Dear doctor,

I am writing this as to as few questions that only the expert in the field can help me.

I am a hemophiliac and I am hoping very much to have perfect eyesight for the purpose

convenience. I am unsure what is the different between LASEK. LASIK, WAVEFRONT

And CUSTOMVUE.

For my conditions being a hemophiliac with deficiency of factor 8, what should I do to

have perfect eyes? And what are the minimum risks with maximum best outcome that I

can get from either LASEK. LASIK, WAVEFRONT And CUSTOMVUE.

Yours sincerely.
ANDY.

LASIK requires two major steps. The first is cutting a flap of corneal tissue that is temporarily moved out of the way, and the second is applying excimer laser energy under that flap to reshape the cornea. The flap is then repositioned over the treated area. See http://www.usaeyes.org/faq/subjects/lasik.htm

The flap can be created with a mechanical microkeratome that uses a metal blade, or a laser microkeratome. The laser microkeratome has been shown to be more accurate and predictable than the mechanical microkeratome, however the laser microkeratome does have some limitations. You would need to be evaluated by a competent surgeon to determine which would be best. See http://www.usaeyes.org/faq/subjects/intralase_intralasik.htm

There are two types of systems that determine how much excimer laser energy needs to be applied where to ablate (remove) tissue. Conventional ablation uses your prescription as the primary basis for determining where to ablate. Wavefront-guided ablation uses a more advanced evaluation system to determine how much tissue needs to be removed and where. In many studies, wavefront-guided ablation has been shown to provide superior results to conventional ablation. See http://www.usaeyes.org/faq/subjects/wavefront_custom_lasik.htm

Different laser manufacturers have trademarked different names for wavefront-guided ablation. Visx uses “CustomVue”. Alcon uses “CustomCornea”. Bausch & Lomb uses “Zyoptix”. These are just brand names for a particular manufacturer’s system of wavefront-guided ablation.

LASEK is similar to LASIK, however LASEK does not require a thick flap of corneal tissue. LASEK applies the laser energy on the surface of the cornea, whereas LASIK applies the energy under the flap. Several studies have shown a surface ablation technique such as LASEK or its cousins PRK and Epi-LASIK to provide a better outcome than LASIK, however surface ablation techniques do have some limitations. You would need to be evaluated by a competent surgeon to determine which would be best. See http://www.usaeyes.org/faq/subjects/lasek.htm

A normal healthy cornea does not have blood vessels in it, so your hemophilia should not be an obvious problem. There may be, however, some interaction with the medications used during surgery and medications used to control the hemophilia. You should check with your hemophilia doctor before having any elective surgery and, of course, notify your refractive surgeon of your condition and medications.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.