News and Technology

The only thing new is the name. Millennium Laser Eye - already a proud member of the TLC family -- has become TLC Laser Eye Centers. The doctors and staff at this Tysons Corner location provide patients with the same outstanding patient care and individual attention that TLC patients expect and enjoy. They offer the same firm commitment to the best possible result for every patient.

Dr. Andrew Holzman, a renowned LASIK surgeon and a leader in the field of laser eye surgery, will continue to serve as Medical Director. When it comes to laser vision correction, there is no substitute for experience and Dr. Holzman has performed more than 40,000 refractive procedures. No one offers more experience than TLC and no one knows that better than Dr. Holzman.

In joining forces with TLC, Dr. Holzman and his patients will enjoy the resources of the world's largest provider of laser vision correction. TLC offers access to the most advanced, proven technologies and state-of-the-art equipment to correct common vision disorders including Bladeless LASIK and CustomLASIK.

Prospective patients will continue to receive a complimentary consultation - one of the most comprehensive in the industry - to help determine if laser eye surgery is the best solution for their unique vision problems. Qualified patients are also eligible for TLC's Lifetime Commitment program, excellent financing options and the backing of more than 80 centers across North America.

TLC's surgical suite in Tysons Corner, which was designed specifically for vision correction, makes it possible to control multiple environmental conditions and limit the influence of variables such as humidity, temperature, and airflow. Our Liebert System air handling unit also allows for 99 percent particle filtration, so patients can be completely confident in the facility where their procedures will be performed.

TLC Laser Eye Centers is the proven choice for LASIK, with more than 1 million procedures performed. TLC Tysons Corner is located at 1750 Tysons Boulevard, Suite 120. For further information or to schedule a consultation, call 888-TLC-2020.

Have you thought about LASIK but didn't think you could afford it? TLC Laser Eye Centers has great news! By utilizing your Flexible Spending Account (FSA) through your employer, you can set aside tax-free dollars now... to pay for LASIK later. FSA enrollment periods are brief and yours may open soon. Before you set aside funds for your FSA, find out if you're a candidate for LASIK. Then see your Employee Benefits Advisor for details..

Call 1.888.TLC.2020 to schedule YOUR complimentary consultation TODAY!

You can even Book Online NOW!

September is Children’s Eye Health & Safety Month. Your family eye doctor and TLC Laser Eye Centers are focusing our Eye Safety Campaign this fall on some of the ways you can protect your child’s sight. Ninety percent of all eye injuries can be prevented.

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No two eyes are alike and TLC Laser Eye Centers recognizes that every refractive condition deserves the right technology. At TLC, we keep our focus on providing the safest and most advanced technologies to our patients.

LASIK is a two-step procedure that reshapes the middle portion of the cornea.

Step One: In order to get to this middle portion of the cornea, a flap must be created so this outer surface layer can then be moved aside. This flap is created with either the microkeratome surgical blade or the IntraLaseR laser. The IntraLase methos allows for an all-laser LASIK procedure also known as Bladeless LASIK. Click here to learn more.

Step Two: This step occurs when the laser actually treats (ablates) this middle portion, reshaping the eye for improved vision and a very rapid recovery time. The type of laser we use for Step two is:

• The VISX STAR S4 ActiveTrakT Excimer Laser System which is used to treat nearsightedness and farsightedness with or without astigmatism. It incorporates the VISX patented variable-beam technology with the new 3-D ActiveTrack eye tracker system that works without pupil dilation. This laser represents next-generation laser technology and reflects our continuing commitment to offer our patients high-quality treatment for each individual condition.
• The Allegretto Wave Excimer Laser corrects spherical and astigmatic prescriptions. Refractive errors and higher order aberrations are corrected in a single step using the laser beam's smaller diameter combined with high-speed scanning capabilities. The Allegretto is a high speed scanning spot laser that allows delivery of 200 laser pulses per second.

Study Reflects Results Shown by TLC Custom LASIK Patients

A collaborative study just released by the U.S. Army, Navy, and Air Force demonstrates the superiority of Custom LASIK, or wavefront, a state-of-the-art laser vision correction procedure. The study was released in conjunction with the recent national meeting of the 31st Annual Symposium of American Society of Cataract and Refractive Surgery held in Washington, D.C.

Captain Steve Schallhorn, MD, director of refractive surgery at the Naval Medical Center, San Diego said, "With wavefront-guided procedures we're getting better quality of vision, better clarity, better night vision, and better contrast sensitivity than we did with conventional laser eye surgeries." Col. Robert Smith of the Air Force Warfighter Refractive Surgery Program agrees. "While conventional laser correction procedures are good, wavefront-guided vision correction is ratcheting up our expectations."

Custom LASIK is the advanced procedure that uses a tool called the wavefront analyzer to measure the way light passes through your eye. Custom LASIK is able to address and correct "higher-order" aberrations, which are distortions thought to cause problems such as halos or glare. The study confirmed the benefits available to patients by showing that Custom LASIK patients did not report experiencing night driving halos or glare while conventional LASIK patients reported an increase in halos. Most patients experienced a satisfactory resolution in halos after three months.

The National Aeronautics and Space Agency (NASA) has announced the approval of Bladeless Custom LASIK vision correction for their astronauts - the same bladeless custom technology that is also available nationwide at TLC Laser Eye Centers.

NASA's approval came following a review of extensive military clinical data using the same two lasers employed in our Bladeless Custom LASIK. The research showed that the use of the combination of technologies provided superior safety and vision - results TLC Centers agree are unparalleled.

 Read more.

The field of refractive surgery is constantly evolving as advanced technologies and treatment techniques are developed and tested. At TLC Laser Eye Centers, we recognize the importance of remaining informed about news, reports, and studies regarding laser vision correction and other refractive procedures. For individuals considering vision correction, information on a variety of topics from a range of reputable sources is recommended to ensure that you are as educated as possible about the benefits, risks, and other considerations of the latest treatments and equipment. To learn more, contact TLC Laser Eye Centers to schedule a consultation.

