision correction centres the initial assessment is done by an opometrist with experience in refractive surgery.  At Western Laser Eye Associates all potential laser vision correction candidates are seen by an ophthalmologist in order to insure they are a good candidate for surgery.

In some cases it can be helpful to comanage with both an optometrist and ophthalmologist.  For example some people from smaller towns may not have convenient access to an ophthalmologist.  In these cases an optometrist can do preliminary testing to determine if laser vision correction may be an option.  It it is not a good option due to the degree of correction or other eye health issues then it may save the time and travel to attend an assessment.  In cases where laser vision correction is a good option, you may return to your optometrist closer to home for follow up care.

Co-management between an ophthalmologist and optometrist works well for a number of common eye conditions.  The key to successful comanagement is good communication between you, your ophthalmologist, and your optometrist.

If you are interested in booking a complimentary laser vision correction assessment with Dr. Anderson Penno, contact Western Laser Eye Associates.

 

Calgary Flood

By | Charity, Laser vision correction | No Comments

We were fortunate to be just outside the mandatory evacuation zone during last week’s flood at our new location at 6427 Bowness Road NW in Bowness, in Calgary.

Many in the city were not so lucky as the river spilled out onto streets and into houses and businesses last Friday:  Aerial View of Flooding.

While the waters are returning to more usual levels there is substantial work to be done.  Volunteer opportunities are posted on:  YYC Helps

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.

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.

LASIK, Epi-LASIK, PRK, Intralase and Diabetes

By | Diabetes, Laser vision correction | No Comments

Diabetes does not automatically disqualify you from laser vision correction surgery.

If the blood sugar is under good control and the prescription is stable you may qualify. If the blood sugar is fluctuating to very high or very low levels then the prescription may be unstable. In some cases a diagnosis of diabetes is made when fluctuating vision leads to a check of blood sugar.

Diabetic people are also at risk for diabetic retinal problems. Whether or not laser vision correction is being considered, people with diabetes should have annual eye examinations regardless of age. The American Academy of Ophthalmology’s patient education site Get Eye Smart has a campaign to get 10,000 diabetic people committed to annual eye examinations.

Over half of diabetic people do not get annual eye examinations and are at risk for vision loss. Over 90 percent of severe vision loss due to diabetes can be prevented by routine examination. For every pledge to have annual eye examinations the Academy of Ophthalmology will donate one dollar to diabetic eye health education.

For more information about laser vision correction in Calgary contact us today.

LASIK and pregnancy

By | Laser vision correction, LASIK, pregnancy | No Comments

Are you pregnant or planning to become pregnant? Are you breastfeeding? If so, you are not a good LASIK candidate until after these activities are finished.

Dr. Penno does thorough screening of potential LASIK patients and two of the questions always asked of women is whether they are pregnant or lactating.
To have excellent LASIK results, you have to be as good a candidate as possible, within the parameters of safety and effectiveness. During pregnancy certain hormones are produced which make many changes in the body, and one of them is increased fluid retention. Most pregnant women experience some degree of fluid retention but may not realize that it occurs in the eye’s lens as well as in the ankles and other areas.

Reasons to Wait for Your LASIK

  • Swelling in the lens causes increased myopia (nearsightedness) and sometimes also astigmatism. In some cases it can cause hyperopia (farsightedness). A vision correction done while swelling is present would not be accurate after the swelling subsided.
  • Drugs used during LASIK are antibiotic eyedrops to prevent infection and cortisone eyedrops to reduce inflammation. A mild sedative may also be used to help you relax. These will all enter the bloodstream and could therefore affect the baby. It is not known whether they enter the milk also, but why take the risk?
  • Pregnancy causes some dryness in the eyes. LASIK also causes dryness during recovery. If you went into your LASIK procedure already having dry eyes and then compounded that with the post-surgical dryness you could develop Dry Eye Syndrome which is chronic.
If you are pregnant or lactating, and would like to learn more about LASIK and whether it would be a good option for you later, by all means contact us. We will be happy to explain things, answer your questions and examine your eyes. Then when you are ready for LASIK we can continue the candidate screening and choose the best procedure for your individual eyes.

LASIK Patients Very Pleased With Their Outcome

By | Cataracts, Laser vision correction, LASIK, PRK | No Comments

Recently, the American Society of Cataract and Refractive Surgery (ASCRS) reported that on average, 95.4 percent of LASIK patients are pleased with their improved vision.

This is worldwide, not just in the U.S. The ASCRS did a large study, looking at patient satisfaction in India, Iran, Turkey, South Africa, Spain, the Netherlands, Scotland, Ireland, France, and the U.K. If they had looked at Australia as well, they would have found more patient satisfaction.

About 16.4 million people have had a LASIK procedure, making it one of the most popular and successful eye procedures done. It was approved in 1995 by the FDA, and perhaps because vision problems are so quickly noticed by anyone who experiences them, and so disruptive of daily life, LASIK is also one of the most-often studied medical procedures. It is not surprising that so many innovations have been developed and improved in the 13 years it has been FDA-approved.

One of the requirements for a LASIK surgeon to have a good record of success with patient outcomes is thorough patient screening. LASIK is not a good option for everybody. Your eye doctor will examine your eyes very closely to determine your candidacy, and will also study your general health history. Performing LASIK on a poor candidate was done too often in the early LASIK years, and surgeons have paid close attention to what makes for a good candidate. If you are not well-suited to LASIK, you might be a good candidate for PRK, which gives results just as good.

Technology is continuing to advance and be refined, and if you are well-screened, have LASIK done by an experienced eye surgeon, and care for yourself afterwards according to your surgeon’s instructions, you can expect a very quick and dramatic improvement in your vision. Please contact us if you would like to have a complimentary evaluation.