K. Dwight Hendricks, M.D. - kceye.com Medical Surgical Eye Care, P.A. in Kansas City

Because he cares about your eye as much as you do. Dr. Hendricks does his own preoperative and postoperative evaluations as well as the surgery. He will counsel you and give you an honest opinion about your candidacy for lasik surgery. If there is any kind of problem during the postoperation period, he will be there for you. You will find no evidence of an assembly line production here. And that's why his outcomes are so good and his patients are satisfied. In summary, you will experience the doctor/patient relationship the way it was meant to be with Dr. Hendricks and his superb lasik coordinator, Mickey Kaminski, C.O.T.

Lasik is an acronym for "laser in situ keratomileusis" which is a corneal reshaping surgery to eliminate refractive errors such as nearsightedness, farsightedness, and astigmatism. This form of surgery is actually a combination of lamellar corneal surgery and excimer laser surgery and is sometimes referred to as the "flap and zap" procedure. Actually that description is quite accurate because that is what takes place during the procedure. A keratome, which is a small slicing instrument, is passed across the surface of the cornea and a thin corneal flap is made. The eye is numbed using eye drops so the patient experiences no pain. The corneal flap that is made has a hinge on it that allows it to be folded back and expose the underlying corneal tissue. The excimer laser is then used to reshape the exposed corneal tissue afterwhich the flap of cornea is replaced. The flap seals down quite readily and no sutures are required.

There are a number of advantages of Lasik Surgery over PRK (photorefractive keratectomy) or the original excimer laser surgery. First of all, the patient's vision improves and stabilizes much quicker. This allows the correction of both eyes at the same time in most situations. Another advantage is that there is much less post-operative pain than with standard PRK. The reason for this is that the corneal flap requires much less healing than PRK. For these two reasons Lasik has become the procedure of choice for most patients.

Another reason you may want to chose Dr. Hendricks as your lasik surgeon is because he uses a disposable microkeratome. As described previously, the microkeratome is the instrument used to make the thin corneal flap during the first part of the lasik procedure. Most surgeons use a reusable keratome which has to be cleaned and sterilized and then loaded with a new blade for each patient. Dr. Hendricks uses a prepackaged, preloaded disposable microkeratome. There is no cleaning or sterilizing necessary and each patient essentially has their own individual instrument. The risk of infection is reduced and the visual outcomes have been amazing with this advanced instrumentation.

There are three basic types of refractive errors and all of them may be treated by the Lasik procedure. Myopia or nearsightedness exists when close objects are seen clearly but distant objects appear blurred. Myopia is caused by a steeply curved cornea or an elongated eye. Hyperopia or farsightedness exists when close objects are blurred and distant objects are clear. This is caused by a flat corneal curvature or a short eye. Astigmatism causes blurring of objects at any distance and is caused by an unevenly shaped cornea.

Wavefront technology is a brand new concept in the field of refractive surgery. As refractive surgery has evolved, we have learned that visual outcomes depend on more than just correcting nearsightedness, farsightedness, or astigmatism. There are what are called "higher order" aberrations which can cause visual disturbances even though a patient's vision is 20/20 or better. Wavefront technology allows us to identify and measure these higher order aberrations. We presently have wavefront diagnostic capability at our laser center in Johnson County. As soon as the FDA approves wavefront laser treatment, our laser is already equipped with the software and hardware upgrades and we will be ready to offer this to our patients. We anticipate this to happen sometime in 2003.

To be eligible for LASIK the eye must be in good health and the vision stable. The minimum age to qualify for Lasik surgery is 21 years old. Some patients are better candidates than others and one of the most important steps leading to the Lasik procedure is the discussion with Dr. Hendricks to determine your candidacy based on your individual refraction, your occupation, your hobbies, and general lifestyle.

The Lasik procedure itself takes only about 10 minutes per eye. Topical numbing drops are instilled and the eye is lightly prepped. A lid speculum is placed between the eyelids and a small suction ring is placed over the cornea. Pressure is applied and the vision blacks out for a few seconds while the corneal flap is made. The laser is then applied and the flap repositioned and allowed to dry for a minute or two. The procedure is ly painless.

Most patients notice immediate visual improvement when the leave the laser treatment room although objects appear hazy. The vision improves almost hour by hour the first day and by the next morning, most patients are able to drive themselves to the office for their checkup. The vision then gradually improves over the next few days and weeks. Medicated drops are used for three or four days and then artificial tears are used as necessary. Follow up visits are tailored to individual patients needs.

If an undercorrection or an overcorrection occurs, then it may be necessary to lift the flap after six to eight weeks and treat the residual refractive error. This procedure is actually easier than the original procedure since the use of the keratome is not necessary. The incidence of enhancements in Dr. Hendricks' experience is about 10-15%.

Monovision is a technique used for patients with presbyopia (those who use bifocals or readers) that corrects the vision in one eye for distance and the other eye for near. Dr. Hendricks recommends this frequently, but not always. If you are over 40 years old, he will help you decide if this might work for you.

Complications can vary from minor to severe and vision threatening. Dr. Hendricks has not experienced a vision threatening complication. The most common complication is eye dryness, which usually improves with time. Another common problem is night glare and halo formation, but again this is usually temporary and improves over time. More serious, but much less frequent complications include corneal infection or inflammation, or corneal flap problems such as wrinkling or tissue growth beneath the flap. The main thing to keep in mind about complications is that they are very infrequent, and even if they occur, they can usually be treated successfully and the patient can still get a good visual result.