Some seven million Americans have had laser vision correction.

NASA and the Air Force have approved its use. Ads are everywhere for the procedure that allows its patients to be free of corrective lenses. But was this leap in technology short-sighted? In April, the FDA took a closer look at Lasik post-surgical complaints.

The agency estimated that 5 percent of patients are dissatisfied with their outcomes. These complaints range from "dry eye" to discomfort.

"Only about 75 percent of patients seeking Lasik are actually good candidates," points out Don Holmes, vice president of refractive services for the Cincinnati Eye Institute. Just because a patient seeks this form of correction does not mean that it's right for them, Holmes and others observe.

"We do a complete eye exam that encompasses all aspects of eye health to determine if someone is a candidate. Our numbers (for post-surgical problems) are very low."

Dr. Howard L. Bell of Cincinnati Eye Physicians Inc. agrees. "You have to do a thorough exam on the patient, including medical history, previous injuries and infections, and personality."

Bell emphasizes that if a patient is determined to be a good candidate, then the risk is very low for complications "” with general population statistics running comparable on areas of concern such as dry eye. "The potential for infection is actually higher for contact wearers than for those having Lasik surgery," he says. In Lasik correction, doctors cut a flap in the cornea, which is the clear covering of the eye, and direct a laser underneath it to reshape and repair it. Advancements in diagnostics, cutting the flap, and the laser repair continue to advance.

"Every year, there's a brand new adventure," Holmes emphasizes. Custom LASIK minimizes complications and maximizes personal vision correction. With WaveScan Technology, a new diagnostic that tracts each individual spot and micro-maps the cornea and all optical systems, each individual eye can be "custom repaired." "Your eye is like a fingerprint with 50 -100 spots that can be corrected," Holmes explains.

To minimize post surgical complications in cutting the flap, Femtosecond laser surgery shoots a laser beam 60,000 times per second to assure the highest accuracy. IRIS registration then allows the laser to deliver with exact precision.

"You have to be very honest with your patients and explain all of the possible outcomes," says Dr. Bell. Even successful surgeries will have various post-surgical symptoms. Dry eye is very common after surgery and can continue for up to six months, there may be pain in the site of the incision, and patients will probably need reader glasses later in life.

Lasik surgery is not the only area of eye care to leap in new technolo g y. "Ca t a r a c t advancements are the biggest advance in ophthalmology in the last two or three years," explains Dr. Bell. In the past, when a cataract was removed, it was replaced with an acrylic or silicon lens. Now advances allow a Toric Intra Ocular Lens to replace the faulty lens with the ability to reduce astigmatism and thereby dependence on glasses. In addition, Custom Cataract Surgery with multi-focal or accommodating IOL implants allow the patient to see well both close and at a distance.

So what is the vision for the future of eye care? "Medicine has advanced exponentially. Every 10 years it gets better. The next five to ten years, there will be even more advances," declares Dr. Bell. Much is on the horizon that is focusing on "aging eye diseases."

Holmes sees the future full of advances for glaucoma, macular degeneration, cataracts and retinopathy.