STEVE INSKEEP, host:
It's MORNING EDITION from NPR News. I'm Steve Inskeep. Good morning.
In Your Health this morning, the latest in Lasik.
Laser surgery revolutionized eyesight correction ten years ago when it was introduced. Originally, that procedure was used only to correct nearsightedness. Now Lasik is used to correct most vision problems, enticing more people to have their corneas reshaped.
NPR's Patricia Neighmond reports.
PATRICIA NEIGHMOND: Chet Lee is a little nervous today. He's here at UCLA's Jules Stein Eye Institute prepping for Lasik eye surgery. First, there are drops to numb his eye. Then, surgeon Rex Hamilton examines Lee's eyes with new technology that helps make Lasik more exact.
Until now, Hamilton says, decisions about how to reshape the eye were more subjective because doctors relied on a person's prescription for glasses. Now it's more scientific. A computer is used to measure exactly how light is reflected in the eye.
Dr. REX HAMILTON (Director, UCLA Laser Refractive Center): Blink, blink, blink a few times and open wide. Okay. Try not to blink. Excellent. The first measurement takes a little longer than the others. Perfect. Blink. Open. These will be faster now. Beautiful.
NEIGHMOND: The pictures reveal a pattern that tells Hamilton exactly how Lee's vision is impaired, and at the same time how it can be fixed.
Dr. HAMILTON: That gives us a detailed map of the optics and then the computer figures out, okay, how do I need to reshape the cornea to remove those optical imperfections. And I make some adjustments based on, you know, my experience with the patient's age and how much correction we're doing and those kinds of things to try and optimize the result. But this is a much more detailed way of reshaping the cornea than what we had previously.
NEIGHMOND: And for a patient like Chet, Hamilton says this means better night vision.
Dr. HAMILTON: Better quality. Less halos, less glare off of lights than if you did a conventional treatment.
NEIGHMOND: Chet is pleased with this potential and in general excited about the procedure. He's hoping for 20/20 vision in both eyes and eager to be done with contacts, which, at various times, have broken inside his eye, cut his cornea, fallen out of his eye and often gotten lost.
But it's the new all laser Lasik that really brought Chet here, finally. He'd been thinking about Lasik for about nine years, but was squeamish about the surgery. During Lasik, surgeons cut a thin flap in the cornea and then use the laser to reshape the cornea underneath.
Most surgeons use a blade, which automatically moves across the cornea to make the flap. But at UCLA they've gotten rid of the blade and now use a laser to create the flap.
Dr. HAMILTON: You can think about it sort of like Velcro, although it's, you know, much, much on a finer scale. So Velcro you have to pull to actually separate, much like with this where we have to go in and bluntly separate with an instrument to actually get the flap to lift up.
NEIGHMOND: Hamilton says using the laser he can create a flap more quickly and precisely than he can with a blade.
Dr. HAMILTON: Look right at that dot for me. Suction on. Here's where you're going to feel the pressure. Keep your head nice and still. Try not to squeeze your arm; I'm going to turn your head here slightly. Good, bring your chin up a little bit. Chin up a little more. Good. Chin up a little more. Good. Perfect, right there.
NEIGHMOND: It only takes a few minutes to laser across the cornea; now there's a smooth, flat surface. Hamilton fixed the laser to make sure the computer measurements he took earlier are accurately loaded into the laser.
Dr. HAMILTON: So we have Chet, right eye, minus 4.13, minus 1.10. Axis 175. Point-three offset. 111 microns. Two minute treatment.
NEIGHMOND: As Hamilton begins the Lasik procedure itself the laser moves across the cornea, firing beams that literally vaporize tissue.
Dr. HAMILTON: You're going to hear the sound of the laser now, Chet. Keep looking right at that light for me. Beautiful. Very nice. Right on target.
NEIGHMOND: Because Lee is very nearsighted, it takes a full two minutes on each eye for the laser to do its work.
Dr. HAMILTON: A little breeze. First set of drops coming. Tape off the other side. And open. Perfect. I'm taking one more look at the other side here. And you are all done, sir.
NEIGHMOND: Chet seems relieved. It wasn't as bad, he says, as expected. The next day on follow-up, Chet's vision tests at nearly perfect: 20/20 in one eye, 20/25 in the other. Typical, says Dr. Hamilton. Complications from Lasik are rare, but include distortions such as glare or halos, especially at night. The risk of that happening is greatly decreased, though, he says, because of the earlier computer measurements he took of Lee's eye.
While that doesn't add a lot to the cost of Lasik, the new all-laser Lasik with out the blade does. Conventional Lasik averages around $1500 per eye. All-laser Lasik is more. In Chet Lee's case he paid $3050 per eye, a total of $6100. And for the most part, Lasik is not covered by insurance.
Patricia Neighmond, NPR News.
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