Laser blended vision
Encyclopedia
Laser blended vision, is a sophisticated laser eye treatment which rectifies short-sightedness (myopia
) in one eye and long-sightedness (hyperopia
) in the other eye. Primarily the treatment is for condition called presbyopia
(progressive loss of the ability to focus on nearby objects) or other age-related eye conditions.
Blended vision can be achieved through laser eye surgery such as LASIK
, PRK
or LASEK
, by correcting the dominant eye and the shape of the cornea, modifying it for reading vision and still maintaining good distance vision. In other words, one eye is focused for distance and the other eye is focused for near vision. As a result there is little difference between the eyes, allowing the eyes to make a compromise and merge the two images of the different eyes to create a blended vision. The eyes are effectively working together to allow good vision at near, intermediate and far, without needing glasses. The effects of blended vision treatment can last between 5 to 10 years.
The key advantage of laser blended vision is the freedom from reading glasses. Over 98% of laser blended vision patients can read normal newsprint and over 90% can read the small print on medicine bottle inserts.
There is a creation of intermediate and far-intermediate distance zone of fusion, allowing the merging of images from each eye in the brain so no dissociation between the eyes. And due to increased depth of field in both eyes, the vision is significantly better than would otherwise be anticipated.
The technology of the excimer laser
provides maximum safety particularly as the eyetracker’s feedback frequency is higher. The laser treatment is a comfortable and gentle procedure and provides an extremely rapid rate of recovery.
, Technolas. Carl Zeiss, along with contribution from Dan Reinstein
, are regarded as the technology pioneers for blended vision treatment.
All lasers can do monovision, but not all lasers can achieve the level of precision and results for laser blended vision like the Zeiss MEL 80 Excimer laser.
Dan Reinstein
is a specialist ophthalmic surgeon in the UK and Medical Director at the London Vision Clinic, Harley St, London. He is certified in USA and Canada, and specializes in the field of refractive surgery. Professor Reinstein is an experienced research scientist in the laser eye surgery field and makes major contributions to the field. He pioneered the development and application of Artemis technology increasing the understanding of LASIK safety and accuracy. He developed the technology for laser blended vision, the LASIK
treatment for presbyopia
(aging eyes) now distributed by Carl Zeiss AG in the MEL80 laser platform and has enabled over 100,000 procedures to be performed in a year by 58 surgeons globally.
also allows for ensuring the eyes can work together to create the blended vision.
The left eye is covered and the right eye is opened and kept open by a speculum, the corneal flap is lifted and the laser correction is done – an ultra thin flap can be created for treatment of very high prescriptions. The flap is replaced and the speculum is removed. The left eye is treated next. The software data given to the Zeiss MEL 80 laser stores all the details of the dominant eye and what correction has to be done for each eye. The laser time for each eye is usually under 30 seconds.
During the laser refractive surgery, the dominant eye is mainly corrected for distance vision and the non-dominant eye is corrected for near vision, whilst also increasing the range of focus for each eye.
The entire procedure takes approximately 20-30 minutes and the visual recover is rapid and there is very little pain afterwards. The recovery period post operative usually is between 24 hours and 7 days. Care is needed to not rub eyes and to wear eye shields during the night. The results are almost instantly available to the patient, where objects and people will seem more in focus.
. People mostly suffer from presbyopia, refractive error
between the ages of 40-45 years. It occurs when the natural eye lens becomes less elastic and the muscle that pulls it into focus becomes less powerful as we age. In the young eye, the muscles contract to relax the ‘jelly like’ lens, changing its focal point to allow for distances and near focus. As we get older, our lens continue to grow and layers of fibers are laid down making the lens less flexible.
According to a study conducted by Dr. Dan Reinstein
, more than 95% of patients he treated tolerated Laser Blended Vision, compared with only 59% to 67% of patients who tolerate contact lens monovision.
After a year of the laser treatment, 94.5% of patients achieved 20/20 vision.
The Excimer laser
enables safe treatment of higher levels of myopia
, and provide accurate calibration. After the laser surgery
, one may require artificial tears and antibiotic eye drops which can caused blurred vision temporarily. Dryness of eyes can be a little uncomfortable for a few weeks after the surgery.
Presbyopia
is progressive and therefore a boost maybe required after some years. Typically the effects of laser blended vision surgery can last between 5-10 years.
Myopia
Myopia , "shortsightedness" ) is a refractive defect of the eye in which collimated light produces image focus in front of the retina under conditions of accommodation. In simpler terms, myopia is a condition of the eye where the light that comes in does not directly focus on the retina but in...
) in one eye and long-sightedness (hyperopia
Hyperopia
Hyperopia, also known as farsightedness, longsightedness or hypermetropia, is a defect of vision caused by an imperfection in the eye , causing difficulty focusing on near objects, and in extreme cases causing a sufferer to be unable to focus on objects at any distance...
