Guest Columnist Dr. Stephen Coleman

Over the years, the applications for technology have been broadened and fine tuned to include the treatment of nearsightedness, astigmatism and farsightedness in various and complex combinations. And just as the technology has changed, so has the profile of the typical person seeking laser vision-correction.

In the mid 1990s, the patients considered to be "early adopters" had relatively large eyeglass prescriptions and were quite motivated to have their eyes corrected. Today, even patients with relatively small prescriptions routinely have LASIK, as their positive perception of the surgery has been reinforced with time.

Three other significant changes in corrective eye surgery have occurred. First, the expectation level of a patient, or what he or she hopes to achieve with LASIK, has consistently been raised over the years.

Second, LASIK has become more complex and expensive from my perspective, no simpler and less expensive, as a patient might reasonabley conclude.

Third, the accuracy, precision, and reproducibility of laser profiles today are, by all accounts, quite profound.

Regarding technology, the most important advances currently in the field of laser vision correction revolve around two main issues: finding a surgical correction for the reversal of presbyopia and the integration of wavefront-guided LASIK.

What is perhaps even more impressive is that wavefront-guided LASIK gives many patients the distinct possibility of actually seeing better than they ever could in the past with their contacts or glasses – in other words, better than 20/20. This truly is a remarkable improvement from where we were just 10 years ago.

All of this is extremely promising. And while we still have plenty to learn about LASIK, the future indeed seems bright.

Optical scientists, are interfacing with eye surgeons, and engineers are working with laser manufacturers in an effort to constantly advance this area of medicine, so that more people can experience the profound and positive impact it can have in their daily lives.

First, I'll address presbyopia, also known as the "gift of aging."

The need for reading glasses, or presbyopia, typically occurs when a person reaches his or her mid-40s. It is a topic that is near and dear to my heart.

With 76 million baby boomers born between 1946 and 1964, many with active lifestyles and high visual demands, the number of people requiring reading glasses has virtually exploded, making the search for a solution the holy grail for corrective eye surgeons.

But because presbyopia is fundamentally an aging process involving the lens in the eye, success with addressing this problem has been limited to date, despite the fact that many modalities abound.

Later in 2004, I will begin a Food and Drug Administration study on a laser profile that essentially mimics the way a bifocal contact lens works, which holds great promise for this segment of the population.

Colleagues in Canada have reported impressive results using the same technology, and we're looking forward to this phase of our FDA investigational work with great anticipation.

The second most important advance in corrective eye surgery is wavefront-guided, or customized LASIK.

Until recently, lasers have been able to correct only the lower-order aberrations of any particular person's prescription. This refers to the correction of a person's nearsightedness and astigmatism, for instance.

Now, thanks primarily to work in the field of adaptive optics, on devices such as the Hubbell telescope, LASIK procedures can correct the many tiny, unique imperfections in an eye that are known as "higher-order aberrations."

Interestingly, Wavefront Sciences, Inc., a five-year-old Albuquerque startup headed by Tim Turner, has done incredible work in the field of wavefront technology, and has had worldwide ramifications for eye surgeons like myself.

In 2002, along with such institutions as John Hopkins, the University of Miami, and Baylor University, ColemanVision was selected as one of six sites nationwide to investigate this technology. I can tell you firsthand that the impact of customized LASIK is dramatic.

There is a greater likelihood, approaching 100 percent, for patients to achieve 20/20 vision without prescription contacts or eyeglasses. It also significantly improves, by roughly four times, the way that a patient sees at night, or in other instances of low illumination.

What is perhaps even more impressive is that wavefront-guided LASIK gives many patients the distinct possibility of actually seeing better than they ever could in the past with their contacts or glasses – in other words, better than 20/20. This truly is a remarkable improvement from where we were just 10 years ago.

All of this is extremely promising. And while we still have plenty to learn about LASIK, the future indeed seems bright.

Optical scientists, are interfacing with eye surgeons, and engineers are working with laser manufacturers in an effort to constantly advance this area of medicine, so that more people can experience the profound and positive impact it can have in their daily lives.

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