Richard Burns, MD on the Latest in Vision Correction
By Mike Bundrant

Keeping up with the latest technology in any field is not always easy to do. In the world of laser vision correction there have been so many advancements in recent years that it is crucial to educate yourself well before having a procedure done. It is important to choose a practitioner who not only understands your present needs, but can also anticipate your future needs in determining which procedure is right for you.

These factors became obvious to me through a recent conversation with Dr. Richard Burns of California Eye Professionals.  With over 10,000 eye surgical procedures formed, Dr. Burns is just the person to help us make decisions in the matter of our precious eyesight.

Read on and learn about the amazing new procedures available.

Dr. Burns:  First of all, allow me to say that I am fortunate in that I am in a profession that I totally enjoy. Everyday I look forward to seeing my patients and helping them toward their best personal vision. My specialty within Ophthalmology is Refractive Surgery, specifically Refractive Cataract Surgery and LASIK.  Everybody has heard of LASIK, but many haven’t heard of Refractive Cataract, so I am in the process of educating the public on that procedure.

A cataract is a clouding of the natural lens. The natural lens sits behind the pupil. As you age, the cataract starts to form. Usually by the age of 40 or 45, you start to get some impurities on the lens. That tends to get worse over time and eventually interferes with visual acuity. Then, we do cataract surgery to take out that clouded lens and replace it
with an artificial lens. Years ago we didn’t put any lenses in and people would have to wear those thick, “coke bottle” glasses. This was as late as the 1970’s. Then we started putting lens implants in.

The evolution of the lens implant has come to the point now that I can use a new type of lens implant that gives a person both distance and near vision and allows them in most cases to be independent of glasses.

There are 2 types of these premium lenses, the multi-focal and accommodating type. Each has its particular strength and through the evaluation process we determine which is the right lens for the patient.  It’s an amazing and significant advancement – a really neat deal compared to the conventional lens implant, which still leaves most people dependent on bi-focals.

There are only a few surgeons that have significant experience in both LASIK and cataract surgery. The advantage of being both a Refractive Cataract surgeon and a LASIK surgeon allows me to guide each patient appropriately. I can even combine the two approaches for the ultimate visual experience.

The goal in Refractive Cataract surgery is to achieve accurate, high definition vision that gives you both distance and near vision without always reaching for glasses.

HT: So, not only have you lost your cataract; you’ve improved your vision all in the same procedure.

Dr. Burns: Yes, and its extremely satisfying for me as a surgeon to see my patients so happy with their new vision. Also, a lot of people in their 50s and 60s come to me thinking they want LASIK. However, some find out through our examination that they have an early cataract formation. We then talk about all their options, including removing the lens early and replacing it with a premium lens to give them both near and far vision. This is called Refractive Lensectomy. This patient is very happy as they get out of their bifocals, trifocals, or progressive lenses and are comforted knowing they will never form a cataract or need another surgery.

HT: I suppose the quality of artificial lens has come a long way since it’s inception.

Dr. Burns: The lens replacement procedure dates back to the 1970’s. Then we used (I was in medical school in the 70’s at the Mayo Clinic) very hard, plastic lenses. When I was training we were able to observe these procedures – it was a very big deal back then. As time went on the indications for using lens implants expanded, the procedures became much more elegant (much smaller incisions) and the lenses have become more flexible with much better optics. This is very exciting to those of us who do both cataracts and LASIK because it allows us to take someone with a cataract and poor visual acuity and take care of both of these issues at the same time.

HT: What about the long-term effects of having artificial lenses?

Dr. Burns: The body can't tell the difference between natural and artificial lenses. The material is inert, so there is no rejection by the body. We’ve figured out what is irritating to the eyes over time and use appropriate materials that don’t do any harm whatsoever.

HT: With all of the new technology available, I am sure it’s a challenge for those in your field to keep people educated. What advice do you have for consumers who are just beginning to learn about these procedures?

Dr. Burns: As with many things, I suggest you start with the Internet. Do your research and begin to learn what’s available. Then, you need to see a doctor who performs these kinds of procedures. Sit down, have a conversation and ask what your options are. It is a little nerve-racking to think about having your eyes operated on, but I can speak to people both as a patient and as a surgeon because I’ve had LASIK on my own eye, so I believe in my product line.

Remember not every place can perform all of the latest surgeries, so that is something to keep in mind. Consumers are typically steered in the direction of the services offered, so make sure you go to someone who offers the latest technologies. The surgeon must have plenty of experience as both a cataract surgeon and a LASIK surgeon, as in some cases you need to combine the two surgeries.

There are many procedures available beyond the ones we’ve discussed here. Including Phakic Lens Implants, also known as an implantable contact lens. Many factors, including age, need to be considered. You have to balance all of the factors and choose the best path for the individual patient. It’s an interesting journey for me as a practitioner to discover what is best for each person.

HT: What can you tell us about the long-term safety of LASIK?

Dr. Burns: LASIK is a fantastic procedure. I have been doing LASIK for over 10 years (since it was first approved by the FDA). Our ability to correct nearsightedness, farsightedness, and astigmatism enables so many people to experience a new freedom in their lives!  I have performed it on my wife and other members of my family, many doctors in the Temecula, Murrieta, Hemet, and San Diego area, and I have had
it on my own eye. So I definitely believe in its long-term safety.

A number of studies have been done that have established long-term stability. Of course it goes without saying that meticulous attention to detail is crucial.  Also, with the new technologies that we use, such as the Intralase All Laser LASIK combined with the top of the line Excimer Lasers, we obtain even safer and better results.

HT: Any red flags people should watch for?

Dr. Burns: It’s like anything else. You want to do your due diligence and make sure your doctor has the best equipment and has the background and experience in both cataract and LASIK surgery. Certainly I’d avoid the “discount” laser centers. LASIK surgery is elegant, complex and extremely successful. However, not every patient is a candidate and it should be the goal of the surgeon to make sure LASIK is right for you.

Beyond that, make sure you visit with the surgeon (in some places you don't see the surgeon until just before the surgery) and discuss all your options prior to showing up for the surgery. The doctor - patient relationship is very important.

Dr. Richard Burns is the leader of California Eye Professionals' refractive surgery team. With more than 22 years experience in refractive surgery, he has been a pioneer in procedures to correct nearsightedness, farsightedness and astigmatism.