) in the other eye. Primarily the treatment is for condition called presbyopia
Presbyopia
Presbyopia is a condition where the eye exhibits a progressively diminished ability to focus on near objects with age. Presbyopia’s exact mechanisms are not known with certainty; the research evidence most strongly supports a loss of elasticity of the crystalline lens, although changes in the...
(progressive loss of the ability to focus on nearby objects) or other age-related eye conditions.
Blended vision can be achieved through laser eye surgery such as LASIK
LASIK
LASIK or Lasik , commonly referred to simply as laser eye surgery, is a type of refractive surgery for correcting myopia, hyperopia, and astigmatism...
, PRK
PRK
PRK could refer to:*Phase Reversal Keying, see BPSK*Photorefractive keratectomy, a laser eye surgery procedure*ISO 3166-1 alpha-3 code, International Olympic Committee country code, and FIFA country code for North Korea...
or LASEK
Lasek
Lasek may refer to:*LASEK or photorefractive keratectomy, a laser eye surgery technique*Lasek, Lower Silesian Voivodeship *Lasek, Kuyavian-Pomeranian Voivodeship *Lasek, Łódź Voivodeship...
, by correcting the dominant eye and the shape of the cornea, modifying it for reading vision and still maintaining good distance vision. In other words, one eye is focused for distance and the other eye is focused for near vision. As a result there is little difference between the eyes, allowing the eyes to make a compromise and merge the two images of the different eyes to create a blended vision. The eyes are effectively working together to allow good vision at near, intermediate and far, without needing glasses. The effects of blended vision treatment can last between 5 to 10 years.
Advantages of treatment
Laser blended vision provides a range of benefits, particularly in comparison to tradition monivision solutions, such as bifocal glasses or contact lenses.The key advantage of laser blended vision is the freedom from reading glasses. Over 98% of laser blended vision patients can read normal newsprint and over 90% can read the small print on medicine bottle inserts.
There is a creation of intermediate and far-intermediate distance zone of fusion, allowing the merging of images from each eye in the brain so no dissociation between the eyes. And due to increased depth of field in both eyes, the vision is significantly better than would otherwise be anticipated.
The technology of the excimer laser
Excimer laser
An excimer laser is a form of ultraviolet laser which is commonly used in the production of microelectronic devices , eye surgery, and micromachining....
provides maximum safety particularly as the eyetracker’s feedback frequency is higher. The laser treatment is a comfortable and gentle procedure and provides an extremely rapid rate of recovery.
Technology
Laser technology, used for laser blended vision, include names like Carl Zeiss AG, Ziemer, IntraLaseIntraLase
IntraLase was a company based in Irvine, California, producing lasers for the medical industry and for eye surgery. In March 2007 it was acquired by Advanced Medical Optics for $800 million in cash. Advanced Medical Optics was acquired by Abbott Laboratories in February 2009...
, Technolas. Carl Zeiss, along with contribution from Dan Reinstein
Dan Reinstein
Professor Dan Reinstein is a specialist ophthalmic surgeon in the UK and is a board-certified ophthalmologist in the USA and Canada, specializing in the field of refractive surgery...
, are regarded as the technology pioneers for blended vision treatment.
All lasers can do monovision, but not all lasers can achieve the level of precision and results for laser blended vision like the Zeiss MEL 80 Excimer laser.
Dan Reinstein
Dan Reinstein
Professor Dan Reinstein is a specialist ophthalmic surgeon in the UK and is a board-certified ophthalmologist in the USA and Canada, specializing in the field of refractive surgery...
is a specialist ophthalmic surgeon in the UK and Medical Director at the London Vision Clinic, Harley St, London. He is certified in USA and Canada, and specializes in the field of refractive surgery. Professor Reinstein is an experienced research scientist in the laser eye surgery field and makes major contributions to the field. He pioneered the development and application of Artemis technology increasing the understanding of LASIK safety and accuracy. He developed the technology for laser blended vision, the LASIK
LASIK
LASIK or Lasik , commonly referred to simply as laser eye surgery, is a type of refractive surgery for correcting myopia, hyperopia, and astigmatism...
treatment for presbyopia
Presbyopia
Presbyopia is a condition where the eye exhibits a progressively diminished ability to focus on near objects with age. Presbyopia’s exact mechanisms are not known with certainty; the research evidence most strongly supports a loss of elasticity of the crystalline lens, although changes in the...
(aging eyes) now distributed by Carl Zeiss AG in the MEL80 laser platform and has enabled over 100,000 procedures to be performed in a year by 58 surgeons globally.