• Want to Work in Space? Squinters Can Now Apply
• LASIK Eye Surgery for Air Force Aviator Applicants
• Sailors, Marines eye free Lasik - 70,000 could undergo surgery by October
• No End in Sight: Results of Laser Eye Surgery Last for Year, New Study Suggests
• Analysis Shows Higher Long-Term Risk Of Infections ForContact Lens Wearers Compared to LASIK

At TLC Laser Eye Centers, we customize each treatment to the specific needs of the individual and are committed to helping you achieve your vision correction goals. We offer the most technologically advanced equipment to produce the highest-quality results while ensuring your overall comfort and safety. We have provided the following information to help patients prepare for their procedure:

LASIK Preparation

PRK Preparation

• Please realize that pre-operative preparation is extremely important in your healing and the ultimate success of your LASIK eye surgery. Dr. Holzman is very concerned about your success and has optimized your pre-operative regimens to help ensure outstanding results.
• All patients will receive three pre-operative medications to use. The first is an ointment to be applied to the eye, just inside of the lower eyelid, at bedtime.
• This starts one week prior to the surgery. It is called MURO 128 Ophthalmic Ointment, and your pharmacist should carry it as an over the counter medication. You will not be using this after the procedure, just prior to it.
• One day prior to your surgery you will begin two different eye drops, each to be used four times per day. They are called VIGAMOX and NEVANAC. They will assist in your healing and comfort. These two drops will also be used post operatively.
• Some patients who were found to have a significant Dry Eye Syndrome will also be prescribed an eye drop called RESTASIS pre-operatively. This is to be used twice daily once you receive the prescription, and then will continue this for at least two to three months post-op. You will be stopping this medication on the surgery day and for the first two days after the surgery, and then restarting it on post op day #3.
• PLEASE MAKE SURE YOU HAVE READ YOUR CONSENT FORMS AND ALL OTHER IMPORTANT PAPERWORK PRIOR TO YOUR ARRIVAL AT THE CENTER. Do not wear any colognes, perfumes or scented soaps on the day of your procedure. When you arrive on your procedure day, you will be given a complete post-operative kit with thorough instructions for your post care. It will contain another eye drop called ECONOPRED PLUS, which you will use along with the Nevanac and Vigamox. It will also contain samples of lubricant eye drops called SYSTANE, which are very important to use frequently during the first few months after the procedure. These are available over the counter and you will need to purchase some once your samples have run out.
• We know that this sounds like you will be using a lot of eye drops! Don€™t worry, it will all be easily spelled out for you on the forms which you will be receiving.

• The procedure is very simple and easy for the patient. However it is very important to keep all the facial muscles relaxed throughout the procedure. This includes the forehead, brows, eyelids, cheeks and jaw muscles. It is also very helpful to do some deep breathing to help relax.
• This is a two step process. Step one is creating the flap with the IntraLase. The IntraLase takes approximately 40 seconds to create the flap, during which your vision will dim out and you may feel some pressure. It is very important not to talk or move around during the laser process. Just breathe gently. Once the flap is made in the first eye, the process is repeated on the second eye.
• Step two involves lifting of the flap and vision correction with the excimer laser. There will be a small piece of tape placed over one eye while the other eye has a lid speculum that will keep your eyelids open. The speculum does not hurt and it is important that you do not fight against it. It is best to keep your brow and forehead relaxed in order to make this easier for both you and Dr. Holzman.
• You will be focusing on a blinking target and will hear the ticking of the laser. It is not uncommon to notice an odor during this portion of the procedure, which lasts only a few seconds.
• The rest of the procedure will move quickly from this point on.
• Dr. Holzman will be talking to you throughout the procedure and keeping you informed each step of the way.
• The key word is relax. The more relaxed you are, especially in the facial area, the faster and easier the procedure will be.

• Immediately post-operative, your vision will be watery and blurry, and will remain that way for most of the first day.
• There will be tearing and burning for a few hours after the procedure, and it is highly recommended that you go home, place your first set of eye drops in, and then take a two to three hour nap. Do NOT sleep for more than three or four hours.
• Visual acuity should improve rapidly over the first 12 to 24 hours, but will fluctuate greatly over the first few days.
• Your vision on day one in no way represents your final result. There is usually significant swelling of the cornea which needs to diminish.
• Visual acuity reaches maximal level expected within three to four weeks following the procedure, with full stabilization reached within three months in most patients.
• The healing process is very much individualized and therefore, results will vary greatly from patient to patient.
• At night, there will be a “halo” or “starburst” affect around lights especially in the early healing process. These usually diminish over time, from weeks to months. You should expect glare/haloes and a “filmy” sensation to your vision during the first month, with resolution of these symptoms over time.
• Most patients will find it difficult to read in the first few days following LASIK eye surgery.
• Most patients will experience dryness after the procedure, varying from several weeks to months. Artificial tears can be very helpful and should be used frequently after the procedure.
• Occasionally, you may see blood-red spots in the white of the eyes following LASIK eye surgery. These are due to fine, fragile blood vessels that have been disrupted. DO NOT worry about these blood spots as they mean nothing to your outcome. They will disappear within a week.
• A very small number of patients may experience under-response, over-response, or regression after the procedure. This can occur if your healing process falls outside the ″normal″ range. In most cases, an enhancement procedure may help improve visual acuity. The enhancement procedure is usually not performed until vision has completely stabilized, typically about three months after the original procedure. There is no guarantee that an enhancement will be successful in improving the outcome, although it usually does. No guarantees of visual outcomes can be made. Rarely, patients may need glasses/contacts to improve vision post op.

