The ophthalmologist who pioneered customized LASIK surgery – supervision – now aims to further improve patients’ eyesight and minimize the risk of side effects. Patients should benefit from several recent discoveries, Scott MacRae, M.D., told an audience of eye doctors in a keynote address at the annual meeting of the American Academy of Ophthalmology last month.
The techniques appear crucial for minimizing unwanted side effects and allowing patients, most of whom now have vision of 20/16 or better, to enjoy the full effects of a type of enhanced vision that wasn’t even a twinkle in the eye of doctors 20 years ago. "We’re trying to improve upon something where people already come out and say, "Wow, I’ve never seen that well." We’re learning how to make an extremely effective surgery even better," says MacRae, professor of Ophthalmology and Visual Science at the University of Rochester Medical Center and medical director of Strong Vision.
The field of supervision or "customized ablation" had its genesis in laboratory work in the early 1990s at the University of Rochester, where a team led by David Williams discovered how to use a laser beam to take the best images ever of the inner eye in people, then used the new technology to discover dozens of defects – "higher-order aberrations" – in our vision that were previously unknown.
Since the field is still emerging, it’s crucial for patients to choose their physician carefully, says MacRae, who has been honored nationally for his work and who is an author of the book Wavefront Customized Visual Correction: The Quest for Supervision II. While price is always a concern for consumers, MacRae says that sometimes a higher price covers costs that contribute to patient safety. For instance, a doctor like MacRae turns away significant business after investing hours with a patient because he discovers that many patients – around 20 percent – are not good candidates for refractive surgery and might have troublesome side effects. MacRae and other top doctors also use extensive, seemingly repetitive screening techniques to check traits such as the thickness of a person’s cornea, which is crucial to the surgery, as well as the characteristics of a patient’s pupil.
"The bottom line is that if you use state-of-the-art techniques and you choose your patients carefully, you should get outstanding results. While most of our patients are ecstatic with the results, the field is so young that there are constantly discoveries that should improve patients’ vision even more," says MacRae, who has helped train nearly 1,000 physicians around the country about refractive surgery.
Tom Rickey | EurekAlert!
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