Frequently Asked Questions
Q. What is LaserACE®?
A. LaserACE® is a new therapeutic technology that is designed to treat the hardened white part of your eye called the sclera to rejuvenate the eye’s natural ability to focus on distant, middle and near objects. LaserACE® can restore a range of your functional vision, from distance to reading vision to reduce the need for dependence reading glasses or contact lenses.
Q. Who will need LaserACE®
A. Aging effects on our eyes occur very similar to aging effects on other parts of our body. In the eye we lose a function called “accommodation” This is the ability for the small crystalline lens inside of our eye to adjust or fine tune our vision for all distances. There are three identifiable ranges of vision: Distance vision (far away),Intermediate Vision ( arm’s length vision); and Near Vision (reading vision). When we start to lose our ‘accommodation” we call this condition “presbyopia” (presbys “old” + opia “eye”) Presbyopia is caused by stiffening of the tissues in the eye including the lens, ciliary muscles and is partially caused by the white part of our eye called the ‘sclera’ getting rigid or inflexible just like other connective tissues in the body do as we age. This age-related problem of the eye occurs in everyone. It becomes most noticeable after the age of 40 although in some cases it can happen earlier. The first sign of losing ‘accommodation’ is often losing the ability to see close objects or small print (Near vision). We also start to notice a loss in the crispness of objects that are far away (Distance vision) and we seeing our computers and watches (intermediate vision) isn’t quite as clear. The need to hold reading material farther away is a new habit and it becomes difficult to read in dim light.
Q. What is the difference between LASIK and LaserACE®?
A. The eye consists of the “refractive area” or central area which is called the cornea. In the LASIK procedure an excimer laser is used to change the shape of the cornea to accomplish more precise focusing of the light as it enters the eye correcting nearsightedness, farsightedness, or astigmatism. The eye also consists of the “non refractive area” or fibrous tissue of the eye: The outer “white” area which is called the sclera and the an inner “vascular” area beneath it which is called the uvea(bluish blood vessels underneath the white). Both the sclera and the uvea are connective tissues similar to what your muscles and tendons are made of. In the LaserACE® procedure an erbium laser is used to create tiny vaporized channels or openings in select areas of the sclerotic white tissue releasing the tension from the muscular and drainage systems beneath it and restoring the mobility of the globe of the eye.
Q. How does LaserACE® work?
A. There are complex structures that are located just inside of this fibrous globe of the eye which perform very special functions regulating muscular control of the focus of the eye and regulating the drainage of the eye. The accommodative mechanism that acts on the lens of our eye performs the ‘zooming’ function necessary to focus our lens on objects up close, while the drainage system is responsible for the transport of both nutrients in and toxic byproducts out of the eye to maintain eye health. As we age the connective tissues of our bodies become dehydrated, less flexible and more rigid as a natural process. Similarly, the connective tissues of the eye undergo a natural aging or “sclerosis” where the fibrous tissues undergo thickening, hardening, and loss of elasticity. As you age, the outer area or sclera of your eye also becomes more fibrous (“scleralsclerosis”)and the inside of your eye becomes increasingly constricted by the outside shell compressing the delicate structures beneath it. The pressure in your eye can increase and the muscle & drainage systems have to work much harder until the constriction prevents them from working efficiently at all. The LaserACE® procedure vaporizes selected areas of this hardened sclerotic tissue which are over these special systems in the eye rejuvenating aged connective tissue to restore these delicate functions.
Q. How do I know if I am a good candidate for LaserACE® ?
A. Most patients over the age of 45 will qualify. Distance vision must be 20/25 or better in each eye uncorrected. Previous Lasik patients are candidates; however if you are corrected for monovision, the “near” eye will first need a Lasik enhancement to enable it to see “distance.” A minimum of three months must elapse after Lasik prior to LaserACE®. General health must be good. Diabetes or hypertension must be well controlled. Any auto-immune diseases such as rheumatoid arthritis or immune-deficient syndromes such as HIV+ are contraindications. Your doctor will perform a thorough examination to determine if you are a candidate.
Q. How long with the surgery take? Is it painful?
A. The actual surgery usually takes less than 20 minutes. Since there are no nerve endings in the white part of your eye (sclera) there is relatively little or no pain during the surgery. After the surgery you may have some aching through the evening which is easily controlled with OTC Tylenol. A pair of clear goggles will be placed over your eye after the surgery and someone will need to drive you home. Once at home, you should rest for the remainder of the day and avoid any strenuous activities. Most patients have no complaints of pain even one day after surgery. Your doctor will see you the day after surgery to examine your eye. Do not rub your eye. The doctor will give you additional medications that you will need to put in your eye for the next week or two.
Q. How long has the procedure been performed?
A. The initial investigational studies on scleral procedures began in 2002. Similar studies were performed in Canada beginning in 2002. Since then, approximately 300 laser scleral procedures have been performed worldwide. The LaserACE® procedure is a revolutionary procedure further advanced with the recent development of new technology and surgical techniques. LaserACE® procedure has been performed since 2006 on over 197 patients. Clinical Studies are being performed in Mexico, Western Europe, and Asia. LaserACE® is not US FDA approved nor available in the USA yet.
Q. How safe is the surgery?
A. Because it is surgery, LaserACE® is not completely risk-free. Current data indicate that 98% of people have no complications after LaserACE® surgery and more than 95% have improved vision. Your doctor will perform a thorough examination and fully inform you of any specific risks of a complication.
Q. What will my vision be like after surgery?
A. Your distance vision will usually be very good within a day or two after surgery. However, your intermediate (arm’s length) and near vision may be somewhat blurred at first. Drops will be applied to your eye after surgery. After about 1-2 weeks, you will notice that your middle (arm’s length) vision is improving and your near vision is also starting to get better.The more you try to read without reading glasses, the quicker you will be able read without them.
Q. When will I be able to return to normal activities after LaserACE® procedure?
A. Typically you will be able to return to normal activities within several days after LaserACE® with minimal to no limitations. You should be able to drive and return to work in one to three days.
Q. Will I have to have LaserACE® surgery again?
A. Because the eye is constantly aging just like your skin and other connective tissue in your body, you may need to have a retreatment to rejuvenate your vision again. This will also depend on what age you are when you receive your LaserACE® treatment. Most people who receive LaserACE® in their mid--40’s have had from 2-5 years of function before needing to be retreated if at all. Those persons who are receiving the LaserACE® treatment after 55 and up appear to have less need for retreatment since the eye has already undergone a majority of the age-related changes it will have.
Q. What can I expect from the LaserACE® Treatment?
A. You should be able to appreciate a significant improvement in close vision even in the early healing process. Most patients will achieve at least an 75% decrease in their dependence on reading glasses for near vision and a 85-90% decrease in dependence on reading glasses for intermediate or functional vision (computer work, reading cell phone text, dashboard, visual objects at arm’s length). If there is any need for reading glasses after LaserACE® they will likely be used only for limited activities such as threading a needle or reading for long periods of time, or in dim light where exceptionally small detail work is needed. This will vary by task and from person to person.
Q. Does LaserACE® affect my distance vision?
A. No. The procedure is performed on a non-optical part of the eye (sclera) that plays no role in how well you see far away. You may experience a temporary change in your distance vision in the first 3-5 days after your procedure during the initial healing phase. Some patients may have a fluctuation in their distance vision that can linger for a few weeks postoperatively, however, this is uncommon.