What is the James W. Jerva Eye Laser Center?

Founded in 1991 as the research and development division of the Excimer Laser Eye Center, the James W. Jerva Eye Laser Center provides Excimer laser surgery for the refractive treatment of nearsightedness, astigmatism and farsightedness as well as for the therapeutic treatment of several corneal diseases, including corneal dystrophy, corneal scars and other surface irregularities of the cornea.  James W. Jerva was a former director of the Central New York Eye Bank and the Eye Bank Association of America.  He volunteered 35 years for the Central New York Eye Bank assisting patients in our community with corneal transplants. In 1991, the Jerva Eye Laser Center was one of the sites chosen for FDA Clinical Trials of the VISX lasers.  Dr. Sylvia Norton has continued to be involved in "cutting edge" research of the VISX laser systems. In conjunction with colleagues at the University of Ottawa Eye Institute, where she is Adjunct Professor, Dr. Norton participates in ongoing outcome analysis.

How was the Excimer Laser developed?

In 1979, Drs. Steven Trokel, Francis L'Esperance and IBM became primary developers of the excimer laser.  When Drs. Trokel and L’Esperance found that IBM had used this laser to etch microchips they determined that an instrument so precise could have a dramatic impact in ophthalmic surgery.  Over 200,000 laser surgeries have been performed during the past 18 years in many countries worldwide, including England, France, Italy, Germany, Sweden, Korea, Brazil, Australia, Japan and Canada.  In the United States, the FDA approved many Excimer laser procedures in the fall of 1995. 

Is the procedure safe?

Excimer laser surgery has been proven safe by the FDA.  The laser is computer-guided and able to re-shape the outer surface of the cornea with the finest precision and control.  Excimer laser surgery for nearsightedness, astigmatism and farsightedness is called photorefractive keratectomy (PRK).  One of the most advanced and revolutionary methods of improving vision since contact lenses were introduced more than 20 years ago, PRK is the “no needles, no knives” way to clearer vision.  There have been no cases of blindness from Excimer laser surgery.  About 95% of laser surgery patients become able to perform their work, sports and leisure without contact lenses or glasses.   In February 1994, Consumer Reports argued strongly that radial keratotomy (RK) is not as safe as photorefractive keratectomy (PRK) and advised patients to avoid radial keratotomy.

Is PRK the same as radial keratotomy?

Radial keratotomy (RK) is an older procedure which originally came out of Japan and Russia.  RK involves using a sharp, hand-held knife which makes anywhere from 4 to 16 cuts approximately 95% deep into the cornea.  The cuts cross the corneal fibers in a perpendicular fashion weakening the structural fibers of the cornea.  In PRK, the excimer laser cuts parallel to these fibers and even in the highest prescriptions, only effects the top 1/3 of the cornea.  The amount of tissue removed depends on the prescription being treated.

Are there long-term risks associated with PRK surgery?

To date there are no serious long-term risks to PRK surgery. The earliest cases for nearsightedness were done in 1987 in West Germany.  Based on results of FDA clinical trials as well as those presented at international laser meetings, PRK is safe and effective.  Dr. Norton has the longest follow-up on patients treated in Central New York as participants in the FDA Clinical Trials.  The stability of their refractions has been excellent.

*What has been the current success of PRK?

85% of our patients see better than 20/20.  Dr. Norton’s re-treatment rate is only about 2% with PRK where other surgeons have as high as 30% with PRK, RK and LASIK. In our experience, more than 95% of the patients are able to drive, play sports or watch TV without glasses.

Are all Excimer Laser machines the same and do they all give the same results?

All lasers are not the same.  Newer generation lasers have better features.  Our Center uses the advanced 3rd generation VISX STAR Laser.  The STAR has unique features different from other FDA approved Excimer lasers, including: its small size, integrated computer and monitor with windows software, joystick alignment and automatic calibration.  The VISX STAR also has fewer optics and considerably lower maintenance costs.  Our one year data with the STAR laser shows less than 1% retreatment rate.  100% of our myopic patients up to -12 diopters and who were less than 20/400, were 20/25 or better without glasses after surgery (this is 2 reading lines better than NY State required Motor Vehicle limit).

How long does the procedure take?

The surgery itself is very quick and usually lasts less than 80 seconds.  The laser reshapes the top 10 - 30% of the cornea, depending on the strength of the prescription to be treated.  This means that up to 90% of the cornea is not touched and therefore, the eye remains stronger after Excimer surgery than it would in other refractive procedures.

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