• The procedure is very simple and easy for the patient. However it is very important to keep all the facial muscles relaxed throughout the procedure. This includes the forehead, brows, eyelids, cheeks and jaw muscles. It is also very helpful to do some deep breathing to help relax.
• There will be a small piece of tape placed over one eye while the other eye has a lid speculum that will keep your eyelids open. The speculum does not hurt and it is important that you do not fight against it. It is best to keep your brow and forehead relaxed in order to make this easier for both you and Dr. Holzman.
• During the procedure, Dr. Holzman will be asking you to look at a red light for fixation. At times, he will also block the red light with instruments. It is best to keep looking straight up in the direction of the light, even if you don€™t see it.
• The procedure is very fast and will frequently be done within a few minutes. A contact lens will be placed over the eye to help it heal during the first several days.
• Dr. Holzman will be talking to you throughout the procedure and keeping you informed of each step of the way.
• The key word is relax. The more relaxed you are, especially in the facial area, the faster and easier the procedure will be.

• Immediately post-operative, your vision will be watery and blurry, and will remain that way for most of the first few days.
• There will be tearing and burning for a few hours after the procedure, and it is highly recommended that you go home, place your first set of eye drops in, and then nap if possible. About 15 percent of patients complain of significant irritation and light sensitivity. This is usually during the first 48 hours. Use as many artificial tears as possible, keep all your drops chilled, and follow instructions carefully. Your irritation will resolve. Get as much rest as possible.
• It is normal for the vision to be better on day one and day two, with a bit more blurring on days three and four. This is because the corneal surface heals across the center of the vision on days three and four. The contact lens which is helping you heal will typically be removed on day four or five.
• Your vision in the first week in no way represents your final result. There is usually a great deal of fluctuation and visual improvement over the coming weeks.
• Visual acuity usually reaches maximal level expected within six to eight weeks following the procedure, with full stabilization usually reached within three months in most patients. You should be functional during the healing period, even during the first weeks.
• The healing process is very much individualized and therefore, results will vary greatly from patient to patient.
• At night, there will be a "halo" or"starburst" affect around lights especially in the early healing process. These usually diminish over time, from weeks to months. You should expect glare/haloes and a "filmy" sensation to your vision during the first month, with resolution of these symptoms over time.
• Most patients will find it difficult to read in the first few days following PRK.
• Most patients will experience dryness after the procedure, varying from several weeks to months. Artificial tears can be very helpful and should be used frequently immediately after the procedure.
• Patients may experience under-response, over-response, or regression after the procedure. This can occur if your healing process falls outside the "normal" range. In some, but not all cases, an enhancement procedure may help improve visual acuity. Re-treatment is usually not performed until vision has completely stabilized, typically about three months after the original procedure. There is no guarantee that re-treatment will be successful in improving the outcome.
• No guarantees of visual outcomes can be made. Rarely, patients may need glasses/contacts to improve vision post op.

The best way to choose the facility and doctor that is right for your LASIK vison correction in Virginia, Maryland or Washington, DC is to visit each center to see where you feel most comfortable. At TLC Laser Eye Centers, you are not just another number, we pride ourselves in our commitment to personal quality care. Our meticulous attention to detail is apparent from the moment of your initial consultation to your final postoperative visit. Every member of the TLC team is a dedicated professional. We will work hard to ensure you receive quality care in a professional environment. Our goal is to let you know you are our first priority throughout every step of your care with us at TLC Laser Eye Centers.

At TLC Laser Eye Centers, our patients come first. We customize each treatment to the specific needs of the individual and are committed to helping you achieve your vision correction goals. Our state-of-the-art surgery centers are designed to ensure your comfort and safety, and we offer the most technologically advanced equipment to produce the highest-quality results. Additionally, our financing options make LASIK vision correction affordable for all of our patients.

TLC Laser Eye Centers has a conveniently located office to care for all of your LASIK eye surgery and vision correction needs. Our professional staff and welcoming atmosphere will help you feel relaxed and at ease throughout the course of your treatment with us.

The surgical suite, which was designed specifically for vision correction, makes it possible to control for multiple environmental conditions and limit the influence of variables such as humidity, temperature, and airflow. Our Liebert System air handling unit also allows for 99 percent particle filtration, so you can be completely confident in our facilities.

Our surgeon, Dr. Andrew Holzman, has dedicated his career to refractive surgery. Dr. Holzman is a Board Certified Ophthalmologist and is also a Corneal Specialist. He has had training in all types of vision correction procedures, such as RK, AK, ALK, PRK, LASIK, and NearVision CK. ALK surgeons were trained in how to create flaps and how to handle flap complications. Creating the flap is the most technical and challenging part of LASIK vision correction. The expertise of Dr. Holzman gives him the ability to handle all ranges of prescriptions, as well as very difficult cases that have been rejected by other less-experienced LASIK surgeons.

The field of laser vision correction experiences continual innovations in both surgical technique and equipment. Our mission is to provide the highest-quality care by remaining on the leading edge of these advancements. We invest in the most technologically sophisticated and precise tools to diagnose our patients and develop customized treatment plans based on their individual goals and needs.

IRVINE, Calif., Dec. 11, 2007 /PRNewswire-FirstCall/ -- Marking both a milestone in U.S. Naval medicine and refractive surgery, IntraLase(R) Corp. (Nasdaq: ILSE) today confirmed the Navy's announcement that the first LASIK procedure using the IntraLase Method has been performed on an aviator as part of a new Bureau of Naval Medicine project. Currently, LASIK is not approved for use in the U.S. military aviation community. But, after many years of intense LASIK clinical trials on non-aviation personnel, the new Bureau of Naval Medicine project is underway to treat four additional aviators with LASIK using the IntraLase Method scheduled as part of the first step of the program.

Though LASIK has been around for many years, concerns about the harsh aviation environment prevented its use in U.S. Navy aviators. Aeromedical professionals have been cautious of employing the procedure on aviators who frequently encounter environmental extremes such as high altitude, dry air, wind blast and 'G' forces.

