Duane Rouse had LASIK eye surgery three years ago. Like most of the other 3 million people who have had LASIK surgery since the mid-1990s, he experienced a dramatic improvement in his vision - going from 20/400 to 20/25 in a matter of minutes - and he no longer wears glasses. The only thing he wishes he could change are the halos he sees around lights, a common side effect of Lasik.

Post-operative problems with night vision, including glare and halos, may be less likely with a newer, more precise Lasik procedure recently approved by the U.S. Food and Drug Administration (FDA).

In May, the FDA approved the CustomVue system by VISX Inc. after a study found that 94 percent of patients had 20/20 vision after six months and 98 percent had 20/20 vision after a year. David Hardten, M.D., an ophthalmologist with Minnesota Eye Consultants and advisor to Sight & Hearing Association, was one of the principal investigators for the VISX procedure and is training doctors to use it. The FDA approved another system, CustomCornea by Alcon Inc., in October.

"This is really a refinement of Lasik - or an incremental improvement in the way Lasik is done," explained Hardten. "We have done now about 200 procedures."

Unlike conventional Lasik, where the patient's eyeglass prescription tells the doctor how the cornea needs to be reshaped to correct nearsightedness, farsightedness or astigmatism, this procedure uses "wavefront" technology. Beams of light aimed at 200 spots on the eye bounce off the retina, taking detailed measurements as the light leaves the eye. Slight distortions on the cornea, which can't be detected in a standard vision test, are then mapped on a computer. The map is used to customize the patient's surgery, allowing the surgeon with a laser to make subtle changes to the cornea.

According to Margie Schmidt, communications director for Phillips Eye Institute, wavefront is 25 times more precise than traditional Lasik.

"It actually captures a 'fingerprint' of the eye," she explained, "tailoring a unique correction for each individual."

This newer technology is similar to traditional Lasik in terms of length of time for surgery - taking 10 to 15 minutes - and minimal to no pain. It differs in cost, ranging $1,700 to $2,400 per eye - at least $600 more than conventional Lasik.

Potential candidates are those who are nearsighted or have astigmatism, says Hardten. Wavefront technology is not available for people with farsightedness, but conventional Lasik is. You are also not a candidate if you changed your prescription for contact lenses or glasses in the past year.

So, do people like Rouse, who have already had Lasik, need to have this procedure done? No, says Dr. Hardten. "Most who have already had Lasik would not need this, as they are doing well the way they are. There have been maybe 5-10 percent of patients that had Lasik once who may need an enhancement, and this may be a good way to do that. Up to three percent of patients will need enhancements with wavefront Lasik also."

In the Minneapolis/St. Paul metro area, there are several groups using the technology, including Minnesota Eye Consultants, Phillips Eye Institute and the Edina Laser Center.

According to Hardten, this new technology overcomes the downside to traditional Lasik: the idea that no two people who have their vision corrected with glasses see at the same level.

"We have, over the past few years, tried to identify those patients with irregularities and have told them to wait for this technology," he said. "I think you'll see most of refractive surgery done this way in about three years."

In the past, the Minneapolis Schools have not been consistent with vision and hearing screening because of budget constraints.

According to Liz Zeno, Healthy Learners Initiatives Coordinator, the purpose of the Healthy Learners board is to improve student achievement by improving student health. One of the ways to reduce the barrier to learning is to correct vision and hearing problems.

"All of the people involved on the board were convinced that some screening should happen," Zeno said. "We had to try to find a cost-effective way to provide that screening. When [SHA] came in with a proposal for how to make this happen, we just felt it was too good of an opportunity to pass up. The proposal is for one year. If it proves successful, we hope it will continue beyond that."

"We are very excited about this opportunity," said Kathy Webb, SHA executive director. "While we still focus our screening energies on preschool children, we want every child to be able to see and hear well so they can excel in school. When kids are falling through the cracks in elementary school, we need to help them."

In addition to providing the screening, SHA will assist with the follow-up for the children who are referred for further vision and hearing evaluations.

The researchers enrolled 179 children with acute otitis media from 11 pediatric offices in the study over an 11-month period. Families were given either acetaminophen, ibuprofen and/or auralgan otic drops for pain control. They were also given a prescription for an antibiotic and instructed not to fill it unless symptoms either increased or did not resolve after 48 hours had passed. Only 47 of the 153 families filled their prescriptions.

The next time your child has an ear infection, ask your pediatrician for a safety net prescription and a recommendation for pain control medication.

If you missed the issue and would like a free copy of the special section, please call the Sight & Hearing Association at 651/645-2546, ext. 16.

Austin Medical Center-Mayo Health System, Austin Helping You Hear, Brainerd Hearing Associates, Duluth Starkey Labs, Eden Prairie Audiologists Hearing Center, Edina Audiology Concepts, Edina Allina Medical Center, Elk River Allina Medical Clinic, Faribault Audiology & ENT East Central Audiology, Forest Lake Minnesota State University-Mankato Minnesota Audiology & Balance Clinic, Maple Grove Abbott Northwestern Hospital, Minneapolis Allied Hearing Services, Minnetonka

Allina Medical Clinic, Northfield Oakdale ENT - West Health Clinic, Plymouth Oakdale ENT/Hearing Aid Center, Robbinsdale Olmsted Medical Center, Rochester Audiology Associates Hearing Care, Roseville Professional Hearing & Audiology Services, St. Cloud St. Cloud State University Associated Hearing of St. Paul, St. Paul Stillwater Medical Group Willmar Hearing Aid Center HEAR Minnesota, Woodbury Fairview Lakes Medical Center, Wyoming

Location: Macaroni Grill, Roseville, Minn.
Type of food: Italian
Time of day: 6:30 p.m. on a Sunday
Duration of stay: One hour

Atmosphere: Twelve-foot high ceilings. Italian music playing in background. Bar area on one end of restaurant, open kitchen on the other.

Average noise level: 72 dB
Noise level range: 69-78 dB
Peak noise level: 80 dB

The main dish: The restaurant was pretty full, and the tables are set pretty close together. (The gentleman at the table next to us noticed that we had a sound level meter.) The food is delicious; my favorite part being the bread. A bonus: Receive free Italian lessons in the restrooms.

Rating on a scale of one to five bells (with one being quiet and five being noisy): 3

Would you recommend this restaurant as conversation-friendly? While there was the general background noise, I never felt I had to raise my voice.