Making Things Clear

Imagine Your Vision Without Contacts or Glasses.

You could see your alarm clock each morning, enjoy outdoor activities like cycling, swimming and golf and enjoy the vibrant colors of a beautiful fall day. Good vision is truly a gift.

When you are considering LASIK to correct nearsightedness, farsightedness or astigmatism, the first and most important decision you can make is choosing the right surgeon. Our vision correction specialists, Edward K Isbey, III , MD, and Damien C. Macaluso, MD are board-certified, fellowship trained cornea and vision correction specialists and are both nationally recognized LASIK surgeons. They understand that your goal is to see clearly and to free yourself from total dependence on glasses and contact lenses. They are committed to each patient. Rest assured that their total personalized attention and care will be focused on you from your very first consultation, during your surgery, and with each follow-up visit.

Dr. Isbey III has developed a "TEAM" approach in his LASIK Center, ensuing excellence in continuity in patient care. The team consists of certified ophthalmic technicians, certified laser vision surgery technicians and certified VISX laser technicians.

As a result of advanced training, technology and personalized care, the Laser Vision Correction Center at Asheville Eye Associates has been recognized by Laser Vision Inc. as one of the Top 50 LASIK Centers in the country for the past 5 years. This designation establishes Asheville Eye Associates as a leader in the field of LASIK.

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Understanding LASIK

LASIK (Laser Assisted in Situ Keratomileusis) reshapes the cornea, the clear tissue at the front of the eye, so that light rays can more precisely focus on the retina in the back of the eye. A thin flap of corneal tissue is created and then the inner cornea is reshaped by the laser. When the flap is replaced, it tightly adheres to the corneal surface and allows a more rapid return of functional vision and less postoperative discomfort. The FDA has approved LASIK for nearsightedness, farsightedness and astigmatism. Presbyopia, difficulty with near vision after 40, is explained below.

• Nearsightedness (myopia) usually occurs when the cornea is too steep or the eye is too long, so that light focuses in front of the retina rather than directly on the retina. Near objects are seen clearly, but objects in the distance appear blurry. LASIK reshapes the cornea by removing tiny amounts of tissue from its center to allow the light to focus on the retina.
  
• Farsightedness (hyperopia) usually occurs when the eye is too short, so that light focuses beyond the retina. LASIK reshapes the outer cornea so the central cornea is made steeper and can better focus light onto the retina.
  
• Astigmatism occurs when the cornea is shaped more like a football, so that light focuses at more than one point on the retina. LASIK makes the cornea more spherical or even by removing more tissue in one direction and less in others.
  
• Presbyopia – the word “presbyopia” comes from the Greek and means “elder eye.” As we age, the crystalline lens of the eye loses its flexibility, making it difficult to focus up close. After age 40, people begin to experience blurred vision at near points, such as when reading or working on a computer. Presbyopia happens to everyone when they age, even those individuals who have never had a prior vision problem.
  
  Presbyopia is detected during a comprehensive eye exam. Using instruments to measure your eyes, your eye doctor will determine your exact prescription. As you grow older, the human lens will continue to change, and your presbyopic prescription will increase over time. Patients with presbyopia are frequently candidates for LASIK treatment in monovision, a treatment where one eye is focused for distance and the other for near.
  

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Wave Scan Technology

Wave Scan Wave Front technology was originally developed for use in high-powered telescopes to reduce distortions when viewing distant objects in space.
Edward K. Isbey, III, M.D., and Damien C. Macaluso, MD our LASIK surgeons, use this technology for laser vision correction procedures. The Wave Scan detects and measures the optical distortions unique to your entire optical system. The Wave Scan produces a visual representation, or map, of how your eye’s own optical system processes light. This produces a fingerprint of your vision, or Wave Print™ map. This digital information is then transferred to the VISX Star S4™ Excimer Laser System and is used as a guide to reshape the cornea for your individual measurements.

With customized treatment zone and measurements, the CustomVue individualized laser vision correction tends to provide improved night vision and better vision under low light conditions.

Dr. Isbey, III, and Dr. Macaluso have developed a team approach to vision correction surgery. They feel this delivers personalized care and the best outcomes. The same doctors who perform your initial evaluation are also involved with your laser treatment and follow-up exams. We stress involvement of the physicians and staff at every step of the vision correction procedure. We continually monitor our processes and results to improve our outcomes.

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Understanding PRK

PRK (photorefractive keratectomy) was the first type of vision correction surgery performed in the U.S. with the excimer laser. The laser treatment is applied to the surface of the cornea after gently removing the surface cells of the cornea. PRK is an excellent option for those patients with thin corneas or other conditions that prevent LASIK from being safe or successful because PRK removes tissue from the frontal areas of the cornea.

Advances in laser technology, including Wave Scan Wave Front, have also optimized PRK outcomes. The disadvantage of PRK is the slow recovery, as vision remains blurry until the surface cells heal and smooth, usually within several weeks.   PRK can be also used for higher degrees of correction if Mitomycin, an anti-scarring medication, is used.

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Understanding CK For Near Vision

You have excellent vision until your 40s – then you need glasses to help you read. You and millions of Americans have most likely developed presbyopia – the need for reading glasses. Near Vision CK (Conductive Keratoplasty) is FDA-approved as a safe, non-laser, non-cutting technique that can eliminate or reduce your need for reading glasses.

Near Vision CK can change how your eye focuses light by reshaping the surface of your eye (the cornea). To produce this reshaping, Near Vision CK uses the controlled release of radio waves to heat and shrink corneal tissue. This steepens the cornea and allows light to properly focus on the retina again for near vision. Near Vision CK improves your ability to focus on near objects without reading glasses. In a clinical study for Near Vision CK, nine out of ten patients could see 20/20 or better at distance and could read newspaper-size print after the procedure without glasses.  Our vision correction specialists will perform  a complete eye examination, and then they will  determine your specific vision needs and treatment plan, and establish if Near Vision CK is the right procedure for you.

The cornea is the clear covering on the front of the eye (like a watch crystal). The cornea bends, or refracts, light so that light rays come into focus on the retina in the back of the eye. Corneal curvature may be surgically corrected through vision correction procedures, such as LASIK, PRK, CK (conductive keratoplasty) and AK (astigmatic keratotomy). Other vision correction procedures such as refractive lensectomy (also called clear lens replacement or CLR) can be used to improve vision and reduce or eliminate the need for eyeglasses or contact lenses.

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Other Refractive Procedures

New refractive procedures and technology include multifocal intraocular implants which allow patients after clear lens replacement surgery or cataract surgery to see better at distance and at near.  A thorough eye examination and consultation are necessary to help your doctor determine which treatment may be beneficial for you.

You may not be a good candidate for any vision correction surgery if:

• You have had significant changes in your vision over the past year
• You have any chronic eye disorders
• You are pregnant or nursing
• You have a chronic illness or disease

Please call our office for an appointment for a complete eye examination and consultation.

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Continue to LASIK FAQ

Meet our Vision Correction Surgery Specialists :

Edward K. Isbey, III, M.D.
Damien C. Macaluso, M.D.

For additional information please visit the U.S. Food and Drug Administration website at http://www.fda.gov/cdrh/lasik.