Preoperative Screening
During the preoperative screening, a complete examination of the eye is carried out at a consultation with the surgeon to determine if a patient is suitable for laser blended vision treatment. The dominant eye is determined and vision tested to identify the level of correction required for distance and near on the dominant eye and non-dominant eye. The analysis of ocular dominanceOcular dominance
Ocular dominance, sometimes called eye dominance or eyedness, is the tendency to prefer visual input from one eye to the other. It is somewhat analogous to the laterality of right or left handedness; however, the side of the dominant eye and the dominant hand do not always match...
also allows for ensuring the eyes can work together to create the blended vision.
During Surgery and Post Operative
During the surgery, a corneal flap is created, during which there can be a sensation of slight pressure on the eye during the procedure.The left eye is covered and the right eye is opened and kept open by a speculum, the corneal flap is lifted and the laser correction is done – an ultra thin flap can be created for treatment of very high prescriptions. The flap is replaced and the speculum is removed. The left eye is treated next. The software data given to the Zeiss MEL 80 laser stores all the details of the dominant eye and what correction has to be done for each eye. The laser time for each eye is usually under 30 seconds.
During the laser refractive surgery, the dominant eye is mainly corrected for distance vision and the non-dominant eye is corrected for near vision, whilst also increasing the range of focus for each eye.
The entire procedure takes approximately 20-30 minutes and the visual recover is rapid and there is very little pain afterwards. The recovery period post operative usually is between 24 hours and 7 days. Care is needed to not rub eyes and to wear eye shields during the night. The results are almost instantly available to the patient, where objects and people will seem more in focus.
Suitability of treatment
Laser blended vision treatment is suitable for people suffering from presbyopiaPresbyopia
Presbyopia is a condition where the eye exhibits a progressively diminished ability to focus on near objects with age. Presbyopia’s exact mechanisms are not known with certainty; the research evidence most strongly supports a loss of elasticity of the crystalline lens, although changes in the...
. People mostly suffer from presbyopia, refractive error
Refractive error
A refractive error, or refraction error, is an error in the focusing of light by the eye and a frequent reason for reduced visual acuity.-Classification:...
between the ages of 40-45 years. It occurs when the natural eye lens becomes less elastic and the muscle that pulls it into focus becomes less powerful as we age. In the young eye, the muscles contract to relax the ‘jelly like’ lens, changing its focal point to allow for distances and near focus. As we get older, our lens continue to grow and layers of fibers are laid down making the lens less flexible.
Treatment results
Patients treated using laser for blended vision, have an increased depth of field compared to traditional monovision. There is a diminishing effect of the depth of field with use of contact lenses.According to a study conducted by Dr. Dan Reinstein
Dan Reinstein
Professor Dan Reinstein is a specialist ophthalmic surgeon in the UK and is a board-certified ophthalmologist in the USA and Canada, specializing in the field of refractive surgery...
, more than 95% of patients he treated tolerated Laser Blended Vision, compared with only 59% to 67% of patients who tolerate contact lens monovision.
After a year of the laser treatment, 94.5% of patients achieved 20/20 vision.
Limitations and potential complications
The aim of this surgery is to produce one eye that sees objects close up, whilst the other sees objects that are far away. This can produce problems initially, as you may feel dizzy or nauseous until your brain adjusts to this new method. This is usually quickly, as the brain begins to ‘blend’ the images from both eyes together, to produce corrected vision. As with all laser eye procedures, there are risks and side effects of the treatment. You should understand these before you decide to go ahead.The Excimer laser
Excimer laser
An excimer laser is a form of ultraviolet laser which is commonly used in the production of microelectronic devices , eye surgery, and micromachining....
enables safe treatment of higher levels of myopia
Myopia
Myopia , "shortsightedness" ) is a refractive defect of the eye in which collimated light produces image focus in front of the retina under conditions of accommodation. In simpler terms, myopia is a condition of the eye where the light that comes in does not directly focus on the retina but in...
, and provide accurate calibration. After the laser surgery
Laser surgery
Laser surgery is surgery using a laser to cut tissue instead of a scalpel. Examples include the use of a laser scalpel in otherwise conventional surgery, and soft tissue laser surgery, in which the laser beam vaporizes soft tissue with high water content...
, one may require artificial tears and antibiotic eye drops which can caused blurred vision temporarily. Dryness of eyes can be a little uncomfortable for a few weeks after the surgery.
Presbyopia
Presbyopia
Presbyopia is a condition where the eye exhibits a progressively diminished ability to focus on near objects with age. Presbyopia’s exact mechanisms are not known with certainty; the research evidence most strongly supports a loss of elasticity of the crystalline lens, although changes in the...
is progressive and therefore a boost maybe required after some years. Typically the effects of laser blended vision surgery can last between 5-10 years.