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Category Archives: In the News

Dr Rick Wolfe presents at the 2021 AUSCRS Virtual Conference

At this year’s annual AUSCRS conference, which was held virtually on 23th October and attended by over 180 eye surgeons and support staff, the theme was “AUSCRS Code to Success – What’s new in the virtual world?”.

Dr Wolfe chaired one of the sessions titled “What’s New – Perfect Predictions – Devices and Planning” and presented on the topic of “Measuring in Microns – OCT in cataract surgery”.  Dr Wolfe discussed new technology called Ray Tracing, that, in a new way, calculates the best intraocular lens for cataract and lens surgery.

Founded by Prof Graham Barrett and Dr Rick Wolfe, The Australasian Society of Cataract and Refractive Surgeons (AUSCRS) was formed in 1995. It is a society dedicated to the specific interests of cataract and refractive surgery and offers a unique forum for discussion and learning for both surgeons and their support staff.  AUSCRS is affiliated with the International Society of Refractive Surgery (ISRS) and the American Society of Cataract and Refractive Surgery (ASCRS), the Asian Pacific Association of Cataract & Refractive Surgeons (APACRS)  as well as other peer societies around the world.   In Australia, RANZCO is also affiliated with AUSCRS.

AUSCRS continues to grow as a society with its core aim of being a committed, special-interest group of ophthalmologists interested in education and dissemination of knowledge, new techniques and exploring the boundaries of the specialty.

At VISTAeyes Laser Eye Clinic, we are proud to be at the forefront of new technology and advances in eye surgery, both internationally and in Australia, to provide our patients with the highest standards available.

Dr Rick Wolfe speaks at APAC Refractive Summit

Dr Rick Wolfe was pleased to be invited to present at two of the four APAC Virtual Refractive Summit webisodes, which were hosted throughout September 2021.  The APAC Refractive Summit webisodes were launched by Alcon, in collaboration with Oftalmo University and attended by refractive surgeons globally.

Dr Wolfe was the panelist for two of the webisodes, held on 9th September and 23rd September.

In the first webisode, which focussed on “Techniques – The Big 5: Best Clinical Tips and Applications for Your Practice”, Dr Rick Wolfe shared his insights about the best clinical tips and applications for the Wavelight FS200 Femtosecond Laser and Topolyzer.  The session was attended by more than 150 participants.

In his second webisode, titled “Complications Management – Simplifying the Complex” Dr Wolfe, together with two other surgeons, Prof Chen Yueguo and Prof Bai Ji, discussed complications management in treating complex LASIK cases.

Having performed over 25,000 laser eye procedures, Dr Wolfe’s extensive experience and clinical insights are highly valued by the refractive surgeons community, both in Australia and internationally.

 

Peninsula Eye Centre hosts “Clinical Update 2021”

On 20th April, the Peninsula Eye Centre hosted an educational evening titled “Clinical Update 2021” for our local optometrists.  The CPD accredited event included presentations from ophthalmologists Dr Rick Wolfe, Dr Zelda Pick and Dr Justin Sherwin.

Thank you to all our guest optometrists for participating in this evening of interactive learning and discussion.

LASIK Technology That’s Out Of This World!

We’ve been amazed by the recent images and audio of NASA’s Mars Exploration Program.  Interestingly, over the decades, NASA’s scientists and engineers have been responsible for many inventions and technological breakthroughs that help us here on Earth too!  These include products such as artificial limbs, wireless headphones, CAT scans, athletic shoes, home insulation, baby formula, camera phones and many more.

But, did you know that LASIK technology also originated at the space agency?

NASA’s Eye Tracking Device technology was used to track astronauts’ eyes during their time spent in space and to evaluate how weightlessness directly affects the human’s frame of reference.  Today this technology is widely used in LASIK surgery.

Tracking the eye’s position is essential in performing the LASIK procedure.  At VISTAeyes, our WaveLight EX500 Excimer Laser has a built-in high-speed eye tracking device that runs at 1,050 Hz and monitors the movement of the eye at the rate of 500 times per second so the laser beam stays on target during the treatment to deliver the highest levels of safety.  This means that even when the patient’s eye moves slightly, the treatment remains perfectly centred.  If, at any time, the eye moves out of range, or if a large movement occurs (such as cough or sneeze), the laser will stop completely and wait for the eye to move back into position.

So, how does LASIK eye surgery work?

LASIK reshapes the cornea to correct short-sightedness, long-sightedness and astigmatism, using a computer-guided laser.  LASIK is a two-step procedure involving two lasers.

Firstly, an ultra-thin, hinged flap of corneal tissue is made using a femtosecond laser.  At VISTAeyes, we use the Wavelight FS200 Femtosecond Laser.  This blade-free technology can create a flap in just 10 seconds per eye.   This flap is lifted in order to access the deeper layers of the cornea.  Secondly, the Wavelight EX500 Excimer Laser applies a customised, computer-generated pattern to permanently reshape the cornea.   During the application of the treatment, the high-speed eye tracker monitors the eye’s position to ensure precise and accurate placement of the treatment.  At the completion of the treatment, the flap is replaced where it bonds to the eye without the needs for stitches.  Most patients can resume normal activities, including driving, the day following their surgery.

At VISTAeyes, as well as investing in state-of-the-art technology and training, we are continually keeping abreast of the latest advances in eye surgery, both internationally and in Australia, to provide patients with the highest standards available – right here on Earth!

