JEI NIDEK Spells Confidence for UAMS Employee

"I love waking up in the middle of the night and being able to see the alarm clock,” Amy Kennedy Theriac, a medical photographer at UAMS, said smiling. But about six months ago, she couldn’t make this comment. Her vision was about 20/400 — she could only see objects clearly if they were no farther than eight inches in front of her face!

Like many people, Amy began wearing glasses in elementary school and progressed to contact lenses when she was in high school. As her astigmatism increased, the contacts became less comfortable and she reluctantly returned to glasses. Wearing glasses interfered with many activities. “Swimming was always a real pain,” she recalled. “I couldn’t swim with glasses and contacts were really no better. I missed a lot of swimming.”

Refractive errors, like those which plagued Amy and so many other individuals, result from problems with the way the human eye bends and focuses light. The cornea, or “window” of your eye, enables you to see by focusing, or refracting, light through the lens and onto the retina, located at the back of the eye. The retina converts light rays into impulses and sends them to your brain where they are recognized as images. When the cornea and lens do not focus the rays precisely on the retina, there is a “refractive error” and the image you see is unclear.

Amy was certainly aware of the benefits of refractive surgery, her husband and her mother-in-law had both experienced RK (radial keratatomy) procedures. She knew she was interested, but said she was not totally comfortable until the Jones Eye Institute (JEI) at UAMS introduced its program. “I work at UAMS,” she said. “I know the reputation of this institution and its doctors. I knew the program would be a good one that I could trust. So when JEI got LASIK, I was ready.”

The NIDEK equipment that is permanently housed at JEI also appealed to Amy. “I didn’t want to have the surgery done with a ‘traveling machine,’” she explained. The NIDEK EC-5000 Refractive Laser System is located on the fourth floor in an area that is specially designated for the procedure. It uses a cool ultraviolet beam of light to gently reshape the surface of the eye. The procedure is performed on an outpatient basis and takes about 15 minutes.

Vahid Feiz, M.D., cornea specialist at JEI, who heads the Refractive Laser Surgery Program, said the eye is numbed completely during the procedure so the patient should not experience any pain during the surgery. Patients may experience some very slight discomfort during the healing process. Usually, over-the-counter pain medication will help with this discomfort.

“There are no stitches to heal,” Dr. Feiz explained. “I create a wafer-thin flap on the cornea’s surface, then I use the laser to reshape the cornea surface to correct the refractive error. When the laser treatment is complete, the cornea flap is replaced in its original position where it self-adheres to the underlying cornea. Actually only the edge around the corneal flap needs to heal, so most patients have a rapid recovery.”

The NIDEK Laser System was perfect for Amy in other ways, according to Cheryl Troillett, LASIK coordinator. “When I met Amy, one of the first things I noticed was her large pupils — she definitely has larger than average pupils,” Troillett said. “Often patients who have undergone refractive surgery complain of annoying night glare following the procedure, especially if they have larger pupil dilation. The glare can be a hazard, particularly when driving. It is not uncommon with LASIK surgery, for a patient to have some slight night glare or halos the first few weeks after the surgery. With the NIDEK laser system the continuation of those glares or halos is less likely to occur.”

Feiz explained that this night vision problem mainly occurs in patients who have very large pupil dilation in dim light. “Most refractive lasers can only accommodate pupil dilation up to 5 or 6mm, but the NIDEK Laser can handle a larger pupil dilation up to a 9 mm,” he said. “To explain, let’s say that your pupils dilate to 8mm in dim light, but the laser will only be able to apply 6 mm of a laser circumference, leaving a 3 mm ring untreated. The untreated 3 mm will always leave you with a greater chance of experiencing halos or glare at night.”

 “Being able to accommodate patients on an individual basis according to pupil size was one of the main factors that lead Jones Eye Institute to select the NIDEK Laser system,” Troillett said. “This is also the only ‘scanning slit’ laser on the market, which means that it applies the cool laser as if it were spreading butter on bread very evenly,” Troillett concluded.

“Most of my friends thought it was ‘interesting’ that I was having the surgery, but they couldn’t imagine spending that amount of money on your eyes,” said Amy. She told them that she had “already spent thousands of dollars on doctor’s visits, eyeglasses, contacts and other vision products. “It’s really a reasonable investment,” she said.

Amy’s comparison of the expense of refractive surgery vs. the cost of a lifetime of eyewear is a valid one. Consider this — if a person starts wearing eyeglasses at the age of 10, a change in the prescription will probably be necessary after four or five years. After the person reaches adulthood, the change may be needed as often as every two years. Based on an average cost of $300 per year, a person could expect to invest at least $4,000 on eyewear alone. The cost of refractive surgery is about $3,000. Maybe we should be asking how a person could afford conventional eyewear instead of surgery?

Laser vision correction with the NIDEK Refractive Laser System is intended as a permanent method to reduce or eliminate the need for glasses or contact lenses for nearsightedness. Although vision changes naturally with age, laser vision correction should allow patients to perform most activities without the aid of spectacles. Laser vision correction cannot remedy a condition known as presbyopia, aging of the eye, that normally occurs around the age of 40 and usually requires the use of reading glasses. In fact, people over 40 who have their nearsightedness reduced with refractive surgery may find they need reading glasses sooner.

Amy said she has no regrets about having the procedure done, even though she experienced some minor pain following the surgery. “The pain was easily medicated and I could see fine the day after surgery,” she said. “It’s totally worth it!”

Are you ready?

You might be a candidate for refractive surgery if you:

• Are at least 18 years old;

• Have eyes free from retinal problems, cataract or certain other eye diseases;

• If female, are not pregnant;

• Do not have severe diabetes or an autoimmune disease; and

• Have the appropriate refractive error that can be helped by the procedure.

To find out more about LASIK or for a free screening, contact Cheryl J. Troillett, LASIK Coordinator at 686-8891 or by e-mail: LASIK@uams.edu.