Dr. Kiley has been a practicing ophthalmologist at the Raleigh Eye Center for over 33 years. He has performed thousands of refractive procedures in the Raleigh and Durham area of North Carolina. In a recent interview, Dr. Kiley discussed refractive surgeries and technological advancements.
1. How did you become a pioneer in refractive surgery over 33 years ago?
Actually I started with Radial Keratotomy in the 1990’s and progressed to PRK then LASIK as they became available. The idea of being able to make almost immediate dramatic changes in a person’s life by permanently improving their vision was fascinating to me. I am still impressed by the accuracy of the technology considering the microscopic level at which we are working.
2. What are your thoughts on the evolution of refractive surgery over the years? Each technique has offered benefits that the previous one did not. We always learn from our results and make changes and improvements. The success rate now with LASIK is quite high and will probably continue to improve as we learn more.
3. How has the evolution of refractive surgery affected the way you treat patients today?
Modern LASIK procedures and equipment provide stable and accurate results more quickly and with less discomfort and side effects than previous techniques
4. Out of the refractive surgery procedures performed today, what makes one better than the other in your opinion?
LASIK has become the overwhelming choice of LASIK surgeons and patients because of its stability, comfort, and accuracy. PRK is still a good choice for some patients but visual recovery takes longer and there is a bit more discomfort for a few days. RK did not offer the stability of vision that we needed.
5. There are several lasers used today for correcting vision. Why do you use the Allegretto Wave?
The Allegretto laser is a newer generation instrument that uses a software program that reduces the amount of glare and halos that are sometimes seen after LASIK. It is one of the most accurate lasers available.
6. Do you feel there is technology still used today that is not optimal?
There are still some older generation lasers out there that are good but probably not the best choices for optimal outcomes.
7. There is a lot of debate over the use of a microkeratome versus a femtosecond laser. What is your preference and why?
We offer both options, and we have seen great results with both. Most of our patients choose the microkeratome because it is hundreds of dollars less expensive and offers comparable results to the femtosecond laser in our hands. Perhaps that is because of our comfort level and experience with the microkeratome.
8. In what cases do you feel it is better to use one over the other?
At this point in time, I think it is something that the patient decides, based on his or her own comfort level with either technology.
9. What is your experience with side effects such as night glare and starbursts following LASIK? (lead to larger ablation zones, etc).
There are some individuals who experience these side effects to varying degrees. It is rarely disabling and tends to improve with time. We see fewer of these side effects with the newer laser, which uses larger “blended” ablation zones, but they still can occur, especially in highly nearsighted people. We limit LASIK to those who are within an accepted treatment range and thus minimize side effects.
10. If you could tell a potential refractive surgery patient anything prior to making a decision, what would it be and why?
Understand that, although LASIK is a wonderful procedure, there are still some who might need glasses or contacts, perhaps on a part-time basis. If they are over 45 they may need readers or “monovision” where one eye sees far and the other sees near. So they should go into it with the goal to be less dependent on glasses and contacts. Then they will be able to enjoy all the times and situations where they truly are “free”.
If you are considering refractive surgery in the Raleigh/Durham area of North Carolina, consider Raleigh Eye Center for our vast experience and knowledge. For more information visit us online or call (919) 876-2427.