For more info about LASIK, click here: https://www.vistaeyes.com.au/procedure/lasik/

Reference: https://www.nasa.gov/mission_pages/station/research/benefits/eye_tracking_device/

LASIK vs LASIK vs LASIK

By Dr Rick Wolfe

LASIK was a breakthrough in laser eye surgery.  It was first performed by Dr Pallikaris in Crete in 1989.  I performed the first LASIK procedures in Melbourne in 1996.

It was an absolute game changer for laser eye surgeons from only having one option to offer our patients: ALSA (also known as PRK).    LASIK allowed us to offer another type of laser eye surgery and it provided patients with a much faster recovery.  That is not to say the modern version of ASLA is not a good procedure in some elected cases.  LASIK, however, if the patient is suitable, is far more convenient for the patient.

LASIK always involves the creation of a corneal flap.  This flap creation was first invented by Dr Barraquer in Colombia in 1962.  It was the combination of the flap and the excimer laser (used in ASLA) that made all the difference.

There are different types of LASIK available in Melbourne currently and we’ve received feedback from many patients that the various meanings and marketing tactics circulating in our industry about LASIK are difficult to decode.  There are claims of “Lasik without a flap”, “Flapless Lasik”, “No-Cut Lasik” being used. Let me be clear: there are no such medical procedures!  These terms refer to surface treatments (and using just one laser) such as ASLA (PRK) – not LASIK.  LASIK necessarily has a flap by definition and always involves the use of two lasers.

The word “LASIK”, always referred to in correct medical terms in capitals, stands for Laser In Situ Keratomileusis.  LASIK treats short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism, eliminating the need for glasses or contact lenses.  LASIK is the most commonly performed laser eye surgery procedure available today, with over 50 million cases performed worldwide.  The convenience of LASIK is the reason for its popularity.  LASIK provides a fast recovery, allowing patients to return to normal activities more quickly.

LASIK always involves the use of two lasers.  The first laser creates the corneal flap and the second laser (Excimer Laser) re-shapes the cornea and corrects vision.   LASIK can be divided into different types in two ways:

1st Laser: Bladeless vs Manual with a Blade

Bladeless

The most popular method to create the corneal flap performed today is blade-less – this is performed using a femtosecond laser (also known as Femto LASIK).

Manual with a blade

Another method, which is rarely used today, is the older method, where the flap is created using an ultra-sharp oscillating blade (also known as Microkeratome or Keratome LASIK).  At VISTAeyes, we do not perform Keratome LASIK, as this is an outdated method.

2nd Laser: Customised LASIK vs Non-Customised LASIK

It’s important to distinguish between the different types of LASIK (and indeed ALSA), by the pattern of treatment performed with the excimer laser: the laser that reshapes the cornea and corrects vision. The treatments can either be customised or non-customised.

Customisation refers not only to the various prescriptions different people have,  but rather a process by which corneal irregularities are dealt with. There irregularities are referred to as aberrations. Addressing aberrations is aimed at improving the quality of vision and preventing reduction in quality of vision, in addition to getting the prescription right.

Some clinics incorrectly refer to customised or personalised LASIK treatment based only on the prescription data collected.  This is not customised treatment, this is the Standard or Traditional LASIK, which does not address aberrations. Other clinics simply change the cornea just by what is in the patients’ glasses. This is not enough anymore.  VISTAeyes is the only clinic in Melbourne to offer Customised LASIK.

Diagram 1. LASIK explained – the different types of LASIK   

Types of Customised LASIK

Topography-Guided LASIK

This is customisation taken to the next level.  It is a personalised vision correction treatment, which uses a computerised device called a corneal topographer to measure a patient’s individual cornea, examining specific corneal irregularities (called aberrations) and calculating how to best improve their vision (in excess of simply correcting what is in the patients’ glasses).  It would appear to have better results in providing lower aberrations, accurate outcomes and improved quality of vision.  This procedure, sometimes called Contoura, is the main LASIK mode we use at VISTAeyes.  We have pioneered the procedure and I have presented on it several times in Australia and overseas.  Admittedly, it is more complex and costly for surgeons to perform topography-guided LASIK than the non-customised LASIK, but we believe the benefits, to those patients who are suitable, are worth it.

Wavefront-Guided LASIK (WFG)

We have been performing WFG for nearly 20 years now. It involves the use of a costly piece of equipment called an aberrometer. It not only accurately measures the prescription but also the aberrations. The complex treatment required is transferred to the excimer laser.

Custom Q LASIK

This is another type of customisation we use at our clinic. It especially targets one sort of aberration, known as spherical aberration.

 

Types of Non-Customised or Standard/Traditional LASIK

Wavefront-Optimised LASIK (WFO).

This is the non-customised form of LASIK.  It makes no attempt to address aberrations. As a result, they are usually increased. A recent study of WFO LASIK with the Schwind laser1 revealed an increase of 100% in aberrations. This can’t help the final quality of vision.  Most other clinics only offer the Non-Customised or Standard / Traditional LASIK because it is less time consuming and cheaper to administer than Customised LASIK.

There is another laser eye procedure called SMILE laser eye surgery.  We do not perform SMILE at VISTAeyes, as it cannot be customised, probably because precision is not adequate and certainly not as precise as an excimer laser used in LASIK.  SMILE is over a decade old and there have been little or no technological advances.

Diagram 2. LASIK Advances over Time

Taking into account all the laser eye technology available today, Custom LASIK shows the most promise as the way forward for achieving the best quality of vision.   It is by far the most advanced procedure available today including WFO LASIK, SMILE or “LASIK without a flap”.

For more information about Custom LASIK (Topography-Guided LASIK) read here:

What is Custom LASIK?