A closer look at LASIK
For her twenty-sixth birthday, Karry Case decided to throw out her eyeglasses, even though she needed them to see everything from her alarm clock to road signs. Instead, she joined more than 3 million Americans who, in the past few years, have undergone LASIK.
LASIK, which stands for laser-assisted in situ keratomileusis, is a brief outpatient surgical procedure in which the cornea is reshaped so that images entering the eye strike the retina more precisely. Nationally, 96 percent of people who undergo LASIK surgery have an outcome of 20/40 vision or better. A week after Karry's surgery, her eyesight was 20/15 - considered a "better-than-perfect" improvement from her uncorrected vision of 20/100. "I'm glad I did it," smiles Case. "After the surgery, I went home to rest. When I woke up, I could see the clock on the microwave across the room. I went out the next morning to walk the dog, and I saw the little bugs crawling on the grass."
How does LASIK work? Karry chose to go to ICON Laser Eye Center in Minneapolis. She initially met with an optometrist who performed a complete eye exam. This determined that she was an appropriate LASIK candidate, what kind of vision correction she would need and how much laser removal was necessary. One week later, on the day of her surgery, she had another eye exam to ensure her vision was still the same. The laser was then calibrated and programmed with her prescription before she entered the laser room. (The laser room, by the way, offered visitors in the waiting area the opportunity to watch the procedure through a plate-glass window.) Most procedures, depending on the amount of correction needed, take about 15 minutes under the laser. Karry's surgery was even shorter - from the time she laid down on the surgical table to the moment she stood up was less than five minutes.
The procedure, step by step A suction ring holds the eye steady while the platform for the microkeratome, a cutting instrument, is put in place. Pressure is applied to the eye so that it is firm enough to be cut cleanly. The patient's vision goes black. After the cornea is moistened, the microkeratome glides across its surface, cutting through the outer layers. The instrument stops automatically, leaving an uncut section to act as a hinge. After the suction is turned off and the cutting device removed, vision returns. The surgeon carefully lifts the still attached corneal flap out of the way, exposing the underlying layers that must be excised by the laser. Guided by a computer program, the excimer laser reshapes the cornea. To correct nearsightedness, the laser trims the cornea's center, making it flatter. For farsightedness, a doughnut-shaped ring of tissue is removed. The flap is then put back in place. Following the surgery, the ophthalmologist examines the operated eye. Karry was then given medicated drops, eye shields (for light sensitivity) and artificial tears to use for one week. She was asked to return one day after her surgery for a follow-up visit, then one week, one month, three months, six months and one year. Typically, eyes require two to three months for the vision to stabilize.
Karry's results "It's so nice that I can just go outside without my glasses," she said. "The best part is to see those results right away."
Possible side effects Duane Rouse, a Twin Cities corporate executive, had worn glasses and contacts for 25 years before he had LASIK in January 2000. He is one of many who have experienced some side effects. "I don't have any major problems, but my vision is not 20/20," he explained. "At night, it's harder to see; I see starbursts around lights." Despite this, he's glad he had the surgery. "I don't have to wear glasses or contacts anymore, that's the bottom line."
Frequently asked questions about LASIK Despite the cost, more than 750,000 Americans had the procedure last year. For answers to the most frequently asked questions, we sought the expertise of David Hardten, M.D., an ophthalmologist with Minnesota Eye Consultants who specializes in laser refractive surgery.
Who has LASIK surgery? What are the reasons a person may not be a good candidate for LASIK? Some patients have unrealistic expectations, and this is often the reason they should not have LASIK. All patients do not end up with perfect vision, and some have residual nearsightedness or farsightedness. All patients over 40 (whether or not they have LASIK) will need bifocals or reading glasses for near tasks if they have good vision, and LASIK cannot make their vision back to what it was like when they were 20 years old. Some patients have problems with their eyes that LASIK cannot fix, such as cataracts or macular degeneration. What are some common complications? The most common occurrences are "nuisance" problems. These are things like under- or over-corrections that may occur frequently, even up to 10-15% in some of the higher corrections. These patients may require a second surgery to fine-tune their vision, even though they had much improvement from the first procedure. Dry eyes, glare and halos are extremely common early on after the surgery, almost universal, but improve with time in most patients. More severe things like infections or scarring can occur, but typically don't interfere with vision, although they could. Realistically, what should people expect? Most patients can expect to have a great improvement in their uncorrected vision. How many procedures have you performed? I have been doing LASIK now for the last seven years, and have done more than 7,500 procedures. The typical surgeon should do about 20 or more procedures per month to stay current with techniques that are performed.
Finding Dr. Right
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| The Sight & Hearing Association and the Minnesota Academy of Ophthalmology provided glaucoma screening at Juneteenth, the largest annual African-American celebration. Glaucoma, which affects African Americans five times more than Caucasians, is an eye disease that slowly diminishes a person's peripheral vision and can lead to blindness. Overall, 63 percent of participants screened at the event were referred for potential glaucoma or vision problems. SHA thanks the following ophthalmologists who volunteered their time and expertise: Andrew Harrison, M.D.; Eric Nelson, M.D.; Scott Schaefer, M.D.; and Janice Sinclair, M.D. |
Dine or Dash? A noise review of local (Minneapolis/St. Paul) restaurants
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How many times have you been out to eat and found yourself raising your voice to talk over the clatter and chatter? As a new, ongoing column, the Sight & Hearing Association will feature a restaurant review in each issue. However, our reviews will concentrate on whether the restaurant was conversation-friendly (one bell) or noisy (four bells). If you have a restaurant you would like us to check out, please call Julee Sylvester at 651/645-2546, ext. 12.
Reader Rita Swanson of Edina suggested we check out Ciao Bella in Edina, where, she says, she "can't enjoy even simple conversation."
Here is what we found.
Location: Ciao Bella, Edina Atmosphere: Open dining room with arched ceilings
Average noise level: 82 dB(A) The main dish: At 11:30 a.m., diners were spread out around the restaurant and conversation was easy to follow. By 12:30 p.m., the restaurant was full and we had to raise our voices slightly. Is this restaurant conversation friendly? If you plan on meeting for lunch, get there early to avoid the chatter. Regarding dinnertime, our guess is that the restaurant becomes even louder. Not only is there a trendy bar at one end of the restaurant, but tables are fairly close together. Overall rating on a scale of one to four bells (one=quiet; four=noisy): 3 bells On the side: The food was delicious. I'd highly recommend the Chop Chop Salad and the Hazelnut Brownie Dessert.
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