Dr. John Barletta and Huron Ophthalmology are proud of our commitment to refractive surgery excellence. Dr. Barletta has over 20 years of experience in refractive surgery and performed thousands of surgeries. He is a fellowship trained cornea and refractive surgical specialist who trained at Duke University. He was LASIK certified by Johns Hopkins University in 1997. He has performed LASIK on hundreds of physicians and nurses affiliated with St. Joesph Mercy Hospital.
Dr. Barletta utilizes only the latest technology and has operated at different LASIK centers and hospitals as newer technology arrives at the various centers. He is certified on multiple FDA approved lasers. Beaumont Hospital has a long commitment to refractive technology and is often the center of choice.
Huron Ophthalmology is proud of our low pressure approach to refractive surgery and ensure you have all the facts before making such an important decision. We encourage you to learn more about LASIK at an unbiased web site such as the FDA web site for LASIK. For questions or screening please call 734-434-6000 and ask to speak with Carol Patterson, our LASIK coordinator.
WHAT IS A REFRACTIVE ERROR?
Refract is an optical term meaning "to bend light". Someone who has a refractive error has eyes which do not bend the light correctly, so they have difficulty keeping objects in focus. A person who is nearsighted, or myopic, has a near focus. This allows for an object to be clear, or in focus, only at a point close to the eyes. Unfortunately, objects at a longer distance are always blurred. In contrast, a hyperopic or farsighted eye has insufficient power and requires muscle effort to focus all the time. Eventually glasses are needed for all distances in a hyperopic eye.
Glasses are worn to correct refractive errors. Of course, there are many activities where glasses "get in the way". Fogging, slipping down, and causing glare are frequent complaints about glasses.
Contact lenses are another way of correcting a refractive error. They may have definite advantages over glasses but contact lenses are not tolerated by everyone for a variety of reasons. Over two million contact lens wearers per year become intolerant to their lenses.
For these people, and others who want to become less visually dependent on their optical aids, we offer refractive surgery.
WHAT IS REFRACTIVE SURGERY?
The clear "window" through which we look is called the cornea. It is responsible for the majority of the eye's focusing power. The lens inside the eye is responsible for the rest of the power. Refractive surgery changes the cornea's natural focusing power.
Photorefractive keratectomy or radial keratotomy reduces myopia by flattening the cornea. Radial keratotomy utilizes a diamond blade and photorefractive keratectomy utilizes an ultraviolet laser to accomplish this task. Hyperopia can also now be treated by steepening the cornea with an excimer laser.
WHO IS A CANDIDATE FOR REFRACTIVE SURGERY?
Patients ranging in age from 21 to 65 who are nearsighted, farsighted, or have astigmatism may elect to have laser vision correction. The predominant form of refractive surgery is called LASIK.
WHAT IS LASIK?
LASIK stands for laser-in-situ-keratomileusis. This procedure utilizes the excimer laser corneal correction after the creation of a thin protective corneal flap. After the laser creates a new corneal curvature, the protective flap is returned to it's normal position and the surface layer is unaffected. There is no need for stitches, patches or a temporary soft contact lens, and because there is no wait for epithelial regeneration, visual recovery is rapid.
Because the surface layers are spared, there is less healing necessary and quicker stability of correction.
Potential disadvantages with LASIK include rare flap complications such as tears, wrinkles, and irregularities in the flap adherence.
WHAT IS PRK?
PRK, or photorefractive keratectomy, uses an excimer laser to alter the curvature of the cornea. This changes the way the eye bends (refracts) light rays to allow a better focus. The excimer laser sculpts the cornea by utilizing an ultraviolet "cool laser" that disrupts collagen bonds and minimizes any tissue destruction or thermal damage. The FDA approved the excimer laser in 1995 after many years of clinical trials and research demonstrated the laser's safety and effectiveness.
HOW IS PRK DONE?
Upon arrival at the laser center, you are given an oral medication for relaxation. Your eye is anesthetized with eyedrops. You are then positioned under the laser and microscope, and allowed to fixate on a light. The eyelids are gently opened for the procedure. The surface layer called the epithelium is lasered and wiped off. The cornea is then reshaped by the laser. Next antibiotic drops and a soft contact lens are applied. The contact lens reduces pain from the corneal abrasion and is removed in two to three days as the epithelium heals.
WHICH PROCEDURE IS BEST AND WHO DECIDES?
The procedures, which are explained above, are discussed at the screening visit by your doctor. The amount of correction, thickness of cornea, lifestyle and hobbies may favor one procedure over the other for certain patients. The doctor will recommend a specific procedure based on a patient's needs.
WHO SHOULD NOT HAVE REFRACTIVE SURGERY?
Pregnancy, auto-immune diseases, and certain medications are contraindications for refractive surgery. Recent significant changes in ones corrective error and some ocular conditions also preclude having the procedure. Patients who have existing cataracts should not have this procedure, but patients who have had cataract surgery may still be good candidates.
WHEN CAN I RETURN TO WORK?
Patients having LASIK may return to work the following day. Patients having PRK can return to work in two to three days due to initial blurriness and mild to moderate tearing. Visual recovery takes three to five days with PRK, but a final stable vision correction may take up to three to six months. In contrast, LASIK patients have more rapid visual recovery.
WHAT IS THE COST OF THE PROCEDURES?
LASIK and PRK cost $1500 per eye which includes all pre and post-operative visits, facility fees, and any enhancement surgery within the first year. Many discount plans exist for certain employee groups. Payment plans are available for all types of refractive surgery.
WHAT TO DO NEXT?
Interested patients can schedule an office screening examination which includes dilation and a corneal topography evaluation to map the curvature of the cornea.
Because contact lenses can alter the natural curvature of the cornea, patients wearing rigid or hard contacts need to discontinue lens wear for at least two weeks, and those wearing soft contacts should stop lens wear for three days prior to the exam.
" Having LASIK eye surgery by Dr. Barletta has changed my life. It's amazing. I now can see to swim with my 8 year old son. "
" Refractive surgery is the best gift I ever gave myself. Snow skiing without any glasses is incredible. " --Sharon M.
" LASIK has changed my life. I'm thrilled with my vision and Dr. Barletta was great. He was very comforting throughout the procedure. You can tell he really cares." --Pat H.
To schedule a screening examination for LASIK call 734-434-6000.