Advances in laser eye surgery bring wider use, less cost

People weary of wearing glasses can choose from eye correction techniques that are now less painful physically and financially. Laser eye correction is growing more sophisticated, more versatile in treatment options for more problems, and is less expensive than ever before.

"Laser eye surgery has had major changes over the last decade," according to Dr. James B. Mattax of Mattax-Neu-Prater Eye Center, 1265 E. Primrose. "We used to treat mild to moderate levels (of eye dysfunction) with RK (radial keratotomy) surgery, making an incision in the cornea with a diamond blade."

Mattax said that RK is "a good operation ... but it has a fairly limited range. The next step was using the laser to reshape the cornea, which broadened the range of refractive, focusing errors we could treat."

When surgeons were treating the surface of the cornea with the laser, Mattax said, "recovery was slower and discomfort greater so the next step in the evolution of the treatment process was the use of the corneal flap ... and an even further improvement with the lasers and the (LASIK) computer technology which controls the lasers.

"We can now treat astigmatism and farsightedness," he said. "We couldn't treat that before we had these modern lasers."

The laser eye surgery business appears to be booming. Mattax points to a steadily increasing acceptance of laser procedures by the general public. About 50 percent of the U.S. population have some type of significant refractive error, he said, and laser surgery can help. He added that for him and for the other refractive surgeon at Mattax-Neu-Prater, Dr. Thomas Prater, correcting refractive problems makes up about 50 percent of their business.

Laser Vision Centers Inc., headquartered in St. Louis, Missouri, cites a 34 percent increase in refractive case volume over the previous fiscal year. In a news release, Laser Vision reported it operated 106 excimer lasers in the United States. alone. These lasers were employed by 710 surgeons in over 47 states making Laser Vision "the largest provider in the world."

Wes Dunn, vice president of the Laser Vision Centers Inc. Market Development Office at 3050 S. Delaware, said, "We specialize in laser refractive surgery. We have 106 lasers in the U.S. and about half of those are transportable; we bring the laser to a surgeon and they use it for a day or two. Then we take it on to the next city. The other half of our lasers are installed in larger ophthalmic practices. We have one fixed laser installed at Mattax-Neu-Prater Eye Center."

Dunn added, "The beauty of it is, our role is to bring the highest technology to surgeons, with the highest quality support staff as possible. The Visx S3 is considered the state-of-the-art laser to treat the highest possible ranges of refractive error and astigmatism."

According to Dunn, the eye surgeons Laser Vision works with across the United States average between 14,000 to 16,000 cases a month. He believed the national cost average was at $1,800 per eye for LASIK (laser assisted in-situ keratomileusis). Mattax and Prater charge a fee of $1,750 per eye for a package that includes pre-operative evaluation, surgeon fee, facility fee post-operative fee, and an enhancing laser procedure, if needed.

Growing popularity

Laser procedures' growing popularity is also attested to in news from Sunrise Technologies International Inc. of Fremont, Calif., makers of the Hyperion LTK (laser thermal keratoplasty) System. Sunrise Technologies reported a record 116 percent increase of sales and other income for the first quarter of 2001.

At St. John's Eye Laser Center, 3231 S. National, Pat Stokes, refractive surgery coordinator, said the center's typical package cost for LASIK surgery is $1,950 per eye and $1,500 per eye for the Sunrise Hyperion LTK surgery.

Stokes said she believes pricing is "pretty much stabilized for the best practices." She added, "It's a medical procedure and you want the best for your eyes. You can cut pennies somewhere else, but not for your vision."

Mattax also warns of laser vision discounters. "Patients should be very cautious about what they are getting for their fee. Oftentimes it doesn't include everything that we include."

The procedure a patient will undergo depends largely upon the patient's needs, health, age, and preferences. For example, the Sunrise Hyperion LTK process, which shrinks collagen to correct ophthalmic refractive conditions, is only used for patients over the age of 40 who are experiencing hyperopia (farsightedness) within specific parameters. Patients outside those numbers may be more suited to the LASIK laser surgery, which has a broader treatment range.

With the Hyperion LTK procedure, Stokes said, the actual time under the laser is about three seconds per eye and nothing touches the eye. "It's a brand new procedure. We were the first to offer that procedure in the state of Missouri. One of our physicians, Dr. Jim Gessler, was our first patient, and now he does it himself."

Dr. Craig Peterson also performs LTK laser surgery at St. John's. Both he and Gessler perform LASIK laser surgery. Stokes describes another laser the Alcon Summit Autonomous Ladarvision as "fantastic, patient-friendly" and one which covers a wide range of near- and farsightedness, as well as astigmatism. This laser device's built-in tracking system is what makes it "really special," she said; patients don't have to worry about keeping the eye still.

At Mattax-Neu-Prater Eye Center, Mattax described the LASIK procedure as one without injections or IVs; instead, a topical eye drop anesthetic is used. Typical time in the operating room is about 20 minutes for treating both eyes.

Whatever procedure is used, recovery time and vision correction results depend on the individual patient as well as the procedure. Mattax said his typical LASIK patient can drive the next day and return to normal activities within 24 to 36 hours.

"Legal driving vision is 20-40; 99 percent of patients who are good candidates for LASIK surgery are 20-40 or better after the treatment, without glasses or contacts. Close to 90 percent are 20-25 or better," Mattax said.

Of the Sunrise Hyperion LTK, Stokes added, "We've been offering the procedure since fall 2000. The results have been good. Our patients say they are happy."

How does the future look for laser eye surgery?

All agree it appears bright. Dunn pointed out that Laser Vision Centers Inc. experienced a record month in January with the number of procedures done in the United States. He added, "We expect the procedure to continue to grow nationally because we've only impacted 1 percent of the population who can be helped by the procedure. We are expecting tremendous growth."