New Developments in L.A.S.I.K.  

Two areas are changing rapidly. The first is the use of computer assisted custom ablations for complex refractions. Companies such as Summit are well positioned to provide this technology. Secondly, the introduction of Hyperopic correction is now available:  

LASIK For The Treatment of Hyperopia
LASIK for the treatment of hyperopia has been performed outside the United States for several years. In November 1999 the FDA approved Summit for the correction of up to +4.00 diopters, for people 21 years or older.  

Hyperopic LASIK Procedure
The basic LASIK procedure is the same whether it is performed for the treatment of myopia or hyperopia. The changes for the correction occur within the laser program. Using the microkeratome, a flap is made in the cornea; the flap is then folded back to expose the stromal bed of the cornea. The Excimer laser is used to remove corneal tissue in a pattern that will steepen the central cornea, changing the way the light rays focus on the retina . This will result in an improvement in the uncorrected distance vision

• Treatment of Hyperopic Astigmatism
  At this time, the FDA has not approved the treatment of hyperopic astigmatism. It has been our experience that for best results we first treat the hyperopia and at a later date decrease the astigmatism; or, depending on your refractive error, we may treat the astigmatism first and then treat the hyperopia.

Complications of LASIK Surgery
While we expect over 95% of our patients to be at least 20/40 or better and over 75% to be 20/25 or better without correction by the time the refractive surgery process is complete, complications can occur. Our commonest complication is that you may still need to wear glasses after surgery , particularly for reading if you are over 40 years. But there can be other infrequent risks such as:  

• Over Correction
  Over correction following LASIK for low-to-moderate degrees of farsightedness occurs much less commonly than does under correction. However, over correction is relatively easily corrected. As with under correction, it is not possible to accurately predict how your eyes will respond to the treatment. A mild degree of over correction may be perfectly well tolerated. More significant degrees of over correction may necessitate the wearing of eyeglasses (in some cases bifocals) or contact lenses. Over correction may also require further refractive surgery.

• Under Correction or Over Correction  Some people will require an enhancement procedure or other surgical correction to attain this satisfactory visual results. In general, there is approximately a 5 to 15 %  enhancement rate with LASIK. With regard to LASIK, the enhancement rate increases proportionately to the degree of your nearsightedness and astigmatism. A patient in the very low range of myopia (-2.00 to -3.00) can expect only a 3 % chance of needing an enhancement, while patients in the very high range (approximately -10.00 to > -18.00) can expect an enhancement rate of closer to 10%. You may need to wear glasses for specific instances such as night driving, watching or participating in sports events held at night, and near vision demands such as needle point. Remember, if you aimed for good distance vision and are over 40 you can expect to need reading glasses. Under correction and over correction are the most common undesirable results of surgery. 

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