According to Capt. Steve Schallhorn, Navy Program Manager for Refractive Surgery, "While LASIK has been around for many years and is a common elective procedure, this is a significant first in the aeromedical field. Wavefront guided LASIK using the IntraLase Method represents the best-of-the-best and is a truly exciting advancement for critical Navy personnel whose sight is of utmost importance in their military duties."

The IntraLase FS laser is the first technology for a truly all-laser, blade-free LASIK procedure, replacing the hand-held microkeratome blade historically used in creating LASIK corneal flaps -- the first step of the procedure -- with a computer-guided, ultra-fast femtosecond (fem-to-second) laser. The IntraLase laser virtually eliminates almost all of the most severe, sight-threatening LASIK complications related to use of the microkeratome and, by creating an optimal corneal surface below the flap, provides for better visual outcomes -- taking many patients to 20/20 vision and beyond.

While LASIK remains the most popular surgery in the civilian community, the Naval Medical Center San Diego's Refractive Surgery Center is the only center currently in Department of Defense offering LASIK using the IntraLase Method.

The first candidate was aviator, Marine Capt. Michael Oginsky, an FA 18/D weapons and sensor officer with VMFAT 101 at U.S. Marine Corps Air Station Miramar. Within just four hours, Oginsky's vision was 20/20. At the 24-hour mark, his vision exceeded 20/20. There are four additional aviators scheduled to take part in the first step of the program and have LASIK using the IntraLase Method performed. More than 1,200 surgeons worldwide have incorporated the blade-free IntraLase Method into their LASIK practices. In fact, the majority of the top U.S. ophthalmic teaching institutes including Duke University Medical School, the Wilmer Eye Institute at Johns Hopkins, the Bascom Palmer Eye Institute at University of Miami, and Stanford University use the IntraLase FS laser technology to train future generations of LASIK surgeons.

The 4th Generation IntraLase FS laser uses an infrared light beam, generating 60,000 pulses per second, to prepare the intracorneal bed and create the corneal flap in the first step of LASIK.

• Using an "inside-out" process, the laser beam is precisely focused to a point within the cornea
• The laser pulses then create thousands of microscopic bubbles which define the incision within the intracorneal surface.
• Along the edge, bubbles are then stacked up at a beveled angle -- a feature unique to the IntraLase Method -- to the corneal surface to complete the flap.
• From start to finish, the IntraLase Method typically takes 15 - 30 seconds.
• The physician then exposes the prepared corneal bed for excimer laser treatment (the second step of LASIK) by lifting the flap.
• The LASIK procedure is complete when the flap is securely repositioned on its beveled edge.

The IntraLase laser makes LASIK safer by replacing the hand-held microkeratome blade with the computer-guided precision of a laser, virtually eliminating almost all the most severe, sight-threatening blade-related LASIK complications as a result. Leading LASIK surgeons have reported on data of the IntraLase Method procedures, which demonstrate an impressive safety profile.

Beyond improving the safety of the procedure, LASIK using the advanced IntraLase Method has been shown clinically to deliver better visual outcomes in both standard and Custom LASIK procedures with more patients achieving visual acuity of 20/20, 20/15 and even 20/12.5. These remarkable results are the product of the optimized corneal surface prepared by the IntraLase FS laser in creating the corneal flap. The precision of the laser reduces the microscopic inconsistencies on the corneal bed, providing an optimal surface for the vision correction performed by the excimer laser in step two of the LASIK procedure.

IntraLase designs, develops, and manufactures an ultra-fast laser that is revolutionizing refractive and corneal surgery by creating safe and more precise corneal incisions. Delivering on the promise of ophthalmic laser technology, the IntraLase FS laser, related software, and disposable devices replace the hand-held microkeratome blade used during LASIK surgery. The unsurpassed accuracy of IntraLase's computer-controlled femtosecond laser has been shown to improve safety profiles and visual outcomes when used during LASIK. Additionally, the IntraLase FS laser creates precision-designed intracorneal incisions that when combined can be used during lamellar and penetrating keratoplasty, and intrastromal ring implantation. IntraLase is presently in the process of commercializing applications of its technology in the treatment of corneal diseases that require corneal transplant surgery. The company's proprietary laser and disposable patient interfaces are presently marketed throughout the United States and 32 other countries. IntraLase is headquartered and manufactures its products in Irvine, California.

Lifeline: Laser Eye Surgery, wwco.com

Since 1995, the Society of Cataract and Refractive Surgery, or ASCRS, estimates more than 3 million Americans have had laser eye surgery.

It's not hard to imagine that millions more are thinking about it. But, many are worried about going forward.

The Mayo Clinic offers reassurances gathered by closely tracking its own laser eye surgery patients. Mayo did not leap into the technology lightly, holding off until just 6 years ago, when its doctors were sufficiently confident the risk was minimal.

Laser surgery, or LASIK, works by cutting minute amounts of tissue off the cornea, so there’s little surprise that patients might have questions about long-term effects. But, so far, Mayo says eye function holds up very well in every way. Researchers are even studying cellular health beneath the eye's surface. Everything there appears to be normal. Complications usually happen with patients who were not good candidates for surgery to begin with. Doctors should warn about increased risks: if your cornea is too thin, astigmatism is too severe, or your eyes need an excessive amount of correction. Near-sighted patients tend to be happier with the outcome than those who are far-sighted.

In a 2003 survey by ASCRS, 93% of patients were satisfied with the results. 95% of people reported improved vision. 85% said LASIK improved their quality of life.

Back to the bottom line on safety.

"Severe complications where you actually have a significant degradation of optical quality are very rare," said Dr. Leo Maguire. Dr. Maguire says contact lenses may put your vision at greater risk than Laser surgery because the risk of developing bacterial infection in the cornea is higher.

