Eye laser surgery: An interview with Dr. Winnie King and Eric Mandel, MD.

It has only been in the past few years that laser procedures were able to correct almost all degrees of nearsightedness and astigmatism. Lasik, which is a laser eye surgery attains one of the highest success rates in optic correction. Dr. Eric Mandel is a board-certified ophthalmologist and ophthalmologic surgeon. He is one of the pioneers in Laser surgery.

WK: We are all really excited about the idea of not having to wear contact lenses or glasses anymore. What is the basic philosophy behind using some device like a laser to change the surface of the eye? How does that make your vision better?  
EM: Basically what we are doing is re-profiling a contact lens right on to your eye and I actually started with this back in 1984. And what we are able to do, with the point of sophistication we have gotten to here is that we can put the numbers in to the computer, the laser can read it and we can reshape the eye to exactly your prescription and correct your astigmatism. The results are permanent and at the present time, the procedures we are doing are both eyes at once and the next day almost everybody is functional and going back to work.

WK: And their vision is corrected.
EM: And their vision is corrected.

WK: Why haven't we done this ages ago. What has taken so long for this type of technology to come along?  
EM: This laser we use, which we found out in the 80's is the perfect wavelength of a laser that matches the cornea. We can re-profile the cornea without damaging it at all. Other lasers, we have many types of lasers, would damage the cornea. This one is just the perfect wavelength and that is what makes it unique.

WK: Are there people for whom this procedure won't work on?  
EM: For the nearsighted people, I would say over 99% of those people are candidates for the procedure. One thing that you mentioned before about people being scared about their eyes, all we use as an anesthetic are drops, no different from drops you get with a glaucoma check. There are no injections, no intravenous and no patch when they leave. My patients tell me they feel some pressure they don't feel any pain from this procedure and afterwards they have a gritty feeling. But, the next day the vast majority wake up feeling absolutely fine and seeing.

WK: I know that feels like a miracle for a lot of folks.  
EM: That is kind of the word that most people use, it feels like a miracle.

WK: Help us to understand the way the eye works, with light coming into the eye, where it lands, and why people have problems with their vision.  
EM: The light rays come all the way back to the retina and when they land at the retina perfectly, sight will be perfectly focused. In nearsighted people, the cornea or focusing area is too strong and so the light rays focus themselves in the wrong area?

WK: They don't go back to where they are supposed to.  
EM: Right, so we either put a pair of glasses or contact lenses to change the light rays from ending up in the wrong area.

WK: Now, when you do your surgery what are you doing?
EM: The first thing I am going to do is I am going to put marks to create a flap. Lasik, the procedure we are talking about, makes a flap in the cornea under 60 microns (less than a hair). We flap open the cornea, we laser and flap it back down. We place a suction device on the eye. They are feeling just pressure and then we place an instrument that will go across the cornea and make 160 micron flaps. Once the flap is open, I go in the cornea and with the prescription that I've calculated, I put it right into the eye and then I put my flap back down. The flap will naturally adhere, no stitches in about 4 minutes. Then we move to the other eye and it takes about 10 minutes per eye. Then they get up and they walk out.