Eye Surgery Performed On Campus

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As a result of a new partnership between the Pacific Laser Eye Center and the UC Berkeley Meredith W. Morgan Eye Center, campus optometrists were able to perform the first ever on-campus LASIK eye treatment on March 16.

A form of refractive eye surgery designed to improve overall vision, Laser-in-Situ Keratomileusis alters the shape of a person's cornea - one of the regions of the eye involved in focusing.

The treatment, which has been in existence for at least 10 years, was approved by the Federal Drug Administration in 1995, according to Maziar Haririfar, the director of clinical services for the new program.

The cornea, a clear layer of tissue, provides the bulk of the eye's refractive power. Refraction is the bending of a light beam as it passes between different media and is critical to the functioning of the eye. The property is illustrated by looking at a glass of water with a spoon in it - the spoon appears to be bent at the junction of the water and the air.

The LASIK treatment involves slicing a thin flap into the cornea leaving enough of a connection to act as a "hinge" and then lifting the flap away to reshape the tissue underneath with laser pulses. The flap is then replaced, and the cornea heals quickly; typically, patients are able to return to work one or two days after the surgery.

Before the 90-minute operation is begun, optometrists make a topographical map of the patient's eye. This map permits doctors to determine whether or not the procedure can be performed on certain individuals, because persons with thin corneas cannot undergo the treatment.

Before doctors begin the surgery, the patient is given a low dosage of Valium and their eyes are anesthetized with numbing drops. The eye that is not being operated is covered and a drape is placed over the lid of the eye that is being treated. A device called a speculum holds the eye open. A suction ring holds the cornea still and makes it firm. The patient looks straight ahead at a target during the procedure.

The instrument that cuts the flap is called a microkeratome. The flap is then moved aside and the laser treats the stroma, which is the tissue beneath the outermost layer of corneal cells. The laser treatment lasts between 30 and 45 seconds.

Once the laser treatment is completed, the surgeon rinses the cornea and replaces the flap. After carefully checking the eye, the surgeon performs the same treatment on the second eye.

Many patients feel normal right after surgery and return to work the next day.

Although the chances of major side effects are slim, the LASIK treatment is not free of complications. Possible effects include infection, inflammation, epithelial growth and tension lines. There is less than a 1 percent chance that a complication will arise, Haririfar said.

Infection is extremely rare, with an occurrence rate of 0.1 percent. Inflammation, which can be easily treated with steroid drops, occurs slightly more often. Epithelial growth, which is tissue growth around the replaced flap, and tension lines, usually caused by vigorous rubbing of the eye, are both treatable complications.

Corrective surgery does not always give the patient perfect 20/20 vision, but it usually comes quite close. The result is almost always better than 20/40.

Professional optometrists determine whether or not a given person is eligible for treatment; good candidates have a stable eye prescription, no active eye diseases, good general health and must be at least 18 years old.

The procedure can correct myopia, or nearsightedness, of up to 14 diopters, hyperopia, or farsightedness, of up to +6 diopters, and astigmatism of less than 6 diopters. A diopter is a unit of measure of the power of a lens and is equal to the power of a lens with a focal length of one meter.

Although the procedure is heralded as one of the best corrective eye treatments to date, LASIK cannot be used to correct presbyopia, which is the typical stiffening of the lens with age. This condition causes a large percentage of people to require reading glasses after middle age.


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