McLean, VA (April 21, 2005) - A previously overlooked aspect of the LASIK procedure, the creation of the corneal flap, may significantly affect the visual outcome of the procedure, according to Dr. Andrew Holzman of Millennium Laser Eye Centers. New science reveals that the IntraLase® FS laser, originally designed to create a safer flap, actually provides for better vision.

"Results have been better than we had ever expected. Our patients appreciate the added safety of a bladeless procedure as well as the outstanding vision," Dr. Holzman notes. There are two steps in the LASIK procedure. First, the surgeon creates a micro-thin corneal flap, which is then lifted to expose the inner cornea for the second step, vision treatment by an excimer laser. Historically, the first step of LASIK was performed using a hand-held device with an oscillating metal razor blade, called a microkeratome. While LASIK has proven to be a successful and relatively safe procedure, it is the microkeratome that caused the majority of LASIK complications.

In addition to a safer procedure, IntraLase-initiated LASIK is now clinically proven to provide better vision. Data shows:

• The IntraLase laser helps Custom LASIK deliver on its promise of better visual outcomes beyond 20/20 to 20/15 and 20/12.5.
• A greater number of standard-LASIK patients also achieve visual results better than 20/20 with IntraLase-initiated LASIK.
• Prospective, randomized evaluation of wavefront aberrations determined that IntraLase creates fewer higher- and lower-order aberrations, which are frequently associated with night glare and halos.
• The intentional planar architecture of the IntraLase flap and corneal bed, created with micron-level precision, significantly reduces the incidence of post-operative induced astigmatism - a complication that occurs with some frequency with the microkeratome.
• Patients who stated a preference in prospective, randomized clinical trials chose the post-operative vision of their IntraLase-treated eye up to 3-to-1 over their blade-treated eye.

With the IntraLase laser, the surgeon can precisely control the critical first step of LASIK. Physician-programmed laser specifications include flap diameter, depth, hinge location and width, and side-cut architecture - factors which can be varied to meet the individual patient's needs. The IntraLase laser also creates a distinctive beveled edge flap, which allows for precise repositioning, alignment and seating after LASIK is completed.

How the IntraLase Laser Works
Pulsing at a speed of one-quadrillionth of a second, the ultra-fast IntraLase FS femtosecond (fem-t_-second) laser uses an infrared beam of light to prepare the intracorneal bed and create the flap, using an "inside-out" process to complete the first step of LASIK.

• The beam of laser light is focused to a precise point within the cornea where a string of microscopic bubbles is formed.
• Thousands of these tiny bubbles are precisely positioned to define the architecture of the intracorneal surface, as well as the distinct beveled edge of the resulting flap.
• Bubbles are then stacked along the edge up to the corneal surface to complete step one.
• The IntraLase process from start to finish takes approximately 30 seconds.
• The physician then lifts the flap to expose the prepared corneal bed for treatment by the excimer laser treatment (the second step of LASIK).
• The LASIK procedure is completed when the flap is securely repositioned thanks to its beveled edge.

Purpose: To examine the history, current status, outcomes, and future direction of the Army Waefighter Refractive Eye Surgery Program (WRESP), which was established to reduce the limitations posed by corrective eyewear in combat arms soldiers.

Participants: Sixteen thousand one hundred eleven Army service members who underwent refractive surgery between May 2000 and September 2003.

Methods: Results were collected from monthly reports and from questionnaires administered to refractive surgery patients returning from deployments to southeast Asia. Soldiers rated the impact of refractive surgery on their ability to perform select operational tasks as well as their overall readiness.

Main Outcome Measures: Visual acuity (VA) and patient satisfaction.

Results: Between May 2000 and September 2003, 32,068 eyes of 16,111 soldiers were treated. Postoperative uncorrected VA was better than or equal to 20/20 in 85.6%, 20/25 in 92.4% and 20/40 in 98.2% of eyes with at least 3 months follow-up, and 93.7% of 175 surveyed patients rated their overall readiness better or much better after surgery.

Conclusions: This program has provided excellent outcomes and enhanced the overall readiness of over 16,000 Army service members. Reports of night vision difficulties, LASIK flap dislocation, and dry eye are infrequent, and do not seem to have a significant negative impact on military operations or individual readiness.

Ophthalmology 2005; 112:184-190 © 2005 by the American Academy of Ophthalmology.

LOS ANGELES (CBS.MW) -- As a tennis umpire for collegiate matches, Bonnie Hartshorn worried how long her vision would remain razor sharp.

Then she noticed how not having a pair of reading glasses always at hand was taking the joy out of her favorite hobbies.

"I make jewelry and a lot of crafty little things, but that became impossible," says Hartshorn, 57. "I could not find a way to get a needle or pin through a bead."

When a friend told Hartshorn about a ground-breaking type of surgery, she consulted her ophthalmologist and had the procedure done a year ago. Today, free of glasses, Hartshorn's blue eyes shine -- and so does her vision.

"It's terrific," she says. "I can read the smallest print on a pharmaceutical bottle. It is so delightful. I can't even begin to tell you what a joy it is."

The desire by baby boomers like Hartshorn to age gracefully and reclaim some of their youth is driving innovation in vision correction. Thanks to new technologies, a growing number of the 80 million boomers in the U.S. are doffing their bifocals and granny glasses and regaining the vision quality they enjoyed in their 20s.

In March, the U.S. Food and Drug Administration approved use of a procedure called conductive keratoplasty, or CK, to correct presbyopia, a condition typically seen in people over 40. In middle age, the natural lens inside the eye loses flexibility, causing near vision to fade. The condition affects tens of millions of Americans, forcing most to wear reading glasses to see up close.

With CK, a tiny probe applies radio waves in a ring near the outer edge of the cornea. The radio-frequency energy heats up collagen to create a tightened band of tissue. The treatment makes the center of the cornea steeper, increasing the curvature and improving near vision.

