Published: Feb. 13, 2012
Updated: Feb. 13, 2012
But, for close to 40 percent of his patients, he chooses a different option.
“LASIK has been a mainstream procedure for correcting astigmatism for 15 years. It’s still a very viable option, and incremental improvements over the years have only made it more so,” Carlson says.
But a number of other procedures have emerged, and Duke Eye Center offers the most advanced ones. “We’ve never had more options for patients,” Carlson says.
He says patients choose to come to Duke Eye Center because Duke tailors treatment to individuals and offers a thorough screening with a surgeon before the procedure.
“Unlike the typical LASIK shops, which approach each patient with one question: ‘Are they a candidate for LASIK, yes or no?’ at Duke we are asking, what is the best procedure for this patient? Patients actually meet their surgeon on the day of their testing, not simply the day they are having surgery. They get the opportunity to go over their surgical options with their surgeon during the preoperative screening. That’s a huge advantage that Duke offers,” Carlson says.
Among the new procedures offered is the implantable collamer lens (ICL), which is made partly of collagen and is implanted on top of the cornea.
ICL may be a better choice for people who need a high degree of vision correction, because drastically reshaping the cornea, as with Lasik, makes it thinner and weaker, making patients more prone to reduced contrast sensitivity. The military has embraced ICL for correcting vision since it enables soldiers to avoid the hassle of contact lenses in dry, arid, and dusty climates, yet it doesn’t run the risk of weakening the cornea.
The collamer lens also gives Carlson the ability to operate on both eyes on the same day using only topical anesthesia. The incision required for the lens is tiny, because it’s folded up when implanted, then unfolds to its full width after implantation. The incision requires no stitches.
Many of the newer intraocular lenses provide a larger range of vision so patients are less dependent on glasses after surgery. This is true even for patients with cataracts.
For instance, John Sandfort of New York was extremely nearsighted; his vision had been described as 20/2000. He had worn thick glasses since he was a child. Then, at age 62, he developed cataracts. He came to Duke for cataract surgery because he had had some retinal problems in the past and had heard Duke was the best.
“John is not simply a cataract patient but presented issues related to having a profound refractive error of -26 Diopters and previous retinal surgery -- all requiring special attention and not simply seeing him as a LASIK or cataract patient, “ Carlson says.
Sandfort is beyond happy with the results he got from the lens replacement that Carlson performed. He no longer needs glasses.
“Since my cataract surgery I am seeing better without glasses than I ever did in my whole life with glasses,” Sandfort says. “It has empowered me. I used to let my wife drive everywhere, and now I am the one driving. The care at the Duke Eye Center was first rate.”
Click through the slideshow to see how intraocular collamer lenses are applied.