Based on an individual’s visual finger print or visual aberration, the Excimer Laser System precisely reshapes the cornea and focuses incoming light rays to the necessary location on the retina. "It makes you believe in God," says Dr. Eric Mandel of laser vision corrective surgery, but deifying the technology in the absence of the discerning eye that should be taken with any invasive medical procedure is where patients incur the most risk.
The safest choice, he'll tell corrective surgery candidates in his New York City and White Plains offices of Mandel Vision, is simply sticking to their glasses. On the otherside, the visual spectrum of risks shows itself, in his opinion, when someone falls asleep with their contact lenses. Having seen things that you couldn't possibly imagine, he says, "The soft contact lenses that you sleep in is like a petridish of bacteria sitting on your brain."
But if you have your heart and optics set on what the 21st century has to offer, finding the right surgeon in accompaniment of the right surgical procedure is the standard that patients should follow. Current Lasik technology now allows access to the cornea without the use of a bladed instrument known as the Microkeratome. “That was a good system, this is an improvement,” he says, as the Intralase Laser creates the flap and opens the cornea to the Wavefront technology that gives us the Excimer Laser.
But the advance that he sees as most significant takes place before or possibly in place of a doctor actually reshaping the cornea with the high beams. “What really has advanced is the technology to screen out people who are not good candidates,” he says. Meaning, for example, that the cornea is too thin or is of an abnormal shape, and for his part, he turns ends up turning away between 15 and 20% of his applicants.
Taking about an hour and a half, he says, “We do three laser evaluations.” In contrast, sometimes patients come in having been told they are good candidates and the doctor is ready to schedule with a minimal amount of tests and only a screening from a tech.
Dr. Mandel also recommends that
All that being said, Dr. Mandel’s resume should put him a t the front of just about any candidate’s short list. Going back to the early 1980’s, he was part of the original research at Columbia University on the Excimer Laser before being recruited by Harvard to continue the work. Not content to simply rest on his laurels or a successful practice, he says, I’m in on the development of the next generation of laser correction.
He’s also been named on the Top Doctors list by Castle Connolly for the last eight years running, but if his recommendation (or that of another surgeon) takes a step back technology wise, it doesn’t imply a step back in the skill or dedication of the doctor. If someone has cornea scars from previous surgery, they might be a better suited to have the flap opened by the Microkeratome blade. Otherwise, thinner corneas might call for surface procedures like PRK or Lasek, which do take longer to heal and require more eye drops.
Of those, he always recommends PRK over Lasek – except in one area. Lasek is cheaper but coming to the realization that you only have one set of eyes hopefully helps people focus in on the right approach to corrected vision. “This is master carpenter and master tools,” he says. The master tools are the laser systems and the master carpenter is the surgeon. You don’t want to short change yourself on either end of it, he concludes.