CK works best for people who have enjoyed good vision and now contend with presbyopia. Though the cornea sometimes reverts to its original shape, most people enjoy long-term results and can have the procedure repeated.

Dr. Robert Lingua, an ophthalmologist in Fullerton, Calif., performed Bonnie Hartshorn's CK surgery.

"I had the procedure about a year-and-a-half ago," Lingua says. "The results are excellent." Because CK is minimally invasive, he says, the risk is much lower than most other types of eye surgeries.

At $1,500 to $1,600 per eye, it also tends to be less expensive.

Lingua performed CK on a colleague, Dr. Mark Golden, earlier this month. Immediately after the surgery, Golden was able to read much smaller print.

"This is finally the first great technology," says Golden, 48, an ophthalmologist who runs a LASIK clinic in Schaumburg, Ill., and has performed CK on a number of patients himself. "There's almost nothing that can go wrong with this. It's quick, it's painless, it's easy. This is going to be a great thing for a lot of people. A very safe procedure that will change a lot of lives."

Irvine, Calif.-based Refractec (refractec.com) - which developed the surgical device -- first received FDA approval for CK to treat farsightedness in 2002. The 11-year-old company has seen sales of its CK device soar since receiving approval for treating presbyopia last spring.

Chief Executive Mitchell Campbell says gross revenue rose more than 60 percent in the first six month of this year, vs. the first half of 2003. "Year over year, we anticipate 50 to 60 percent top-line revenue growth."

Campbell projects that privately held Refractec will reach profitability in the second half of next year.

A level of clarity
Research analyst Michael Lachman of ThinkEquity describes the market for presbyopia treatment as "really kind of staggering, with easily a market potential of over $1 billion in the U.S. and $1 billion in Europe.

"But I think the most promising technologies for presbyopia are the accommodating intraocular lenses," Lachman adds.

Those are new implants for people with cataracts, like 65-year-old Henry Fakhouri. The clouding of his natural lenses coupled with presbyopia was making his job as a bank service manager tough.

"It was really annoying," Fakhouri says. "I was frustrated with myself when I used to go to work and had to have some of my coworkers read things for me.

"I almost gave up on my eyesight, really. I kind of said, 'Hey, maybe it's time to retire,'" he recalls.

Earlier this year, his ophthalmologist in San Clemente, Calif., Dr. John Hovanesian, suggested the revolutionary Crystalens. The hinged artificial lens, approved by the FDA last November, replaces a patient's cataract-tinged lens and moves with the ciliary muscle in the eye, enabling clear vision near, far and in between.

Fakhouri had a Crystalens implanted in each eye last April.

He recalls, "The surgery took place on a Thursday, I took off from work on Friday, stayed home over the weekend. And Monday morning I was at work with no glasses. Shocked everyone!

"Now I'm more rejuvenated, more excited. I don't need to worry about seeing, about reading small print, about spending time on the computer. I look up in the trees and I see the difference: the browns, the greens, all types of colors I didn't see before," Fakhouri says.

And at a cost of $5,000 per eye, he declares, "It's the best investment I've ever made in my life."

Says Hovanesian, his surgeon: "Ninety-seven percent of our patients are able to pass a drivers test without corrective lenses and also read a newspaper comfortably without glasses. And that's an incredibly gratifying thing to give to patients."

Eyeonics (eyeonics.com) of Aliso Viejo, California, says sales of its Crystalens were double the company's expectations in the first half of this year. And the aging population globally is bound to fuel sales.

Cataracts are the leading cause of preventable blindness worldwide. With nearly 3 million procedures performed in the U.S. last year, cataract surgery is among the most common surgical procedure for Americans over 65 years of age.

"It's an enormous market opportunity," Eyeonics Chief Executive J. Andy Corley says. "In North America and Western Europe, there are 375 million people over the age of 50. And that number is going to grow 25 percent in the next 25 years."

Corley says that, after six years, privately held Eyeonics just recently became profitable.

Competition among accommodating intraocular lens (IOL) developers abounds. HumanOptics of Germany, also has a mechanical accommodating IOL available outside the U.S. Bausch & Lomb and Visiogen are developing accommodating IOLs that use two lenses to allow a range of vision near to far.

In addition, LASIK - the laser-surgery technique used to treat other vision problems -- is in testing to treat presbyopia.

The new technologies are allowing some people to enjoy their later years glasses free, often with the best vision they've ever had.

Says Fakhouri: "Now I can go and hit some golf balls, which I was never able to do before. I always missed. And the best thing is now I can go to any sunglass store and pick out the best designer shades I can find - and look really cool!"

A few months ago, George Miller, 55, a computer sales manager in Lexington, S.C., had reading glasses scattered all over the house. Worse, he found it was impossible to read a menu at night in a dimly lighted restaurant or the many car magazines that came to his house. "It really bothered me a lot because I love to read," Mr. Miller said.

So, when he heard about a new experimental eye surgery on the local television news, he researched it on the Internet and called his ophthalmologist.

"I'm a little vain," Mr. Miller conceded. Though the new procedure, which uses radio waves to correct near-vision problems, had not yet been approved by the Food and Drug Administration for his problem, he had it done last winter.

"It was a no-brainer," said Mr. Miller, who no longer needs reading glasses. "I can't imagine why anyone who could afford it would not do it."

Biology and vanity are collaborating to make vision correction techniques a boom market, as some 78 million aging Americans seem intent on seeing well but looking good. Granny glasses? Grandpa's bifocals? Not for them. Offer them the option of paying $1,500 for a three-minute remedy and the eyeglasses are gone.

"The baby boomers are kind of a picky bunch," said David Harmon, president of MarketScope, an eye care market research company in Baldwin, Mo., near St. Louis. "They want to be fixed."

