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Vision Correction: Alternatives to Laser Eye Surgery

Summary & Participants

The number of people seeking LASIK and PRK, the two most common laser eye surgeries, has increased dramatically. In the year 2000, an estimated 1.5 million surgeries were performed in the United States alone. But is surgery the only way to achieve 20/20 vision? And is it possible to see better than 20/20? Join eye specialist Julius Sherman as he discusses alternative options to laser surgery, both present and future.

Medically Reviewed On: June 18, 2008

Webcast Transcript

DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Up to 60 million Americans have vision problems and a lot of them are turning to Lasik and PRK, which are new procedures that can really correct vision very well. But there may be some other options. And joining me to talk about these options is Dr. Julius Shulman. He's an Associate Clinical Professor at Mount Sinai Hospital in New York and he also has a private practice in New York City. Thanks for being here.

JULIUS SHULMAN, MD: Thank you.

DAVID R. MARKS, MD: These procedures are tremendously popular but there are other options available for people. What are they?

JULIUS SHULMAN, MD: Other options fill about 5 to 10% of procedures done to correct vision. Most people have Lasik or PRK. Intacs is another options. Intacs is appropriate for people who have low degrees of myopia. Intacs are tiny little plastic pieces that are inserted into the cornea to reshape the cornea. The surgery takes about 15 minutes and it is as effective in most cases as Lasik or PRK but it's only for low degrees of myopia. Another option that's fairly new is LTK as opposed to PRK. LTK is laser thermal keratoplasty. That is only for low degrees of farsightedness or hyperopia. Without touching the eye, the laser reshapes the cornea by placing 16 tiny spots on the outside of the cornea. The whole things takes three seconds and a minute or two after this procedure the farsightedness is gone and people can read without glasses. It's not for everyone. No procedure is for everyone, but it is very effective.

DAVID R. MARKS, MD: How does a person know if they should have one procedure over another, Lasik, PRK, LTK?

JULIUS SHULMAN, MD: Good question. It comes down to talking to your doctor, trusting your doctor, and letting him guide you through this array of procedures to correct your vision. You can also get educated yourself by reading material, by the internet, by talking to other people, talking to your family doctor. But it comes down to trusting your ophthalmologist.

DAVID R. MARKS, MD: There are certain people who are not necessarily candidates for Lasik or PRK. Would they still be candidates for, let's say, Intacs?

JULIUS SHULMAN, MD: Yes. In certain cases, someone who is not a good candidate for PRK or Lasik can have Intacs. They may not be a good candidate for Lasik or PRK. They can have LTK or they may be told wait, there's something even newer coming out, and that's called wavefront technology. Wavefront technology is being done in Europe where there's no FDA, but we're fairly strict here. That's basically taking a light, shining it into the patient's eye. The light comes out in a certain pattern which reflects any aberrations or abnormalities and that wavefront is programmed into the laser as opposed to your eyeglass prescription being programmed into the laser. So theoretically this has the potential for making a perfect eye and giving you vision way beyond 20/20.

DAVID R. MARKS, MD: Is it working in Europe?

JULIUS SHULMAN, MD: It's working in Europe.

DAVID R. MARKS, MD: Because you said theoretically. How about in practice?

JULIUS SHULMAN, MD: OK. In practice it is working in Europe, although there are a few studies now, since this is so new, that are comparing Lasik and wavefront, and there is not a huge difference between them. Wavefront is still in its infancy but it's projected that vision of not only 20/20 but 20/10, 20/8, 20/5 might be possible, but it's at least, I would say, three to five years away.

DAVID R. MARKS, MD: So it is possible to see better than 20/20 with these procedures, or at least in the future.

JULIUS SHULMAN, MD: Well, it's possible now to see better than 20/20 with contact lenses, with glasses or with PRK and Lasik. These procedures or contacts or glasses will let you see as well as your eye will allow. Not everyone has the potential for 20/20. Some people have 20/25, some 20/15. It's what your eye will allow.

DAVID R. MARKS, MD: Why would someone want to see better than 20/20?

JULIUS SHULMAN, MD: Why not? I would want to see 20/15, so your long distance vision is better. I would want to see as well as I'm capable.

DAVID R. MARKS, MD: So it would make a lifestyle difference, a change in the way a person lives and the way they can function.

JULIUS SHULMAN, MD: I think most people with 20/20 or thereabouts would have excellent quality of life. Their vision would not handicap them in any way. But if you can see 20/10 or 20/15, it's just that much better.

DAVID R. MARKS, MD: So there are some exciting things coming down the pipeline.

JULIUS SHULMAN, MD: That's correct.

DAVID R. MARKS, MD: Thank you very much.

JULIUS SHULMAN, MD: You're welcome.

DAVID R. MARKS, MD: And thank you for joining us. I'm Dr. David Marks and I'll see you next time.

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