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Changing focus

Advances in eye surgery are opening new avenues for people who couldn't be helped by lasik.

By SANDRA G. BOODMAN
Published January 2, 2007


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WASHINGTON

Linette Hwu had been warned by doctors that she was not a candidate for laser eye surgery: Her corneas were too thin, her pupils too large and she was extremely nearsighted. The 33-year-old lawyer said she had resigned herself to being permanently tethered to the glasses she had worn since third grade.

But four months ago, Hwu underwent a relatively new procedure, one of several new options now available. This one is known as Epi-Lasik, which is designed for patients who can't have conventional laser surgery because it removes too much corneal tissue. A recent eye exam showed she could see 20/20 without glasses.

"It's pretty great," Hwu said of the elective surgery that cost her $5,900. "I never thought I'd be able to wake up and see the alarm clock" without putting on her glasses.

Her experience is emblematic of the maturing market for procedures to correct common vision problems, especially nearsightedness, a condition that affects one in four Americans.

Lasik is an acronym for laser-assisted in-situ keratomileusis; the procedure reshapes the cornea using pulses from a laser.

Whereas some procedures such as lasik and Epi-Lasik (a more painful operation that requires a much longer recovery time) are popular in patients younger than 50, newly approved intraocular lenses are more common among patients older than 55, ophthalmologists say.

Lasik remains by far the dominant procedure, according to David Harmon, president of the St. Louis research firm MarketScope. He said there are about 1.4-million procedures annually.

Cost varies from about $1,400 to $2,900 per eye, depending on the surgeon and technology; because it is considered elective, the surgery is rarely covered by insurance.

At the same time, improvements in technology have broadened the pool of patients, and new treatments have won federal approval.

There is now IntraLase, which uses a laser rather than the special blade used in lasik to cut a flap in the cornea. IntraLase may offer improved precision and reduce side effects such as dry eye.

Intraocular lenses are implanted in the eye like a contact lens and are approved for use in extremely nearsighted or farsighted people, and those who can't have laser surgery.

And there is now the use of so-called wavefront technology - sometimes called custom treatment - that creates a kind of ocular fingerprint, mapping the terrain of the cornea in three-dimensional detail that is then used to program the laser.

Fast Facts:

 

Eye issues

Lasik and the second most popular procedure - PRK, or photorefractive keratectomy - are designed to correct three refractive errors:

- Myopia, or nearsightedness, is an inability to see distant objects, which is the most common visual problem.

- Hyperopia, or farsightedness, which is difficulty seeing close objects.

- Astigmatism, a visual distortion that causes blurred vision.

. FAST FACTS

Eye issues

Lasik and the second most popular procedure - PRK, or photorefractive keratectomy - are designed to correct three refractive errors:

- Myopia, or nearsightedness, is an inability to see distant objects, which is the most common visual problem.

- Hyperopia, or farsightedness, which is difficulty seeing close objects.

- Astigmatism, a visual distortion that causes blurred vision.

 

[Last modified January 2, 2007, 11:16:15]


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