Last month, the F.D.A. approved the latest surgical procedure, called conductive keratoplasty, to correct a common near-vision problem for people whose eyesight is otherwise excellent, in a minimally invasive way.

Unlike LASIK, the popular laser surgery, conductive keratoplasty procedures do not involve using lasers to change the shape of the eye. Instead, a tiny instrument applies radio waves in a circular pattern on the outer cornea, shrinking small areas of collagen, a fibrous protein found in connective tissue, bone and cartilage. The treatment increases the cornea's curvature, improving near vision.

In the last few years, about three million people, as many as 5 percent of Americans with vision problems, have opted for LASIK surgery to correct nearsightedness, farsightedness and astigmatism. In LASIK, the surgeon cuts and pulls a flap in the cornea and then uses a laser to reshape the underlying tissue at a cost of up to $1,600 an eye. Neither LASIK nor conductive keratoplasty is covered by most insurance plans.

The latest procedure is only one of an array of new vision therapies, recently introduced or in late stages of development. They include improvements that make laser surgery machines more accurate and eliminate the knife blade typically used to prepare the eye, as well as a dozen new types of lens implants.

One new artificial lens mimics a healthy 20-year-old's ability to see at both near and far distances. Others eliminate harmful high-spectrum blue light, reducing the need for sunglasses.

William Link, a California scientist and entrepreneur who helped start several eye care companies, estimates that established companies like Alcon Laboratories, Bausch & Lomb and VISX™ have spent a total of $750 million in the last five years developing products for the baby boomers. In addition, Mr. Link says, he and other venture capitalists have contributed more than $140 million to companies like Refractec, the start-up based in Irvine, Calif., that developed conductive keratoplasty.

The company teaches eye surgeons to do the procedure and sells them the machines for about $58,000, compared with about $325,000 for laser machines.

Conductive keratoplasty was approved by the F.D.A. for hyperopia, a less common vision problem, two years ago. After 30,000 cases, an agency panel of 12 experts unanimously recommended it for near-vision problems, and it received approval March 16.

Conductive keratoplasty is usually performed on one eye only. The other eye provides most of the distance vision, and the mind coordinates the visual information as it does for people who naturally have one farsighted eye and one nearsighted eye. Even so, if the patient's prescription requires treatment in both eyes, it can be done on the same day.

Ophthalmologists say the corrective effects may weaken after five years or so, but the procedure is too new for them to be sure. An F.D.A. panel said patients should be warned that the treatment "may affect depth perception," which could be a driving hazard. The panel also recommended to the full agency that there be information in the label about a relatively few patients who ended up with astigmatism after the procedure. Dr. Penny A. Asbell, an ophthalmologist at the Mount Sinai School of Medicine in New York, recalled that a patient who works with younger colleagues in the music industry also wanted the procedure even before it was approved.

"He didn't want to be the only one at the table putting on reading glasses to read a contract," Dr. Asbell said. "Everybody else there is hip-hop, or whatever they do," she said.

Ophthalmologists say they find that many middle-aged patients are conservative about trying risky eye operations. An estimated 1 in 10 LASIK patients needed a repeat treatment until the technology was improved. The F.D.A. warns on its Web site that the procedure is not for everyone.

Last year, Alcon, which says it has 30 percent of the market for eye surgery in the United States, received approval in the European Community for a new intraocular lens implant for cataract patients that enhances close-up and distance viewing. The procedure has not yet been priced in the United States, the company said. These new lenses may cost as much as $600 each.

Although the company expects F.D.A. approval in 2005 for United States cataract patients, who are typically in their late 60's and 70's, the new multifocal lenses will probably attract some younger patients willing to pay for the implants. The new lens will also protect against blue light, eliminating dependence on sunglasses after the operation. "Also, they won't need a cataract operation later on," Bill Barton, an Alcon vice president, said.

Mr. Barton said tests with cells in the laboratory suggested that blue light might be a "causative factor" in macular degeneration, the leading cause of blindness in older Americans.

Alcon is also testing a prescription drug that is intended to stop or prevent changes in the eye that lead to macular degeneration. Bausch & Lomb is doing early stage research on a continuous drug delivery system at the back of the eye implant to combat the disease.

Despite all of the advances, millions of Americans will hold fast to their eyeglasses. After all, it might not have been as funny to watch Jack Nicholson and Diane Keaton using their vision problems (along with Viagra jokes) to illustrate advancing age in the comedy movie "Something's Gotta Give."

Still, for people who are over 40 and start having trouble reading, the message from the eye industry is clear: there are more options than ever.

Mr. Link, a managing director of Versant Ventures, a venture capitalist firm in Menlo Park, Calif., turns 58 today. He had the conductive keratoplasty procedure last year and was rewarded as a fly fisherman. "Now I can tie the flies on my line without reading glasses," he said.

• Dr. Andrew Holzman of Millennium Laser Eye Centers Among First to Offer NearVision CK -Sole Procedure for Millions Who Want Freedom from Reading Glasses
• America's Most Prevalent Eye Condition: 90 Million Have or Will Develop Presbyopia

WHAT: On March 16, 2004, the FDA approved the first and only vision technology that improves near vision in the millions of presbyopic baby boomers. Presbyopia (Greek for "aging eye") is the most prevalent eye condition in America, affecting most people by the age of 40 and everyone by age 51. LASIK isn't approved for it; neither are IOLs (intraocular lenses).

• NearVisionSM CK® (Conductive Keratoplasty®), performed using the ViewPoint™ CK System, is the first vision procedure specifically for baby boomers who are tired of the hassle and age-stigma of reading glasses.
• Dr. Holzman of Millennium Laser Eye Centers is among the first ophthalmologists in the Washington Metropolitan Area to offer NearVision CK.
• Symptoms of presbyopia include difficulty with all forms of near vision, such as reading, ordering from a menu, checking a price tag, dialing a cell phone, or even doing hobby work. People affected by presbyopia often own multiple pairs of reading glasses (called "granny glasses," "readers" or "half eyes") and must rely on them for even the most mundane of daily tasks, like checking their watch.

