LASIK improved with advanced technology

A new generation of LASIK eye surgery that combines laser surgery with wavefront diagnostic system technology is available in northern Michigan.

Wavefront-guided LASIK is a promising technology that provides an advanced method for measuring optical distortions in the eye. Measuring and treating these distortions goes beyond nearsighted, farsighted, and astigmatism determinations that have been used for centuries.

This new wavefront technology is available through Dr. Robert Butryn at Northern Vision Eye Care in Traverse City and Dr. Jeffrey Chaulk at Alpine Eye Care in Gaylord. They both use CustomVue, an individualized laser vision correction system by the VISX corporation. A new dimension was added recently to VISX's system when the U.S. Drug and Food Administration (FDA) approved its Iris Registration in May.

CustomVue with WaveScan was developed by VISX in conjunction with their excimer laser. Using WaveScan-based digital technology, doctors can now identify, measure and correct imperfections in an individual's eye 25 times more precisely than with standard methods used for glasses and contact lenses.

"We know much more about your eye going into the procedure," Butryn explained, "And now with custom-driven technology, the laser actually uses that reading to treat your eyes instead of us determining what your glasses needs are and just programming your glasses (prescription) into the laser."

WaveScan works by light traveling in a procession of flat sheets known as wavefronts. Gentle wavefront lights enter the eye, pass through the entire optical system (cornea, lens and retina) and are then reflected back into the WaveScan sensors. This creates an optical map of the eye, highlighting individual imperfections. The information from the wavefront diagnostic procedure is then transferred to the laser, providing a custom guide for the LASIK correction surgery.

"Another thing that is unique in the WaveScan and custom technique is that we're measuring higher order aberrations," Butryn pointed out. "With WaveScan we capture all of that."

Iris Registration is the first iris-based, automated method of aligning the eye during a LASIK procedure. It works only with VISX's CustomVue LASIK technology to allow eye surgeons to have the proper placement of the laser during treatment. The eyes of some patients rotate when they go from a sitting to a lying position. To take this difference into account, CustomVue Iris Registration takes photographs of the iris at the same time it creates a wavefront image assessment. The laser then uses this photo to confirm that the treatment is in pupil alignment.

"CustomVue is really the major difference these days in how we're doing LASIK surgery," Butryn explained, "And now it's just some fine-tuning of the custom approach."

The FDA approves treatment of eye corrections in steps, he said.

"Just over the past 10 months or so, we have been able to treat anybody with glasses, basically. Now we can treat nearsightedness, farsightedness and astigmatism. They are all approved for VISX technology."

Butryn has been doing traditional LASIK procedures since 1999. He used a mobile excimer laser at the beginning of his practice, but soon decided there were advantages of having his own stationary laser. He added CustomVue technology as soon as it became available.

"Sinai Hospital in Detroit was my residency program and Sinai was a FDA test center for excimer laser clinical trial… So, that gave me a wealth of experience with LASIK patients, treating them surgically and for post-operative care… I had three years of treating patients… and then when I came to town (Traverse City) I had that experience under my belt."

Dr. Mat Madion of the Grand Traverse Ophthalmology Clinic was instrumental in bringing the first excimer laser to Traverse City in 1997 and has been involved with refractive surgery and its evolving techniques since joining GTOC in 1992. He felt the VISX vision correction system was the most reliable and highly developed system on the market when LASIK surgery was initiated here in this area. In the excimer laser industry, the two other giants, Alcon and Bausch & Lomb, vision correction systems are available downstate in the Detroit and Ann Arbor areas.

Prices for Dr. Butryn's traditional LASIK procedure range around $1,900 per eye and the custom wavefront technology costs around $2,300 per eye.

Is it worth it? These patients believe it is.

Mary Ellen Sommerfield is a retired RN who was told by another doctor that she wasn't a candidate for regular LASIK surgery.

"I heard on the radio that Dr. Butryn did Custom(Vue), so when I went there, they told me I was a candidate and would be able to do it. Two days later I had it done," she said. "It's wonderful!"

She talked her husband, a former area businessman, into having CustomVue LASIK surgery two weeks later. After wearing bifocals for 17 years, Sommerfield had 20/20 in one eye and 20/30 in the other after the procedure. Best of all, she doesn't wear glasses anymore.

"Its just amazing," she said. "Not a day goes by that I don't wake up and think, 'it's so nice!'"

Bruce Winters is a computer software consultant and travels extensively, depending on his eyesight everyday for his career. Having worn contact lenses for 21 years (since he was 22 years old), they were starting to cause some discomfort as he grew older. He wanted to try the custom LASIK, but, like many people, had some reservations about the outcome of the surgery. But in March 2004, he decided to have Butryn do the procedure, even though astigmatism in his left eye was more challenging.

"I couldn't be happier. Had I known how things were going to turn out, I would have done it sooner… The integrity of the whole process was good, too."

Winters' eye with the astigmatism needed further touch up, but he only needs glasses now for very fine print.

"Anything within arm's reach was my world (before)," Winters pointed out. "Now I wake up seeing the clock."

Many of the eye clinics in Traverse City perform regular LASIK procedures, but CustomVue is only available, for the time being, through Dr. Butryn's and Dr. Chaulk's practices. BN