After nearly 40 years of evolution, the art and the science of refractive surgery have now reached unprecedented levels, enabling millions of people to dramatically reduce, if not eliminate, their dependence on glasses or contact lenses.

Refractive surgery is microsurgery of the cornea or the lens of the eye that is precisely calibrated to improve the eye's focusing ability, thereby producing harper vision. In correcting the focus or so-called refractive errors, specifically myopia (nearsightedness), hyperopia (farsightedness) and astigmatism ("football" shaped cornea), refractive surgery improves the eye's natural vision. These procedures are neither experimental or investigational, but rather they have become the accepted means of surgical improvement of vision worldwide, with more than one million procedures being performed annually in the USA alone and even more done internationally.

The major breakthrough advance occurred in the late 1980's with the adaptation of the excimer laser (a so-called "cold" laser designed by IBM to etch microcircuits) to reshape the surface of the cornea by precisely removing microscopic amounts of tissue without inducing corneal scaring or loss of clarity. Following rigorous scientific trials by the U.S. Food & Drug Administration (FDA) beginning in the early 1990's, the excimer laser was declared safe and effective. In 1996, a variation on the excimer laser technique involving the creation of a hinged flap of corneal tissue beneath which the laser tissue reshaping was performed (see figure) afforded the next advance of rapid visual recovery, elimination of post-operative pain and performance of simultaneous surgery for both eyes. This technique, termed LASIK (an abbreviation for laser assisted in situ keratomileusis) has become the "Gold Standard" and continues to account for greater than 95% of the refractive surgical procedures currently performed.

While the excimer laser may be miraculous, it, like any procedure, has limitations. Thus while individuals having myopia, hyperopia and/or astigmatism of mild to moderately high degree may be candidates for LASIK and its variations, patients with ultra-high refractive errors are better managed by either refractive lens exchange (especially if over 45 years of age or if early lens clouding or cataract is present) or possibly the newly FDA-approved intraocular contact lens (ICL). For everyone beyond age mid-40's, the inevitable loss of "zoom" focus (accommodation) is evidenced by the progressive difficulty in reading and close work, so called presbyopia or "My-arms-are-getting-too-short Disease." Many such individuals have already adapted to the use of contact lenses specifically fitted to focus one eye for distance and the other eye for near. This solution is termed monovision, and can be precisely replicated with refractive surgery, attaining a greater than 95% success rate in our patients.

Thus, while refractive surgery nearly offers "something for everybody", the best candidates are usually between the ages of 20 to 65 years, are motivated for personal, recreational (skiing, swimming, running) or professional (police, fireman, pilot) reasons to become less glasses or contact lens dependent. LASIK procedures are brief (less than 10 minutes per eye), nearly painless (requiring only eye drop anesthetic), and usually performed in both eyes at the same time. Our results of laser vision correction in particular are usually excellent with nearly 100% of individuals achieving vision without glasses of at least 20/40 (legal driving vision) and about 75% attaining perfect 20/20 vision (although varying with the type and degree of refractive error). Fortunately problems and complications are rare (less than 1%) but can include corneal haze or irregularity of the ocular surface. These results have proven to be stable for many years, and thus additional laser treatment, so-called enhancement, is required in less than 5% of our patients, in which case it is performed both safely & predictably and at no additional expense.

To be sure, refractive surgery has indeed come of age, affording visual improvement for nearly all refractive problems in most individuals. Yet it is also critical to recognize that refractive surgery is not a one technique, one technology, "one size fits all" approach to solve all vision problems. Instead a final recommendation is determined only after careful and complete ocular examination by an experienced refractive surgeon who can determine the most appropriate selection from the "menu" of refractive surgical choices, depending upon the several factors of ocular health, age, refractive error, occupation, avocation, visual needs & expectations. At Eye Health, the use of sophisticated instrumentation including ORBSCAN topography, ultrasonic pachymetry, and wave front analysis are applied to determine the corneal microstructure of each potential refractive surgical candidate.

At Eye Health Vision Centers, the state-of-the-art VISX Star excimer laser is available as the South Coast's only permanent "fixed" laser vision correction facility, operated by highly experienced Boston-trained staff. Our specialist, Kenneth R. Kenyon, MD, is Johns Hopkins trained and a Harvard faculty member with 25 years of experience, and has performed more corneal and refractive surgery (including over 5,000 excimer laser procedures) than any other New England ophthalmologist. Having personally undergone LASIK in 1999. Dr. Kenyon and Cindy Ponte, COT, our Refractive Surgery Coordinator, give informational seminars, including live surgical procedures, at our North Dartmouth and Taunton offices. They also invite interested prospective candidates for a no cost personal consultation to determine their ocular health, to measure their refractive error, and, as appropriate, to determine how best to "custom tailor" refractive surgery to their individual situation.

Appointments to schedule an individual consultation may be arranged by calling 508-999-3150.