OREM -- Dr. Jay D. Clark thinks the "laser in situ keratomileusis" eye surgery -- more popularly known as Lasik -- is a good answer for the majority of nearsighted and farsighted patients who are frustrated with glasses and contact lenses.
It's a long-term, safe solution for a wider range of vision needs, basically painless and becoming cost-effective for more and more people, Clark said.The Cataract and Lasik Center of Utah in Orem saw more than 200 patients in December and Clark is listed as one of the top 100 surgeons performing the excimer laser surgery in the United States last year.
The price of the surgery is going down at the Orem center because it is a fixed site with a high number of success stories.
"This is the only fixed site in the valley. What we've done is kind of a departure; we've eliminated the middle guys and provide care directly, quality care at reduced cost," Clark said. "Until recently, we've had two corporate laser centers from out-of-state coming in to offer treatment."
Clark believes patients are served better from a clinic that doesn't move around and that will be in business for years to come.
"I think mobile centers will go out of business," he said, backing up his supposition with market research that shows a phenomenal number of surgeon-owned centers are being opened across the country while corporate-owned centers are seeing only moderate gains.
He also believes surgery performed in a clinic with controlled humidity and air temperatures provides for a better rate of success.
Currently, the cost of correcting one eye with excimer laser surgery is a $1,900 global fee that covers the procedure and any enhancement follow-up surgery. Some insurers pay for the Lasik surgery.
Patients who qualify for the treatment are evaluated with the contours of their cornea mapped and recorded onto a disk that will feed pertinent information into the Visx laser equipment.
The eyes are numbed with drops and the patient lies back on a lounge-type chair. The eyelids are held back with a clamp and the surgeon marks the surface of the eye with a tiny circular pattern.
Tissue from the top of the cornea is then sliced with a microkeratome to create a tiny flap that allows the laser pulse to remove 25-50 microns of tissue that essentially flattens the central cornea -- correcting the myopia.
For farsighted patients, the tissue around the center is removed, creating more steepness.
Patients with stigmatisms have the tissue removed in one direction more than another.
The procedure generally takes just a few minutes as the surgeon operates a kind of joystick to direct the laser for a few seconds and then carefully replaces the corneal flap, matching the lines of the circle put on the eye earlier.
The surgery is a walk-in-and-walk-out procedure with patients generally able to return immediately to work or other activity.
Patients need to be at least 18, with stabilized vision problems. No pregnant or nursing mothers, AIDS patients or people on Accutane or Cordarone are accepted as patients nor are patients with eye diseases such as corneal ulcers.
People with extreme eye problems are not good candidates, Clark said.
The surgery cannot solve the vision problems for people who need bifocals, although Clark said there is an implant procedure awaiting approval that will eventually help with the multiple vision problems.
In the meantime, some patients only have one eye treated with the Lasik surgery, he said, and that can provide help for patients with a mixed correction need.
"As far as disasters? Gosh, we just don't see them," Clark said. "This is a very cool laser, not the kind that creates a burn."
The machines are constantly being calibrated, he said, and in fact, the Visx laser will not begin to operate until a personalized disk is inserted with the patient's specific information. And then it can only be used once.
The laser does not cause bleeding and there's minimal discomfort.
"That's it?" said a patient in the clinic Thursday as Clark finished the procedure.
"That's the response we usually hear," Clark said, "And that's usually followed by what we call the 'wow factor' as people begin to enjoy seeing clearly for the first time without corrective lenses."