Why is this news?

• CK has become the fastest-growing new refractive procedure since the introduction of LASIK according to research firm Market Scope combined with sales data on file at Refractec.
• Minimally invasive and painless, NearVision CK is performed in less than three minutes in the doctor's office with only eye-drop anesthesia. There is no cutting and no removal of tissue.
• The procedure is extremely safe. NearVision CK uses radio waves, instead of a laser or scalpel, to change the shape of the cornea and bring near vision back into focus.
• You're a candidate for NearVision CK if you're 1) over age 40; 2) had great vision your whole life; and 3) rely on reading glasses to compensate for the loss of near vision.

How NearVision CK® Works

NearVision CK is performed using a probe thinner than a strand of hair that releases radiofrequency energy. Applied to the cornea in a circular pattern, the radio waves shrink small areas of collagen to create a constrictive band (like tightening a belt), increasing the curvature of the cornea to improve near vision.

CLINICAL TRIAL DATA *Collected at the 12-month follow-up data point

• 98 percent of patients could see J5 (magazine- and newspaper-size print) in the eye that was treated*
• 87 percent of patients could see 20/20 in the distance and also read J3 or phonebook-sized print (significantly smaller than news print) when using both eyes*
• NO reported serious, sight-threatening or unanticipated safety events*

Media Resources

• Film or Observe A NearVision CK Procedure: Obtain exclusive B-roll and doctor/patient interviews in your local market.
• High-Resolution Digital Artwork: Available on request.

IntraLASIK: Creating a LASIK Flap with Precision
A new laser, the IntraLase FS, may make LASIK (laser-assisted in situ keratomileusis) even safer. Surgeons use it in a LASIK variation called IntraLASIK to create the corneal flap under which they reshape your eye to correct your vision. In traditional LASIK, surgeons use a blade called a microkeratome to create the flap. Although surgical complications during LASIK are relatively rare, when they do occur, the microkeratome portion of the procedure is often the source of the problem.

The laser's technology is distinguished by the speed of the laser pulse - in the femtosecond (one quadrillionth of a second) range. It is used only to create the flap for IntraLASIK, and then surgeons use an excimer laser to perform the rest of the LASIK procedure.

How IntraLASIK Works
The surgeon uses IntraLASIK computer software to guide the IntraLase laser beam, which passes into the cornea and pulses a pattern of tiny (3-micron-diameter) overlapping spots. This pattern results in a precise cut of the cornea at a depth determined by the surgeon. As with a mechanical microkeratome, a small section of tissue at one edge of the corneal flap is left uncut, forming a hinge that allows the surgeon to fold back the corneal flap and reshape the corneal bed with the excimer laser as in traditional LASIK.

Comparing IntraLASIK and LASIK:

The Difference Is in the Corneal Flap

People ineligible for LASIK may be able to have IntraLASIK. The thickness of the cornea is an important variable in LASIK. Most people have corneas between 500 and 600 microns thick. Most microkeratomes cut flaps that are between 100 and 200 microns thick. For people with thin corneas, LASIK surgeons tend to move cautiously, balancing the thickness of the cornea against the amount of vision correction needed, and even may decide that the procedure is inadvisable in a particular patient.

The IntraLase laser can make corneal flaps as thin as 100 microns, which may allow surgeons to perform IntraLASIK in people with thinner and flatter corneas, according to Vance Thompson, M.D., a Sioux Falls, S.D., refractive surgeon with experience using the femtosecond laser.

IntraLASIK may present fewer complications. A laser-made corneal flap reportedly differs from a microkeratome-made flap in several other ways. The laser cut follows the curvature of the cornea and produces a flap with vertical edges, unlike the edges left by a microkeratome. This difference in flap architecture may reduce the chance of corneal epithelial ingrowth, a complication of LASIK.

Microkeratome-related problems, which are avoided with IntraLASIK, include partial and "buttonholed" flaps, epithelial sloughing, corneal wrinkles and flaps that are too thick, according to Thompson. Microkeratome use is also more difficult in people with prominent orbital rims and small eyes, and introduces sterility issues not posed by the laser, Thompson said.

The IntraLase laser employs a suction ring that utilizes low vacuum (the microkeratome uses high vacuum), and delivers the laser pulse to the cornea through a disposable glass lens. The lower vacuum in IntraLASIK presents less risk of complications associated with the higher pressures needed with microkeratome use. The outer layer of the cornea experiences no trauma and the procedure is painless.

After IntraLASIK
Recovery after IntraLASIK is similar to that after traditional LASIK with a few important differences. Following surgery, some patients have reported experiencing eye irritation for up to two days; LASIK patients with eye discomfort report a similar duration. Although it may take longer (four to seven days) to recover good vision, the approach appears to be associated with a lower incidence of dry eyes, corneal complications and reoperations compared with traditional LASIK.

Flaps made with the laser appear to adhere more tightly to the corneal bed at the end of the procedure, according to Thompson. Laser-made flaps demonstrate a more aggressive healing response at the edges compared with microkeratome-made flaps, some of which can be lifted easily many years after surgery, he said.

Thompson avoids laser-made flaps in patients with previous corneal surgery, such as radial keratotomy.

The "all-laser" LASIK approach, utilizing the IntraLase laser and a standard excimer laser, not only avoids microkeratome-related complications such as corneal irregularities and scarring, which can degrade vision, but also offers the potential for better vision after LASIK. Precision and control in LASIK surgery have everything to do with accuracy of vision correction, quality of resulting vision and reproducibility among differing patients and surgeons. Replacing the mechanical microkeratome, the source of many LASIK complications, with a computer-guided laser may be a significant advance.